Effects on Bacterial Translocation of High-Fat Enteral Nutrition in Bile Duct Ligated Rats

Yıl 2012, Cilt: 2012 Sayı: 3, 301 - 305, 01.03.2012

Tufan Elipek Nihat Zafer Utkan

https://doi.org/10.5152/balkanmedj.2012.009

Öz

Objective: Bacterial Translocation (BT) from the gastrointestinal system is at the center of current sepsis theories. In patients with obstructive jaundice, the absence of intraluminal bile flow causes some alterations and mucosal damage in the gut. In the present study, it was aimed to investigate the effects on BT of high-fat enteral nutrition in bile duct ligated rats. Material and Methods: In this study, a total of 28 healthy Spraque-Dawley rats, weighing 230-300 gr, were grouped into four as sham group, control group, high-fat enteral nutrition group and low-fat enteral nutrition group. The rats in all the groups were sacrificed on the seventh postoperative day The values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total and direct bilirubin were measured for biochemical evaluation. Also, samples were taken from the blood, lung, liver, spleen and mesenteric lymph nodes for microbiological evaluation. The results were calculated as CFU/gr and evaluated statistically. Results: In all bile duct ligated rats, all findings of obstructive jaundice were observed clinically (in postoperatively third day) and in the laboratory. It was determined that the lymphatic system is an essential pathway for BT, as reported by similar studies. However, it was observed in this study that the high-fat enteral nutrition may be not severely effective in reducing BT in bile duct ligated rats. The results were supported by statistical analyses. Conclusion: It was observed that high-fat enteral nutrition has no meaningful effects on reducing BT in bile duct ligated rats. Turkish Anahtar Kelimeler: Obstruktif sarılık, yüksek yağlı enteral beslenme, bakteriyal translokasyon Amaç: Gastrointestinal sistemden Bakteriyel Translokasyon (BT) güncel sepsis kuramlarının merkezinde yer almaktadır. Tıkanma sarılığı olan hastalarda, intraluminal safra akışının olmaması bazı değişikliklere ve bağırsak mukozasında hasara neden olur. Çalışmamızda, safra kanalı ligasyonu yapılan sıçanlarda yüksek yağ enteral beslenmenin BT üzerindeki etkilerinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmada, 230-300 gr ağırlığında 28 adet sağlıklı Spraque-Dawley cinsi sıçan, sham grubu, kontrol grubu, yüksek yağlı enteral beslenme grubu ve düşük yağlı enteral beslenme grubu olarak toplam dört gruba ayrıldı. Tüm gruplarda sıçanlar postoperatif yedinci gün sakrifiye edildi. Biyokimyasal değerlendirmede, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), alkalen fosfataz (ALP), gama-glutamil transferaz (GGT), total ve direkt bilirubin değerleri ölçüldü. Ayrıca mikrobiyolojik değerlendirme için kan, akciğer, karaciğer, dalak ve mezenterik lenf nodlarından örnekler alındı​​. Sonuçlar CFU / gr olarak hesaplandı ve istatistiksel olarak değerlendirildi. Bulgular: Safra kanalı ligasyonu yapılan tüm sıçanlarda, tıkanma sarılığının tüm bulguları klinik (postoperatif üçüncü günde) ve laboratuar olarak gözlenmiştir. Benzer çalışmalarda da bildirildiği gibi BT için lenfatik sistemin önemli bir yol olduğu tespit edilmiştir. Bununla birlikte, safra kanalı ligasyonu yapılan sıçanlarda yüksek yağlı enteral beslenmenin BT'yi azaltmada ciddi bir etkisi olmadığı görülmüştür. Sonuçlar istatistiksel analizler ile desteklenmiştir. Sonuç: Yüksek yağlı enteral beslenmenin safra kanalı ligasyonu yapılan sıçanlarda BT'nin azaltılması üzerinde anlamlı bir etkisi olmadığı gözlenmiştir.

Anahtar Kelimeler

Obstructive jaundice, high-fat enteral nutrition, bacterial translocation

Effects on Bacterial Translocation of High-Fat Enteral Nutrition in Bile Duct Ligated Rats

Öz

Kaynakça

• Kimmings AN, Van Deventer SJH, Obertop H, Rauws EAJ, Huibregtse K, Gouma DJ. Endotoxin, cytokines, and endotoxin binding proteins in obstructive jaundice and after preoperative biliary drainage. Gut 2000;46:725-31. [CrossRef]
• Clements WDB, Erwin P, McCaigue MD, Halliday MI, Barclay GR, Rowlands BJ. Conclusive evidence of endotoxemia in biliary ob- struction. Gut 1998;42:293-9. [CrossRef]
• Kordzaya DJ, Goderdzishvili VT. Bacterial translocation in ob- structive jaundice in rats: role of mucosal lacteals. Eur J Surg 2000;166:367-74. [CrossRef]
• Kimmings AN, Van Deventer SJH, Obertop H, Gouma DJ. Treat- ment with recombinant bactericidal/permeability-increasing pro- tein to prevent endotoxin-induced mortality in bile duct-ligated rats. J Am Coll Surg 1999;189:374-9. [CrossRef]
• Comert M, Taneri F, Tekin E, Ersoy E, Oktemer S, Onuk E, et al. The effect of pentoxifylline on the healing of intestinal anasto- mosis in rats with experimental obstructive jaundice. Surg Today 2000;30:896-902. [CrossRef]
• Reynold JV, Murchan P, Leonard N, Clarke P, Keane FBV, Tanner WA. Gut barier failure in experimental obstructive jaundice. J Surg Res 1996;62:11-6. [CrossRef]
• Memiş D, Yelken B, Şahin SH, Vatan İ, Yardım T. The effect of the prebiotic solutions in treatment of severe sepsis. Balkan Med J 2007;24:194-9.
• Nieuwenhuijs VB, Van Dijk JE, Gooszen HG, Akkermans LMA. Ob- structive jaundice, bacterial translocation and interdigestive small- bowel motility in rats. Digestion 2000;62:255-61. [CrossRef]
• Gencer A, Ozdemir Y, Sucullu I, Filiz AI, Yucel E, Akin ML, et al. The effects of enteral immunonutrient products and total paren- teral nutrition in patients who underwent major abdominal sur- gery. Balkan Med J 2010;27:404-10.
• Luyer MD, Jacobs J, Vreugdenhil AC, Hadfoune M, Dejong CH, Buurman WA, et al. Enteral administration of high-fat nutrition be- fore and directly after hemorrhagic shock reduces endotoxemia and bacterial translocation. Ann Surg 2004;239:257-64. [CrossRef]
• Luyer MD, Buurman WA, Hadfoune M, Jacobs JA, Konstantinov SR, Dejong CH, et al. Pretreatment with high-fat enteral nutri- tion reduces endotoxin and tumor necrosis factor-alpha and pre- serves gut barrier function early after hemorrhagic shock. Shock 2004;21:65-71. [CrossRef]
• Vreugdenhil AC, Rousseau CH, Hartung T, Greve JW, van’t Veer C, Buurman WA. Lipopolysaccharide (LPS)-binding pro- tein mediates LPS detoxification by chylomicrons. J Immunol 2003;170:1399-405.
• Parks RW, Clements WD, Smye MG, Pope C, Rowlands BJ, Dia- mond T. Intestinal barrier dysfunction in clinical and experimental obstructive jaundice and its reversal by internal biliary drainage. Br J Surg 1996;83:1345-9. [CrossRef]
• Sewnath ME, Karsten TM, Prins MH, Rauws EJ, Obertop H, Gouma DJ. A meta-analysis on the efficacy of preoperative bili- ary drainage for tumors causing obstructive jaundice. Ann Surg 2002;236:17-27. [CrossRef]
• Parks RW, Stuart Cameron CH, Gannon CD, Pope C, Diamond T, Rowlands BJ. Changes in gastrointestinal morphology associated with obstructive jaundice. J Path 2000;192:526-32. [CrossRef]
• Erbil Y, Berber E, Ozarmagan S, Seven R, Eminoglu L, Calis A, et al. The effects of sodium deoxycholate, lactulose and gluta- mine on bacterial translocation in common bile duct ligated rats. Hepatogastroent 1999;46:2791-8.
• Aldemir M, Geyik MF, Kokoglu OF, Buyukbayram H, Hosoglu S, Yagmur Y. Effects of ursodeoxycholic acid, glutamine and poly- clonal immunoglobulins on bacterial translocation in common bile duct ligated rats. ANZ J Surg 2003;73:722-6. [CrossRef]
• Luyer MDP, Buurman WA, Hadfoune M, Jacobs JA, Dejong CHC, Greve JVM. High-fat enteral nutrition reduces endotoxin, tumor ne- crosis factor-alpha and gut permeability in bile duct-ligated rats sub- jected to hemorrhagic shock. J Hepatol 2004;41:377-83. [CrossRef]
• Karatepe O, Acet E, Battal M, Adas G, Kemik A, Altiok M, et al. Ef- fects of glutamine and curcumin on bacterial translocation in jaun- diced rats. World J Gastroenterol 2010;16:4313-20. [CrossRef]
• Kaya O, Ozdemir F, Atli M, Aslan V, Cagatay M, Anlar M, et al. The effects of ciprofloxacin and ursodeoxycholic acid on bacte- rial translocation in obstructive jaundice. Turk J Gastroenterol 2009;20:186-91.
• Geyik MF, Aldemir M, Hosoglu S, Ayaz C, Satilmis S, Buyuk- bayram H, et al. The effects of Saccharomyces boulardii on bac- terial translocation in rats with obstructive jaundice. Ann R Coll Surg Engl 2006;88:176-80. [CrossRef]
• Gencay C, Kilicoglu SS, Kismet K, Kilicoglu B, Erel S, Muratoglu S, et al. Effect of honey on bacterial translocation and intesti- nal morphology in obstructive jaundice. World J Gastroenterol 2008;14:3410-5. [CrossRef]
• Gennari R, Alexander W, Gianotti L, Eaves-Pyles T, Hartmann S. Granulocyte macrophage colony stimulating factor improves survival in two models of gut derived sepsis by improving gut barrier function and modulating bacterial clearance. Ann Surg 1994;220:68-76. [CrossRef]
• Wells CL, Maddaus MA, Simmons RL. Role of the macrophage in the translocation intestinal bacteria. Arch Surg 1987;122:48-53. [CrossRef]
• Narioka J, Nishi M, Ogata Y, Kuwahara T, Nakayama H, Tashiro S, et al. Promotion of bacterial translocation by major liver resec- tion in obstructive jaundice in rats colonised predominantly with indigenous Escherichia coli. J Med Microbiol 2002;51:687-94.
• Wang XD, Parsson H, Andersson R, Soltesz V, Johansson K, Beng- mark S. Bacterial translocation, intestinal ultrastructure and cell membrane permeability early after major liver resection in the rat. Br J Surg 1994;81:579-84. [CrossRef]
• Wiest R, Rath HC. Gastrointestinal disorders of the critically ill. Bacterial translocation in the gut. Best Pract Res Clin Gastroen- terol 2003;17:397-425. [CrossRef]
• Berg RD. Bacterial translocation from the gastrointestinal tract. Trends Microbiol 1995;3:149-54. [CrossRef]
• Gianotti R, Alexander W, Nelson JL, Fukushima R, Pyles T, Chalk CL. Role of early enteral feeding and acute starvation on post- burn bacterial translocation and host defense: prospective, ran- domized trials. Critical Care Med 1994;22:265-72. [CrossRef]