title: Early enteral nutrition improves intestinal immune barrier in a rat model of severe acute pancreatitis.
abstract: BACKGROUND
  The aim of the present study was to investigate the role of early enteral nutrition (EEN) in the intestinal immune barrier in severe acute pancreatitis (SAP), and to explore its potential mechanisms.
  
  
  METHODS
  Sixty rats were randomly assigned to three groups: sham-operated group (SO group, n = 20), SAP group receiving EEN (SAP + EEN group, n = 20), and SAP group receiving total parental nutrition (SAP + TPN group, n = 20). SAP was induced by infusion of sodium taurocholate. Rats were killed 5 days after nutritional support. The pathological damage of the intestine was determined using HE staining. The expression of MAdCAM-1, CD4+, and CD8+in Peyer's lymph nodes of the distal ilium was examined by immunohistochemistry. Serum levels of endotoxin and bacterial translocation were determined.
  
  
  RESULTS
  The survival rate in the SAP + TPN (50%) and SAP + EEN (75%) groups was significantly lower than in the SO group (100%) (P < 0.05). The survival rate in the SAP + EEN group was significantly higher than in the SAP + TPN group (P < 0.05). The expression of MAdCAM-1, CD4+and CD8+in the intestine was decreased in SAP rats. EEN significantly increased the expression of MAdCAM-1, CD4+and CD8+compared with TPN, accompanied by a decrease in the serum levels of endotoxin and bacterial translocation.
  
  
  CONCLUSIONS
  Early enteral nutrition improves intestinal immune barrier, thus reducing bacterial and endotoxin translocation and improving the survival rate in SAP rats.
authors.affiliation: Department of Gastroenterology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Gastroenterology, Wenjiang People Hospital, Chengdu, Sichuan, China.
authors.forename: Li-Guo
authors.initials: LG
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Sichuan Medical University, Luzhou, Sichuan, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Hospital of Sichuan Medical University, Luzhou, Sichuan, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Gastroenterology, Mianyang 404 Hospital, Mianyang, Sichuan, China.
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Wen
mesh_terms: D000681:Amylases / Q000097:blood; D000704:Analysis of Variance; D000818:Animals; D001707:Biopsy, Needle; D004195:Disease Models, Animal; D004731:Endotoxins / Q000378:metabolism; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D007085:Ilium / Q000473:pathology; D007150:Immunohistochemistry; D007408:Intestinal Absorption / Q000276:immunology*; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000473:pathology; D019283:Pancreatitis, Acute Necrotizing / Q000473:pathology / Q000628:therapy*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012016:Reference Values; D012720:Severity of Illness Index; D015996:Survival Rate
chemical_list: D004731:Endotoxins; D000681:Amylases
keywords: Bacterial translocation; CD4+ and CD8+; Early enteral nutrition; Endotoxin; MAdCAM-1; Several acute pancreatitis