Total parenteral nutrition supplementation with glutamine improves survival after gut ischemia/reperfusion.
BACKGROUND
Total parenteral nutrition (TPN) alters gut cytokines and mucosal immunity and increases intercellular adhesion molecule-1 (ICAM-1) expression, gut neutrophil levels, and mortality after gut ischemia. Supplementation of TPN with glutamine partially supports mucosal immunity by preserving respiratory and intestinal IgA levels, maintaining the proper IgA-stimulating cytokine milieu within the intestine, and reducing intestinal ICAM-1 expression and neutrophil accumulation. This work investigates whether glutamine supplementation of TPN affects mortality in mice after gut ischemic insult.


METHODS
Thirty-eight mice were randomized to receive chow, TPN, or 2% glutamine-supplemented TPN (GLN-TPN) for 5 days. After feeding their respective diets, gut ischemia/reperfusion (I/R) was induced with superior mesenteric artery occlusion for 30 minutes followed by resuscitation with 1 mL saline. Survival was recorded until 72 hours after reperfusion.


RESULTS
Survival time was significantly reduced in the TPN-fed mice compared with both chow-fed and GLN-TPN-fed mice (p < .05). Survival at 72 hours after reperfusion was also significantly lower in the TPN-fed mice than in the chow-fed and GLN-TPN-fed mice (p < .05)


CONCLUSIONS
Glutamine supplementation of TPN significantly improves survival after gut I/R, suggesting modulation of the inflammatory response or improved gut tolerance to low-flow states.
Ikeda
Shigeo
S
Department of Surgery, University of Wisconsin, Madison, USA.
Zarzaur
Ben L
BL
Johnson
Cheryl D
CD
Fukatsu
Kazuhiko
K
Kudsk
Kenneth A
KA
D000818:Animals; D016207:Cytokines / Q000032:analysis; D005973:Glutamine / Q000008:administration & dosage* / Q000494:pharmacology; D018928:Immunity, Mucosal / Q000187:drug effects; D007070:Immunoglobulin A / Q000276:immunology; D018799:Intercellular Adhesion Molecule-1 / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D051379:Mice; D008813:Mice, Inbred ICR; D010289:Parenteral Nutrition, Total; D011897:Random Allocation; D015427:Reperfusion Injury / Q000628:therapy*; D016019:Survival Analysis
D016207:Cytokines; D007070:Immunoglobulin A; D005973:Glutamine; D018799:Intercellular Adhesion Molecule-1