title: High-fat enteral nutrition reduces intestinal mucosal barrier damage after peritoneal air exposure.
abstract: BACKGROUND
  Peritoneal air exposure is needed in open abdominal surgery, but long-time exposure could induce intestinal mucosal barrier dysfunction followed by many postoperative complications. High-fat enteral nutrition can ameliorate intestinal injury and improve intestinal function in many gastrointestinal diseases. In the present study, we investigated the effect of high-fat enteral nutrition on intestinal mucosal barrier after peritoneal air exposure and the underlying mechanism.
  
  
  METHODS
  Male adult rats were administrated saline, low-fat or high-fat enteral nutrition via gavage before and after peritoneal air exposure for 3 h. Rats undergoing anesthesia without laparotomy received saline as control. Twenty four hours after surgery, samples were collected to assess intestinal mucosal barrier changes in serum D-lactate levels, intestinal permeability, intestinal tight junction protein ZO-1 and occludin levels, and intestinal histopathology. The levels of malondialdehyde and the activity of superoxide dismutase in the ileum tissue were also measured to assess the status of intestinal oxidative stress.
  
  
  RESULTS
  High-fat enteral nutrition significantly decreased the serum D-lactate level and increased the intestinal tight junction protein ZO-1 level when compared to the group treated with low-fat enteral nutrition (P < 0.05). Meanwhile, histopathologic findings showed that the intestinal mucosal injury assessed by the Chiu's score and the intestinal epithelial tight junction were also improved much more in the high-fat enteral nutrition-treated group (P < 0.05). In addition, the intestinal malondialdehyde level was lower, and the intestinal superoxide dismutase activity was higher in the high-fat enteral nutrition-treated group than that in the low-fat enteral nutrition-treated group (P < 0.05).
  
  
  CONCLUSIONS
  These results suggest that high-fat enteral nutrition could reduce intestinal mucosal barrier damage after peritoneal air exposure, and the underlying mechanism may be associated with its antioxidative action. Perioperative administration of high-fat enteral nutrition may be a promising intervention to preserve intestinal mucosal barrier function in open abdominal surgery.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Shan-Jun
authors.initials: SJ
authors.lastname: Tan
authors.affiliation: Department of Nephrology, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yu
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Lin
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: wuguohaozs@163.com.
authors.forename: Guo-Hao
authors.initials: GH
authors.lastname: Wu
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: kuiwenyu@163.com.
authors.forename: Wen-Kui
authors.initials: WK
authors.lastname: Yu
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Jie-Shou
authors.initials: JS
authors.lastname: Li
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. Electronic address: liningnju@163.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
mesh_terms: D000388:Air; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D059305:Diet, High-Fat; D004750:Enteral Nutrition / Q000379:methods*; D007082:Ileum / Q000378:metabolism* / Q000473:pathology; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D007813:Laparotomy / Q000009:adverse effects*; D008297:Male; D019990:Perioperative Care / Q000379:methods; D010537:Peritoneum; D010539:Permeability; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011897:Random Allocation; D051381:Rats; D019108:Tight Junctions / Q000378:metabolism
chemical_list: D015415:Biomarkers
keywords: Animal experiment; High-fat enteral nutrition; Intestinal mucosal barrier; Open abdominal surgery; Oxidative stress; Peritoneal air exposure