Basic Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2018; 24(5): 583-592
Published online Feb 7, 2018. doi: 10.3748/wjg.v24.i5.583
Enteral nutrition combined with glutamine promotes recovery after ileal pouch-anal anastomosis in rats
Yan-Yan Xu, An-Qi He, Gang Liu, Kai-Yu Li, Jian Liu, Tong Liu
Yan-Yan Xu, An-Qi He, Gang Liu, Kai-Yu Li, Jian Liu, Tong Liu, Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Author contributions: Xu YY and He AQ collected the data; Liu G conceived and designed the study; Li KY and He AQ contributed to the data analysis; Xu YY contributed to the interpretation of the data; Liu G participated in streamlining the study protocol; Xu YY, He AQ, Li KY, Liu J and Liu T proofread the study protocol; Li KY supervised the data collection process; Xu YY, He AQ, Liu G, Li KY, Liu J and Liu T contributed to drafting the manuscript; all authors contributed to the revision of the manuscript and approved the final version.
Supported by Li Jie-Shou Gut Barrier Foundation, No. LJS_201008.
Institutional review board statement: The study was reviewed and approved by Tianjin Medical University General Hospital Institutional Review Board.
Institutional animal care and use committee statement: Animal care and experiments were conducted according to the international guidelines on animal research and ethics.
Conflict-of-interest statement: The authors have no financial or other conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gang Liu, MD, PhD, Professor, Surgeon, Department of General Surgery, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin 300052, China. landmark1059@163.com
Telephone: +86-22-60362365 Fax: +86-22-60362365
Received: November 15, 2017
Peer-review started: November 15, 2017
First decision: December 3, 2017
Revised: December 10, 2017
Accepted: December 26, 2017
Article in press: December 26, 2017
Published online: February 7, 2018
Abstract
AIM

To assess the effect of enteral nutrition (EN) supplemented with glutamine on recovery after ileal pouch-anal anastomosis (IPAA) in rats, to provide an experimental basis for nutritional support in patients with ulcerative colitis (UC) after IPAA.

METHODS

Male Sprague-Dawley (SD) rats were randomly divided into three groups (n = 8) after IPAA operation using a microsurgical technique. From the third postoperative day, rats in the control group, EN group, and immune nutrition (IN) group were fed standard rat chow, short peptide EN, and short peptide EN combined with glutamine ad libitum, respectively. The rats’ general condition was observed throughout the study. Serum levels of total protein (TP), albumin (ALB), prealbumin (PA), and transferrin (TF) were detected on the 30th postoperative day, using an automatic biochemical analyzer. The ileal pouch mucosa was stained with hematoxylin and eosin (HE), and occludin protein levels were detected by immunohistochemistry.

RESULTS

The body weight of rats in the EN group (359.20 ± 10.06 g) was significantly higher than that in the control group (344.00 ± 9.66 g) (P < 0.05) and lower than that in the IN group (373.60 ± 9.86 g) (P < 0.05) on the 30th postoperative day. The levels of serum TP, ALB, PA, and TF in the EN group were significantly higher than those in the control group (P < 0.01 for all) and lower than those in the IN group (P < 0.05 for all). Histopathological score (EN: 0.80 ± 0.37; IN: 0.60 ± 0.40; control group: 2.29 ± 0.18) and expression level of occludin protein (EN: 0.182 ± 0.054; IN: 0.188 ± 0.048; control group: 0.127 ± 0.032) were significantly lower in the control group compared with the EN and IN groups (P < 0.05 for all), but there were no significant differences between the latter two groups (P > 0.05 for all).

CONCLUSION

EN combined with glutamine may effectively improve nutritional status after IPAA. Our results suggest a benefit of glutamine supplementation in EN for UC patients undergoing IPAA, although human studies are required to confirm this finding.

Keywords: Enteral nutrition, Glutamine, Ileal pouch-anal anastomosis, Nutritional status, Recovery

Core tip: We assessed the effect of enteral nutrition (EN) supplemented with glutamine on recovery after ileal pouch-anal anastomosis (IPAA) in rats, to provide an experimental basis for nutritional support in patients with ulcerative colitis after IPAA. Male Sprague-Dawley rats underwent IPAA and were then fed standard rat chow, short peptide EN, or short peptide EN combined with glutamine from postoperative day 3. The rats’ general condition was observed throughout the study, and serum levels of total protein, albumin, prealbumin, and transferrin were measured on the 30th postoperative day. The ileal pouch mucosa was stained with hematoxylin and eosin and occludin protein levels were measured by immunohistochemistry.