The growing pancreatic duct ligated pig as a model for exocrine pancreatic insufficiency in children: investigations to achieve sufficient vitamin A and vitamin E supply.
Human patients suffering from exocrine pancreatic insufficiency (EPI) are susceptible to deficiencies in fat-soluble vitamins. In children with cystic fibrosis, EPI is common and aspects of sufficient vitamin supply are of special interest. The aim of this study was to determine the best application form to maintain vitamin A and E levels in the physiological range in growing pigs with EPI (induced by pancreatic duct ligation) as a model for children. The pancreatic duct was ligated (PL) in twelve 8-wk-old pigs; 4 sham-operated pigs served as controls (Con). Pigs (n = 16) were individually housed and fed a diet containing 13,393 IU vitamin A and 122 mg vitamin E/kg DM. The PL pigs (n = 12) were divided into 3 groups (n = 4) 2 wk after surgery: PL-0, without extra vitamin supply; PL+ORAL, 90,000 IU vitamin A and 600 mg vitamin E/kg of DM plus emulsifier E 484 added to the diet; and PL+IM, intramuscular injection of vitamin A (5,250 IU) and vitamin E [aqueous; 3.15 mg/(kg BW · wk)] plus 700 mg vitamin E (oily)/(animal · wk). All PL pigs were supplemented with the pancrelipase Creon (19.8 g = 1,048,727 IU lipase/kg feed) beginning 2 wk after ligation of the pancreatic duct. Pigs were euthanized at 16 wk of age. Tocopherol levels (mg/kg DM) in liver were reduced (P ≤ 0.005) in PL-0 and PL+IM (6.91 and 8.61, respectively) whereas PL+ORAL did not differ from Con (27.4 and 25.8, respectively; P ≥ 0.77). Compared to control pigs (241 ± 14.1 mg vitamin A/kg DM of liver), the concentration of vitamin A (mg/kg DM) in liver was lower (P < 0.003) in PL-0 (136 ± 18.5) but higher (P < 0.003) in PL+ORAL (375 ± 50.0). In the group PL+IM a high individual variation was observed (288 ± 142 mg vitamin A/kg DM of liver). Extra dietary supply of high doses of vitamin A and E with an efficient emulsifier was adequate to maintain vitamin A and E in liver tissue within reference values. The present data underline the need for extra supplementation of vitamin A and E in juvenile patients with EPI and indicate that oral application is suitable.
Institute of Animal Nutrition, University of Veterinary Medicine Hannover, Foundation, Germany. anne.moesseler@tiho-hannover.de
A
A
Mösseler
T
T
Schwarzmaier
J
J
Grunemann
P C
PC
Gregory
M
M
Höltershinken
J
J
Kamphues
D000818:Animals; D002648:Child; D019587:Dietary Supplements; D010188:Exocrine Pancreatic Insufficiency / Q000473:pathology*; D006801:Humans; D008954:Models, Biological; D010183:Pancreatic Ducts / Q000601:surgery*; D014801:Vitamin A / Q000008:administration & dosage*; D014810:Vitamin E / Q000008:administration & dosage*
D014801:Vitamin A; D014810:Vitamin E