title: Increased hepatic blood flow during enteral immune-enhancing diet gavage requires intact enterohepatic bile cycling.
abstract: OBJECTIVE
  Total hepatic blood flow (HBF) via the hepatic artery and portal vein is highly dependent on gastrointestinal perfusion. During postprandial hyperemia, intestinal blood flow depends on nutrient composition, gastrointestinal location, and time. Immune-enhancing diets (IEDs) containing n-3 polyunsaturated fatty acids (PUFAs) selectively augment blood flow in the ileum at 60-120 min via a bile-dependent mechanism. My colleagues and I hypothesized that liver blood flow would be similarly affected by IEDs containing n-3 PUFAs.
  
  
  METHODS
  Mean arterial blood pressure, heart rate, and effective HBF (galactose clearance) were measured in anesthetized male Sprague-Dawley rats after gastric gavage of either a control diet (CD, Boost, Novartis) or an IED (Impact, Nestle Nutrition), with or without bile-duct ligation (BDL), and with or without supplemental bile (bovine, dried, unfractionated). Significance was assessed by 2-way ANOVA for repeated measures with the Tukey-Kramer honestly significant difference test.
  
  
  RESULTS
  Compared with baseline levels, a CD increased HBF (peak at 40 min , *P < 0.05) whereas an IED increased HBF in two distinct peaks at 40 min (*P < 0.05) and 120 min (*P < 0.05), but BDL prevented both the early (CD and IED, †P < 0.05) and late peaks (IED, †P < 0.05). Bile supplementation in the CD + BDL or IED + BDL groups restored neither the CD peak nor the early or late IED peaks.
  
  
  CONCLUSIONS
  HBF during absorptive intestinal hyperemia is modulated by a mechanism that requires an intact enterohepatic circulation. The early peaks at 40 min (CD or IED) were prevented by BDL, even though fat absorption in the proximal gut occurs by bile-independent direct absorption. Bile supplementation with the diet (CD + BDL or IED + BDL) was insufficient to restore HBF hyperemia, which implies that a relationship exists between intestinal and hepatic blood flow that is not solely dependent on bile-mediated intestinal fat absorption and bile recirculation.
authors.affiliation: Department of Surgery, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Nagengast
authors.affiliation: Department of Physiology and Biophysics, University of Louisville, Louisville, Kentucky, USA; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Hurt
authors.affiliation: Department of Surgery, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Downard
authors.affiliation: Department of Surgery, University of Louisville, Louisville, Kentucky, USA; Department of Physiology and Biophysics, University of Louisville, Louisville, Kentucky, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Smith
authors.affiliation: Department of Surgery, University of Louisville, Louisville, Kentucky, USA; Department of Physiology and Biophysics, University of Louisville, Louisville, Kentucky, USA; Louisville Robley Rex VA Medical Center, Louisville, Kentucky, USA.
authors.forename: R Neal
authors.initials: RN
authors.lastname: Garrison
authors.affiliation: Department of Surgery, University of Louisville, Louisville, Kentucky, USA; Department of Physiology and Biophysics, University of Louisville, Louisville, Kentucky, USA. Electronic address: paul.matheson@louisville.edu.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Matheson
mesh_terms: D000818:Animals; D001646:Bile / Q000378:metabolism*; D004032:Diet; D019587:Dietary Supplements; D004750:Enteral Nutrition; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D007413:Intestinal Mucosa / Q000378:metabolism; D008099:Liver / Q000098:blood supply* / Q000378:metabolism; D008297:Male; D019518:Postprandial Period; D051381:Rats; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow / Q000502:physiology*
chemical_list: D015525:Fatty Acids, Omega-3
keywords: Effective hepatic blood flow; Enterohepatic bile transport; Galactose clearance; Immune-enhancing diet; Intestinal absorptive hyperemia; Intestinal lipid absorption; Liver blood flow; Postprandial hyperemia; Sprague-Dawley rat