The immune-enhancing enteral agents arginine and glutamine differentially modulate gut barrier function following mesenteric ischemia/reperfusion.
The immune-enhancing enteral agents arginine and glutamine differentially modulate gut barrier function following mesenteric ischemia/reperfusion.
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免疫增强肠内制剂精氨酸和谷氨酰胺在肠系膜缺血/再灌注后差异调节肠道屏障功能。
DOI：
10.1097/01.ta.0000151273.01810.e9
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Moore,FrederickA
中科院分区：
文献类型：
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作者：
Kozar,RosemaryA;Verner-Cole,Elizabeth;Schultz,StanleyG;Sato,Nario;Bick,RogerJ;Desoignie,Roland;Poindexter,BrianJ;Moore,FrederickA
背景：免疫增强型肠内饮食已被证明可以改善患者的预后。一种作用机制可能是通过维持肠道屏障功能。虽然最近的数据表明谷氨酰胺有益，但精氨酸可能有害。因此，我们假设免疫增强剂谷氨酰胺和精氨酸对肠屏障功能有不同的调节作用。方法：在剖腹手术时，大鼠的空肠囊中充满10 mmol/L的谷氨酰胺、精氨酸、果糖或硫酸镁(渗透压对照)，然后阻断肠系膜上动脉60分钟，再灌注2小时。取空肠进行组织学、去卷积显微镜、F：G肌动蛋白、ATP和通透性测定。结果：与对照组和精氨酸相比，谷氨酰胺和果糖对粘膜的损伤最小。去卷积显微镜证实，谷氨酰胺和果糖保留了肌动蛋白的细胞骨架，但精氨酸对其有破坏作用，这与F/G肌动蛋白比例和组织ATP水平有关。结论：与谷氨酰胺相比，精氨酸可加重粘膜损伤，破坏肌动蛋白细胞骨架，降低组织ATP，增加通透性。免疫增强剂精氨酸导致肠道屏障功能的破坏，这可能对危重损伤患者具有重要意义。
Background:Immune-enhancing enteral diets have been shown to improve patient outcome. One contributing mechanism may be via maintenance of gut barrier function. While recent data has shown that glutamine is beneficial, arginine may be harmful. We therefore hypothesized that the immune-enhancing agents, glutamine and arginine, differentially modulate gut barrier function.Methods:At laparotomy, rats had jejunal sacs filled with 10 mmol/L glutamine, arginine, fructose, or magnesium sulfate (osmotic control) followed by 60 minutes of superior mesenteric artery occlusion and 2 hours of reperfusion. Jejunum was harvested for histology, deconvolution microscopy, F: G actin, ATP, and permeability measurements.Results:Glutamine and fructose minimized mucosal injury compared with controls and arginine. Deconvolution microscopy confirmed that glutamine and fructose preserved the actin cytoskeleton but there was disruption by arginine which correlated with F: G actin ratios and tissue ATP levels. Permeability was enhanced by arginine compared with the other groups.Conclusion:Arginine resulted in worsened mucosal injury, disruption of the actin cytoskeleton, decreased tissue ATP and enhanced permeability compared with glutamine which appeared protective. The immune-enhancing agent arginine results in breakdown of gut barrier function which may have important implications for critically injured patients.