Glutamine Stabilizes Intestinal Permeability and Reduces Pancreatic Infection in Acute Experimental Pancreatitis

被引：8

作者：

Foitzik T. ^{[1
,6
]}

Stufler M. ^{[2
]}

Hotz H.G. ^{[1
]}

Klinnert J. ^{[1
]}

Wagner J. ^{[3
]}

Warshaw A.L. ^{[5
]}

Schulzke J.D. ^{[2
]}

Fromm M. ^{[4
]}

Buhr H.J. ^{[1
]}

机构：

[1] Department of Surgery, Univ. Klin. Benjamin Franklin, Freie Universität Berlin, Berlin

[2] Department of Gastroenterology, Univ. Klin. Benjamin Franklin, Freie Universität Berlin, Berlin

[3] Department of Microbiology, Univ. Klin. Benjamin Franklin, Freie Universität Berlin, Berlin

[4] Department of Clinical Physiology, Univ. Klin. Benjamin Franklin, Freie Universität Berlin, Berlin

[5] Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA

[6] Chirurgische Klinik, Univ. Klin. Benjamin Franklin, Freie Universität Berlin

来源：

Journal of Gastrointestinal Surgery | 1997年 / 1卷 / 1期

关键词：

Pancreatitis; Acute Pancreatitis; Severe Acute Pancreatitis; Bacterial Translocation; Ussing Chamber;

D O I：

10.1007/s11605-006-0008-8

中图分类号：

学科分类号：

摘要：

Intestinal barrier failure and subsequent translocation of bacteria from the gut play a decisive role in the development of systemic infections in severe acute pancreatitis. Glutamine (GLN) has been shown to stabilize gut barrier function and to reduce bacterial translocation in various experimental settings. The aim of this study was to evaluate whether GLN reduces gut permeability and bacterial infection in a model of acute necrotizing pancreatitis. Acute necrotizing pancreatitis was induced in 50 rats under sterile conditions by intraductal infusion of glycodeoxycholic acid and intravenous infusion of cerulein. Six hours after the induction of pancreatitis, animals were randomly assigned to one of two groups: standard total parental nutrition (TPN) or TPN combined with GLN (0.5 g/kg-1/day-1). After 96 hours, the animals were killed. The pancreas was prepared for bacteriologic examination, and the ascending colon was mounted in a Ussing chamber for determination of transmucosal resistance and mannitol flux as indicators of intestinal permeability. Transmucosal resistance was 31% higher in the animals treated with GLN-supplemented TPN compared to the animals given standard TPN. Mannitol flux through the epithelium was decreased by 40%. The prevalence of pancreatic infections was 33% in animals given GLN-enriched TPN as compared to 86% in animals receiving standard TPN (P < 0.05). Adding GLN to standard TPN not only reduces the permeability of the colon but decreases pancreatic infections in acute necrotizing pancreatitis in the rat. This confirms previous reports that GLN decreases bacterial translocation by stabilizing the intestinal mucosal barrier. The present findings provide the first evidence suggesting that stabilizing the intestinal barrier can reduce the prevalence of pancreatic infection in acute pancreatitis and that GLN may be useful in preventing septic complications in clinical pancreatitis.

引用

页码：40 / 47

页数：7

共 31 条

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