Lin Zhi-Liang, Tan Shan-Jun, Cheng Min-Hua, Zhao Chen-Yan, Yu Wen-Kui, He Yu-Long, Li Jieshou, Li Ning
Department of Gastrointestinal Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China; Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
J Surg Res. 2017 Jun 1;213:75-83. doi: 10.1016/j.jss.2017.02.007. Epub 2017 Feb 22.
It has been reported that lipid-rich enteral nutrition (EN) could ameliorate inflammation in various diseases. In this study, we investigated whether lipid-rich EN could control intestinal inflammation, improve intestinal motility and mucosal barrier injury after intestinal ischemia/reperfusion (I/R) injury.
Male adult rats received saline, conventional EN, or lipid-rich EN via gavage before and after intestinal I/R injury. The superior mesenteric artery was occluded for 60 min. The sham group underwent laparotomy without superior mesenteric artery occlusion and was administrated saline. Intestinal motility was measured 4 h after intestinal I/R injury by fluorescein isothiocyanate-dextran transit assay; the intestinal and systemic inflammation were assessed by analyzing intestinal and serum concentrations of tumor necrosis factor α, interleukin (IL)- 6, and IL-10, separately. The intestinal mucosal barrier injury was assessed by analyzing the serum levels of intestinal fatty acid-binding protein (I-FABP) and intestinal mucosal tight junction (TJ) proteins.
The intestinal I/R injury decreased intestinal motility and intestinal mucosal TJs expression significantly when compared with the sham group (P < 0.05). The intestinal and systemic inflammatory parameters and the serum I-FABP were also significantly higher in the I/R groups than those in the sham group (P < 0.05). Both conventional and lipid-rich EN increased the intestinal motility and the intestinal mucosal TJs expression and decreased the intestinal and systemic inflammatory parameter and serum I-FABP levels to different degrees when compared with the I/R group (P < 0.05). However, lipid-rich EN significantly improved the negative alterations in these biochemical parameters when compared with the conventional EN (P < 0.05).
These results suggest that lipid-rich EN might be able to control intestinal inflammation, improve intestinal motility and mucosal barrier injury after intestinal I/R injury. Thus, the administration of lipid-rich EN may be an effective treatment for promoting gastrointestinal function recovery after intestinal I/R injury.
据报道,富含脂质的肠内营养(EN)可改善多种疾病中的炎症反应。在本研究中,我们调查了富含脂质的EN是否能控制肠道炎症、改善肠道缺血/再灌注(I/R)损伤后的肠道动力和黏膜屏障损伤。
成年雄性大鼠在肠道I/R损伤前后通过灌胃给予生理盐水、常规EN或富含脂质的EN。肠系膜上动脉阻断60分钟。假手术组进行开腹手术但不阻断肠系膜上动脉,并给予生理盐水。在肠道I/R损伤后4小时,通过异硫氰酸荧光素-葡聚糖转运试验测量肠道动力;分别通过分析肠道和血清中肿瘤坏死因子α、白细胞介素(IL)-6和IL-10的浓度来评估肠道和全身炎症。通过分析血清中肠脂肪酸结合蛋白(I-FABP)水平和肠道黏膜紧密连接(TJ)蛋白来评估肠道黏膜屏障损伤。
与假手术组相比,肠道I/R损伤显著降低了肠道动力和肠道黏膜TJ蛋白的表达(P<0.05)。I/R组的肠道和全身炎症参数以及血清I-FABP也显著高于假手术组(P<0.05)。与I/R组相比,常规EN和富含脂质的EN均不同程度地增加了肠道动力和肠道黏膜TJ蛋白的表达,并降低了肠道和全身炎症参数以及血清I-FABP水平(P<0.05)。然而,与常规EN相比,富含脂质的EN显著改善了这些生化参数的负面变化(P<0.05)。
这些结果表明,富含脂质的EN可能能够控制肠道炎症、改善肠道I/R损伤后的肠道动力和黏膜屏障损伤。因此,给予富含脂质的EN可能是促进肠道I/R损伤后胃肠功能恢复的有效治疗方法。