Zhang Zihao, Li Xiaohua, Cao Chun
Department of General Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Anesthesiology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
Department of General Surgery, the Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Thyroid and Breast Surgery, Suzhou Wuzhong People's Hospital, Suzhou, China.
Nutrition. 2024 Mar;119:112329. doi: 10.1016/j.nut.2023.112329. Epub 2023 Dec 15.
Metabolic disorders and no response to intravenous nutrition because of sepsis have been urgent problems for clinical nutrition support. Enteral nutrition (EN) has been an important clinical therapeutic measure in septic patients; however, simple EN has not demonstrated good performance. This study aimed to investigate the effects of different concentrations of octanoic acid (OA)-rich EN on hypercatabolism in endotoxemic rats and test whether OA-rich EN could attenuate hypercatabolism through the acylated ghrelin-proopiomelanocortin (POMC) pathway.
Rats were randomly divided into six groups: sham, lipopolysaccharide (LPS), LPS + EN and LPS + EN + OA (0.25, 0.5, and 1 g/kg, respectively) groups to investigate the effects of different concentrations of OA-rich EN on hypercatabolism in endotoxemic rats. The rats were then randomly divided into four groups: sham, LPS, LPS + OA, and LPS + OA + Go-CoA-Tat, to test whether OA-rich EN attenuated hypercatabolism through the acylated ghrelin-POMC pathway. Rats received nutrition support via a gastric tube for 3 d (100 kcal/kg daily). Insulin resistance, muscle protein synthesis and atrophy, inflammatory cytokines, ghrelin in circulation and hypothalamus, ghrelin O-acyltransferase (GOAT), and the adenosine 5'-monophosphate-activated protein kinase (AMPK)-autophagy-POMC pathway were measured.
Compared with simple EN, OA-rich EN promoted the acylation of ghrelin in a dose-dependent manner and attenuated POMC-mediated hypercatabolism in endotoxemic rats. Inhibition of GOAT activity decreased the level of acylated ghrelin and aggravated POMC-mediated hypercatabolism conferred by OA-rich EN.
OA-rich EN could increase the level of acylated ghrelin and attenuate hypercatabolism through the acylated ghrelin-POMC pathway compared with simple EN in endotoxemic rats.
代谢紊乱以及因脓毒症导致对静脉营养无反应一直是临床营养支持面临的紧迫问题。肠内营养(EN)一直是脓毒症患者重要的临床治疗措施;然而,单纯的EN并未表现出良好的效果。本研究旨在探讨不同浓度富含辛酸(OA)的EN对内毒素血症大鼠高分解代谢的影响,并测试富含OA的EN是否能通过酰化胃饥饿素-阿黑皮素原(POMC)途径减轻高分解代谢。
将大鼠随机分为六组:假手术组、脂多糖(LPS)组、LPS + EN组以及LPS + EN + OA组(分别为0.25、0.5和1 g/kg),以研究不同浓度富含OA的EN对内毒素血症大鼠高分解代谢的影响。然后将大鼠随机分为四组:假手术组、LPS组、LPS + OA组和LPS + OA + Go-CoA-Tat组,以测试富含OA的EN是否通过酰化胃饥饿素-POMC途径减轻高分解代谢。大鼠通过胃管接受营养支持3天(每日100 kcal/kg)。检测胰岛素抵抗、肌肉蛋白质合成与萎缩、炎性细胞因子、循环及下丘脑胃饥饿素、胃饥饿素O-酰基转移酶(GOAT)以及腺苷5'-单磷酸激活蛋白激酶(AMPK)-自噬-POMC途径。
与单纯EN相比,富含OA的EN以剂量依赖方式促进胃饥饿素的酰化,并减轻内毒素血症大鼠中POMC介导的高分解代谢。抑制GOAT活性降低了酰化胃饥饿素水平,并加重了富含OA的EN所导致的POMC介导的高分解代谢。
与单纯EN相比,富含OA的EN可提高酰化胃饥饿素水平,并通过酰化胃饥饿素-POMC途径减轻内毒素血症大鼠的高分解代谢。