Effect of glutamine on intestinal mucosal integrity and bacterial translocation after abdominal radiation

Karatzas, Theodore; Scopa, S.; Tsoni, I.; Panagopoulos, Konstantinos; Spiliopoulou, Iris; Moschos, Stergios; Vagianos, Kathy; Kalfarentzos, Fotios

doi:10.1016/0261-5614(91)90039-f

Cited by 26 publications

(20 citation statements)

References 18 publications

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“…Radiation, however, resulted in a significant increase in positive MLN cultures (71%), in accordance with previous experimental data [4,5,8]. Treatment with IGF-I and GH significantly reduced bacterial translocation as only 21 and 29% of the animals, respectively, were found to have positive MLN cultures after radiation.…”

Section: Discussionsupporting

confidence: 78%

“…This is in accordance with the turnover of the epithelial cells in the small intestine and the migration from the crypt base to the villus top, which takes approximately 3-5 days. The incidence of the microbial translocation could be correlated with the histological picture [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…In previous studies, this has been shown to be a reliable and reproducible radiation enteritis model without mortality until the 4th day after radiation when the mucosal atrophy and ulceration are more evident. On the 10th day following this severe bowel insult, mortality is approximately 50%, and the positive blood cultures in portal vein (PV) and aorta (AO) were 90 and 70%, respectively [4][5][6]. Histological examination of the irradiated gut has shown a significantly more pronounced effect of radiation on the ileal mucosa [4,5].…”

Section: Methodsmentioning

confidence: 99%

“…abdominal radiotherapy complicated by damage to the intestinal mucosa, the mucosal barrier is disrupted, allowing bacteria and endotoxins to pass through the epithelial mucosa and reach extraintestinal tissues and the systemic circulation [1][2][3]. Intestinal trophic factors that prevent radiation enteritis or accelerate recovery of intestinal mucosa after radiation damage have been shown to prevent bacterial translocation [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Growth Hormone and Insulin-Like Growth Factor-I on Radiation Enteritis

Alexandrides

Spiliotis²,

Mylonas³

et al. 1998

Eur Surg Res

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The effect of growth hormone (GH) and insulin-like growth factor-I (IGF-I) on intestinal mucosal integrity and bacterial translocation after abdominal radiation was studied in rats. Animals were divided into the following groups: I (control), II (radiation), III (radiation plus GH) and IV (radiation plus IGF-I). Radiation (1,100 cGy) was administered on the 1st day to groups II, III and IV. GH [0.25 mg/kg body weight (BW) s.c. once daily] was administered on days 1, 2 and 3 to group III, and IGF-I (0.1 mg/kg BW s.c. twice daily) was given on days 1, 2 and 3 to group IV. On day 4, animals were sacrificed. Cultures of the mesenteric lymph nodes (MLN) and blood cultures from aorta and portal vein were performed. The number of villi per centimeter (V/cm), the villus height (Vh), mitoses per crypt (M/C) and protein and DNA contents of the mucosa were evaluated in samples from the terminal ileum. Radiation increased the number of positive MLN cultures, while treatment with GH and IGF-I reduced them significantly. V/cm, Vh, M/C, protein and DNA contents were significantly increased in all irradiated animals treated with GH and IGF-I. In conclusion both GH and IGF-I are not only capable of improving the mucosal integrity but also to reduce the bacterial translocation that follows intestinal radiation. In small doses IGF-I could reproduce the effects of GH and in some parameters the effects were more pronounced, although not statistically significant. This suggests that the effects of GH on intestine could be mediated through the local and systemic generation of IGF-I.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Growth Hormone and Insulin-Like Growth Factor-I on Radiation Enteritis

Alexandrides

Spiliotis²,

Mylonas³

et al. 1998

Eur Surg Res

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“…93 Administering glutamine to animals after irradiation and chemotherapy prevented mucosal atrophy and reduced bacterial translocation, endotoxaemia and infections. [94][95][96] It is much less clear whether glutamine given orally prevents human oral MBI, 97,98 although patients treated with high-dose chemotherapy experienced less diarrhoea. 99 Glutamine supplementation given to HSC transplant recipients parenterally helps to preserve hepatic function, reduces the length of stay in hospital, improves the nitrogen balance and lowers the infection rate 100,101 but has no influence on the occurrence of mucositis or fever.…”

Section: Glutaminementioning

confidence: 99%

Mucosal barrier injury: biology, pathology, clinical counterparts and consequences of intensive treatment for haematological malignancy: an overview

Blijlevens¹,

Donnelly²,

Pauw³

2000

Bone Marrow Transplant

236

153

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Summary:Mucositis is an inevitable side-effect of the conditioning regimens used for haematopoietic stem cell transplantation. The condition is better referred to as mucosal barrier injury (MBI) since it is primarily the result of toxicity and is a complex and dynamic pathobiological process manifested not only in the mouth but also throughout the entire digestive tract. A model has been proposed for oral MBI and consists of four phases, namely inflammatory, epithelial, ulcerative and healing phases. A variety of factors are involved in causing and modulating MBI including the nature of the conditioning regimen, the elaboration of pro-inflammatory and other cytokines, translocation of the resident microflora and their products, for example, endotoxins across the mucosal barrier, exposure to antimicrobial agents and whether or not the haematopoietic stem cell graft is from a donor. Neutropenic typhlitis is the most severe gastrointestinal manifestation of MBI, but it also influences the occurrence of other major transplant-related complications including acute GVHD, veno-occlusive disease and systemic infections. The pathobiology, clinical counterparts and the means of measuring MBI are discussed together with potential approaches for prevention, amelioration and, perhaps, even cure. Bone Marrow Transplantation (2000) 25, 1269-1278. Keywords: mucositis; mucosal barrier injury; diagnosis; risk factors; treatment Mucositis is an inevitable side-effect of the intensive conditioning therapy used for haematopoietic stem cell transplantation 1 and usually refers to the mucosal ulceration of mouth and throat. However, it is generally accepted that oral mucositis is in reality the most obvious manifestation of damage or injury elsewhere particularly that of the gut. Hence, mucosal barrier injury (MBI) may be a more appropriate term for this biological process. There exists no clear definition of MBI which is defined by a constellation of signs and symptoms that vary in their clinical expression. Oral MBI is reported to affect 60% to 100% of transplant recipients 2,3 and is characterised by pain, oedema, erythema, lesions, pseudomembrane formation, excessive mucous production, reduced saliva and bleeding, all of which reduce the patient's ability to eat and drink. In contrast, there are no reliable data on the incidence of gut MBI although intestinal symptoms affect almost every transplant recipient to some extent and include nausea, vomiting, abdominal cramping and watery diarrhoea occasionally accompanied by macroscopic blood loss. The exact course and severity of bowel symptoms of MBI are also difficult to ascertain because many patients are in such pain due to oral MBI that they only gain relief from narcotic analgesia which induces constipation as a result of reduced gut motility. There are also a number of scoring systems for oral MBI 4 although none is universally accepted and all lack standardisation. As yet, there is no system for registering gut MBI although there are published definitions for grading toxicity o...

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Glutamine: A Gut Essential Amino Acid

Hulst¹,

Meyenfeldt²,

Soeters³

1996

Update in Intensive Care and Emergency Medicine

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Effect of glutamine on intestinal mucosal integrity and bacterial translocation after abdominal radiation

Cited by 26 publications

References 18 publications

Effects of Growth Hormone and Insulin-Like Growth Factor-I on Radiation Enteritis

Effects of Growth Hormone and Insulin-Like Growth Factor-I on Radiation Enteritis

Mucosal barrier injury: biology, pathology, clinical counterparts and consequences of intensive treatment for haematological malignancy: an overview

Glutamine: A Gut Essential Amino Acid

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