Effects of enteral immunonutrition on the maintenance of gut barrier function and immune function in pigs with severe acute pancreatitis.
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.
Zou
Xiao-Ping
XP
Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, P.R. China. zouxiaoping795@hotmail.com
Chen
Min
M
Wei
Wei
W
Cao
Jun
J
Chen
Lei
L
Tian
Mi
M
D000208:Acute Disease; D000681:Amylases / Q000378:metabolism; D000818:Animals; D015703:Antigens, CD / Q000378:metabolism; D001120:Arginine / Q000627:therapeutic use*; D018988:Bacterial Translocation; D019587:Dietary Supplements; D004195:Disease Models, Animal; D004731:Endotoxins / Q000097:blood; D004750:Enteral Nutrition; D005973:Glutamine / Q000627:therapeutic use*; D007082:Ileum / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D007109:Immunity / Q000187:drug effects*; D007136:Immunoglobulins / Q000097:blood; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000276:immunology / Q000382:microbiology; D016131:Lymphocyte Subsets / Q000187:drug effects / Q000378:metabolism; D010195:Pancreatitis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D019936:Probiotics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013552:Swine
D015703:Antigens, CD; D004731:Endotoxins; D007136:Immunoglobulins; D005973:Glutamine; D001120:Arginine; D000681:Amylases