Effects of Enteral Immunonutrition on the Maintenance of Gut Barrier Function and Immune Function in Pigs With Severe Acute Pancreatitis
Effects of Enteral Immunonutrition on the Maintenance of Gut Barrier Function and Immune Function in Pigs With Severe Acute Pancreatitis
复制标题
肠内免疫营养对重症急性胰腺炎猪肠道屏障功能和免疫功能维持的影响
DOI：
10.1177/0148607110362691
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发表时间：
2010-09-01
影响因子：
3.4
通讯作者：
Tian, Mi
中科院分区：
文献类型：
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作者：
Zou, Xiao-Ping;Chen, Min;Tian, Mi
背景：本研究评价了添加谷氨酰胺、精氨酸和益生菌的肠道免疫营养(EIN)对重症急性胰腺炎(SAP)猪肠道屏障功能和免疫功能的影响。方法：经胰管逆行注射5%牛磺胆酸钠和胰酶复制大鼠模型。建立SAP模型后，18头猪随机分为3组，分别给予肠外营养(PN)、对照肠内营养(CEN)和肠内营养(EIN)8天。测定血清和胰液淀粉酶浓度。用高效液相色谱法测定肠道通透性(乳果糖/甘露醇比值)，显色法定量血浆内毒素。静脉血和器官样本用标准技术培养。根据组织病理学分级对胰腺炎严重程度和回肠绒毛进行评分。用流式细胞仪检测血浆T淋巴细胞亚群，用酶联免疫吸附试验检测免疫球蛋白(Ig)。结果：三组患者的血清和胰液淀粉酶浓度及胰腺炎严重程度均无显著差异。与PN和CEN相比，EIN显著降低肠道通透性、血浆内毒素浓度和细菌移位的发生率和程度，而增加回肠粘膜厚度、绒毛高度、隐窝深度和正常肠绒毛百分率。3组间CD3(+)、CD4(+)淋巴细胞亚群、CD4(+)/CD8(+)淋巴细胞亚群比值、血清IgA和Ig G差异均有统计学意义，但Ig M差异无统计学意义。结论：EIN对SAP猪的肠道屏障功能和免疫功能有一定的保护作用。(JPEN J Parenter Enteral Nutr.2010；34：554-566)
Background: This study evaluated the effects of enteral immunonutrition (EIN) supplemented with glutamine, arginine, and probiotics on gut barrier function and immune function in pigs with severe acute pancreatitis (SAP). Methods: The model was induced by retrograde injection of 5% sodium taurocholate and trypsin via the pancreatic duct. After induction of SAP, 18 pigs were randomly divided into 3 groups, in which either parenteral nutrition (PN), control enteral nutrition (CEN), or EIN was applied for 8 days. Serum and pancreatic fluid amylase concentration was determined. Intestinal permeability (lactulose to mannitol ratio) was measured by high-performance liquid chromatography, and plasma endotoxin was quantified by the chromogenic limulus amebocyte lysate technique. Samples of venous blood and organs were cultured using standard techniques. Pancreatitis severity and villi of ileum were scored according to histopathologic grading. Plasma T-lymphocyte subsets were measured by flow cytometry, and immunoglobulins (Igs) were determined via enzyme-linked immunosorbent assay. Results: There were no significant differences in serum and pancreatic fluid amylases concentrations or in pancreatitis severity between any 2 of the 3 groups. Compared with PN and CEN, EIN significantly decreased intestinal permeability, plasma endotoxin concentration, and the incidence and magnitudes of bacterial translocation, but increased ileal mucosal thickness, villous height, crypt depth, and percentage of normal intestinal villi. Significant differences were found in CD3(+), CD4(+) lymphocyte subsets, the ratio of CD4(+): CD8(+) lymphocyte subsets, and serum IgA and IgG, but not IgM, between any 2 of the 3 groups. Conclusions: EIN maintained gut barrier function and immune function in pigs with SAP. (JPEN J Parenter Enteral Nutr. 2010; 34: 554-566)