No Effect of Bolus Glutamine Supplementation on the Postresectional Adaptation of Small Bowel Mucosa in Rats Receiving Chow ad libitum

Yang, Hua; Larsson, Jörgen; Permert, Johan; Braaf, Ylva; Wirén, Mikael

doi:10.1159/000018844

Cited by 22 publications

(11 citation statements)

References 21 publications

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“…7,28,29,30 Yang et al (2000), after administering 2 g/kg/day of glutamine by enteral bolus to rats undergoing extensive intestinal resection, did not observe improvement in intestinal adaptation after the 10th day post surgery. 31 Regarding the toxic effect of cyclosporin on the intestinal epithelium, Zhang et al (1995) studied rats undergoing small bowel transplant while using immunosuppression with cyclosporin (15 mg/kg). Animals received either elemental diet with 2% glutamine or the same diet with balanced nonessential amino acids (without glutamine).…”

Section: Discussionmentioning

confidence: 99%

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

et al. 2004

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Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized.PURPOSE: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa.METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20 th postoperative day). Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300) connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS:The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the withoutglutamine diet group, though not significantly different from with standard-diet group.CONCLUSIONS: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.

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Section: Discussionmentioning

confidence: 99%

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

et al. 2004

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“…Since enteral glutamine can be readily absorbed by small intestinal epithelium, and glutamine oxidation 70 ISSN 1007 -9327 CN 14 -1219/ R World J Gastroentero February 2001 Volume 7 Number 1 stimulates enterocyte Na + /H + exchange, leading to a high rate of electroneutral NaCl absorption in healthy and diseased jejunum [20] , we studied the effect of enteral glutamine perfusion on the remnant intestinal mucosal structure during TPN. Because previous studies have not confirmed the b e n e f i c i a l e f f e c t o f e n t e r a l g l u t m i n e supplementation during EN [21][22][23][24][25] , we also studied the effect of adding extra glutamine to nutritioncomplete enteral diet. Our results confirmed the existence of TPN induced intestinal hypoplasia, which was indicated by significantly lower villi in both jejunum and ileum and markedly shallower crypts in jejunum in TPNcon group compared with ENcon group.…”

Section: Discussionmentioning

confidence: 99%

Effect of bowel rehabilitative therapy on structural adaptation of remnant small intestine: animal experiment

Zhou

Li²,

Li³

et al. 2001

WJG

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AIM To investigate the individual and the combined effects of glutamine, dietary fiber, and growth hormone on the structural adaptation of the remnant small bowel. METHODS Forty-two adult male SpragueDawley rats underwent 85% mid-small bowel resection and received total parenteral nutrition ( T P N ) s u p p o r t d u r i n g t h e f i r s t t h r e e p o s t o p e r a t i o n a l d a y s . F r o m t h e 4 t h postoperational day, animals were randomly assigned to receive 7 different treatments for 8 days: TPNcon group, receiving TPN and enteral 20 g·L -1 glycine perfusion; TPN+Gln group, receiving TPN and enteral 20 g·L -1 glutamine perfusion; ENcon group, receiving enteral nutrition (EN) fortified with 20 g·L -1 glycine; EN+Gln group, enteral nutrition fortified with 20 g·L -1 glutamine; EN+Fib group, enteral nutrition and 2 g·L -1 oral soybean fiber; EN+GH group, enteral nutrition and subcutaneous growth hormone (GH) (0.3IU) injection twice daily; and ENint group, glutamine-enriched EN, oral soybean fiber, and subcutaneous GH injection. RESULTS Enteral glutamine perfusion during TPN increased the small intestinal villus height (jejunal villus height 250 µm ± 29 µm in TPNcon vs 330 µm ± 54 µm in TPN+Gln, ileal villus height 260 µm ± 28 µm in TPNcon vs 330 µm ± 22 µm in TPN+Gln, P<0.05) and mucosa thickness (jejunal mucosa thickness 360 µm ± 32 µm in TPNcon vs 460 µm ± 65 µm in TPN+Gln, ileal mucosa thickness 400µm ± 25 µm in TPNcon vs 490 µm ± 11 µm in TPN+Gln, P<0.05) in comparison with the TPNcon group. Either fiber supplementation or GH administration improved body mass gain (end body weight 270 g ± 3.6 g in EN+Fib, 265.7 g ± 3.3 g in EN+GH, vs 257 g ± 3.3 g in ENcon, P<0.05), elevated plasma insulinlike growth factor (IGF-I) level (880 µg·L -1 ± 52 µg·L -1 in EN+Fib, 1 200 µg·L -1 ± 96 µg·L -1 in EN ± GH, vs 620 µg·L -1 ± 43 µg·L -1 in ENcon, P<0.05), and increased the villus height (jejunum 560 µm ± 44 µm in EN ± Fib, 530 µm ± 30 µm in EN ± GH, vs 450 µm ± 44 µm in ENcon, ileum 400 µm ± 30 µm in EN+Fib, 380 µm ± 49 µm in EN ± GH, vs 320 µm ± 16 µm in ENcon, P<0.05) and the mucosa thickness (jejunum 740 µm ± 66 µm in EN ± Fib, 705 µm ± 27 µm in ENGH, vs 608 µm ± 58 µm in ENcon, ileum 570 µm ± 27 µm in EN ± Fib, 560 µm ± 56 µm in EN ± GH, vs 480 µm ± 40 µm in ENcon, P<0.05) in remnant jejunum and ileum. Glutamine-enriched EN produced little effect in body mass, plasma IGF-I level, and remnant small bowel mucosal structure. The ENint group had greater body mass (280 g ± 2. 2 g), plasma IGF-I level (1450 µg·L -1 ± 137 µg·L -1 ), and villus height (jejunum 620 µm ± 56 µm, ileum 450 µm ± 31 µm) and mucosal thickness (jejunum 800 µm ± 52 µm, ileum 633 µm ± 33 µm) than those in ENcon,EN+Gln (jejunum villus height and mucosa thickness 450 µm ± 47 µm and 610 µm ± 63 µm, ileum villus height and mucosa thickness 330 µm ± 39 µm and 500 µm ± 52 µm), EN+GH groups (P<0.05), and than those in EN+Fib group although no statistical significance was attained. CONCLUSION Both dietary fiber and GH when used separately c...

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“…It has been shown that glutamine supplementation protects the GALT atrophy and IgA depletion that result from long-term TPN and enhances nutrient absorption [17,18]. However, conflicting results have been reported in terms of enteral or parenteral glutamine administration in animal studies, as well as clinical trials that evaluated intestinal adaptation after massive intestinal resection [4,5,[19][20][21][22][23][24][25][26][27]. Therefore, the efficacy of Gln administration in the management of SBS is currently controversial.…”

Section: Some Trophic Factors (Ie Growth Hormone [Gh] Insulinlike mentioning

confidence: 99%

“…These results may be related to the lack of additional growth factors, nutrients, and supportive enteral or parenteral nutrition. To remedy this problem, a glutamine and GH combination seems to be the most frequently studied combination, although conflicting results are reported (Table 4) [5,9,10,[25][26][27]33,[48][49][50]. Although some authors report enhanced intestinal adaptation either with enteral [25] or parenteral [5] glutamine supplementation alone, others report no effect on intestinal adaptation [9,10,26,27,33,50].…”

Section: Gln -Glutamine; Gh -Growth Hormon; En -Enteral Nutrition; Hgmentioning

confidence: 99%

“…To remedy this problem, a glutamine and GH combination seems to be the most frequently studied combination, although conflicting results are reported (Table 4) [5,9,10,[25][26][27]33,[48][49][50]. Although some authors report enhanced intestinal adaptation either with enteral [25] or parenteral [5] glutamine supplementation alone, others report no effect on intestinal adaptation [9,10,26,27,33,50]. Several studies report that parenteral or enteral Gln in combination with GH [48][49][50], growth factors [9], EN [27], or PN [5] enhances adaptation after massive intestinal resection in experimental models.…”

Section: Gln -Glutamine; Gh -Growth Hormon; En -Enteral Nutrition; Hgmentioning

confidence: 99%

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The effects of parenteral glutamine on intestinal adaptation in a rat model of short bowel syndrome

et al. 2010

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AbstractShort bowel syndrome (SBS) is characterized by the malabsorption of nutrients and fluids that occurs after major intestinal resection, resulting from an adaptation process that begins immediately to increase the mucosal surface area and absorption. Certain nutrients and trophic factors are widely used to increase intestinal adaptation following massive intestinal resection. The efficacy and benefits of glutamine on the intestinal adaptation process is still controversial. This study was conducted to determine the effects of parenteral glutamine administration on intestinal adaptation in a rat model of SBS. Fourteen male Wistar rats were divided into two groups; all 14 underwent 75% small bowel resection. Within each group, rats were assigned to 14 days of treatment with subcutaneous glutamine (0.3 g/kg/day) or isotonic saline daily. Weight changes and histological intestinal adaptation parameters (mucosal thickness, villus height, and crypt depth) were measured. Non-mucosal intestinal changes were evaluated by intestinal fractioned collagen analysis. All rats initially lost weight and began to gain weight postoperatively; however, they did not reach their preoperative weights during the experiment and there was no significant difference between the groups. Histological adaptation parameters were significantly increased after 75% intestinal resection in both groups compared to paired native samples (P<0.01); although the percent of increase was slightly higher in Gln group, no significant difference was detected between the two groups. Fractioned-collagen amounts were found to be similar between groups. The results indicated that parenteral glutamine administration alone does not improve the intestinal adaptation process after massive intestinal resection in rats.

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No Effect of Bolus Glutamine Supplementation on the Postresectional Adaptation of Small Bowel Mucosa in Rats Receiving Chow ad libitum

Cited by 22 publications

References 21 publications

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

Effect of bowel rehabilitative therapy on structural adaptation of remnant small intestine: animal experiment

The effects of parenteral glutamine on intestinal adaptation in a rat model of short bowel syndrome

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