Administration of branched chain amino acids prevents bacterial translocation after liver resection in the cirrhotic rat

  • Takashi Higashiguchi
  • Akihiro Ito
  • Masato Kitagawa
  • Hiroki Taoka
  • Yoshifumi Kawarada
Original Articles
  • 35 Downloads

Abstract

After major liver resection, bacterial infectious complications, including sepsis and endotoxemia, can be at least in part, attributed to translocation of enteric bacteria and endotoxin. We evaluated the effectiveness of the enteral and parenteral administration of branched-chain amino acids (BCAA) in preventing bacterial translocation after 70% liver resection in rats with thioacetamide-induced-cirrhosis. Bacterial translocation after hepatectomy was induced by a disturbance of protein metabolism in intestinal epithelial cells. However, the administration of BCAA, particularly via the enteral route, improved amino acid metabolism in the gut and stimulated the synthesis of nonsecreted protein and the proliferation of crypt cells, thereby preventing bacterial translocation after liver resection. Improvement in this cascade of metabolic reactions is believed to have been responsible for the improved outcome after extensive resection of the cirrhotic liver.

Key words

bacterial translocation liver resection isolated enterocytes protein synthesis 

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References

  1. 1.
    Rigotti P, Peters JC, Tranberg KO, Fischer JE (1986) Effect of amino acid infusions on liver regeneration after partial hepatectomy in the rat. JPEN 10:17–20Google Scholar
  2. 2.
    Saint-Aubert B, Astro C, Andriguetto PC, Yakoun H, Joyeux H (1983). Influence of nutrition on liver regeneration. In: Kleinberger G, Deutsch E (eds) New aspects of clinical nutrition. Karger, Basel, pp 548–557Google Scholar
  3. 3.
    Holecek M, Simek J, Palicka V, Zadak Z (1991) Effect of glucose and branched chain amino acid (BCAA) infusion on onset of liver regeneration and plasma amino acid pattern in partial hepatectomized rats. J Hepatol 13:14–20PubMedCrossRefGoogle Scholar
  4. 4.
    Higashiguchi T, Noguchi T, Kawarada Y, Mizumoto R, Hasselgren PO, Fischer JE (1993) Effect of nutritional management on the alteration of protein and amino acid metabolism in liver, skeletal muscle and gut during sepsis in cirrhosis (in Japanese) Nippon Syokakigeka Gakkai Zashsi (Jpn J Gastroenterol Surg) 26:1157–1162.Google Scholar
  5. 5.
    Higashiguchi T, Yokoi H, Noguchi T, Mizumoto R (1993) Liver failure (in Japanese). Kyukyuigaku (Jpn J Acute Med) 17:1567–1571Google Scholar
  6. 6.
    Wang X, Andersson R, Soltesz R, Bengmark S (1992) Bacterial translocation after major hepatectomy in patients and rats. Arch Surg 127:1101–1106PubMedGoogle Scholar
  7. 7.
    Higgins GM, Anderson RM (1931) Experimental pathology of the liver. I. restoration of liver of white rat following partial surgical removal. Arch Pathol 12:186–202Google Scholar
  8. 8.
    Higashiguchi T, Hasselgren PO, Wagner K, Fischer JE (1993) Effect of glutamine on protein synthesis in isolated intestinal epithelial cells. JPEN 17:307–314Google Scholar
  9. 9.
    Higashiguchi T, Noguchi Y, Noffsinger A, Fischer JE, Hasselgren PO (1994) Sepsis increases production of total secreted protein, vasoactive intestinal peptide, and peptide YY in isolated rat enterocytes. Am J Surg 168:251–256PubMedCrossRefGoogle Scholar
  10. 10.
    Fischer JE, Hasselgren PO (1991) Cytokines and glucocorticoids in the regulation of the “Hepato-skeletal muscle axis” in sepsis. Am J Surg 161:266–271PubMedCrossRefGoogle Scholar
  11. 11.
    Clowes GHA, George BC, Villee CA, Saravis CA (1983) Muscle proteolysis induced by a circulating peptide in patients with sepsis or trauma. N Engl J Med 308:545–552PubMedCrossRefGoogle Scholar
  12. 12.
    Sax HC, Talamini MA, Hasselgren PO, Rosenblum L, Ogle CK, Fischer JE (1988) Increased synthesis of secreted hepatic protein during abdominal sepsis. J Surg Res 44:109–116PubMedCrossRefGoogle Scholar
  13. 13.
    Garlick PJ (1990) Protein turnover in the whole animal and specific tissues. In: Florkin M, Stotz EH (eds) Comprehensive biochemistry: Protein metabolism. Elsevier. Amsterdam, pp 77–152Google Scholar
  14. 14.
    Dobbins WO (1982) Gut immunophysiology: A gastroenterologist’s view with emphasis on pathophysiology. Am J Physiol 242:91–98Google Scholar
  15. 15.
    Van Leeuwen PAM, Boermeester MA, Houdijk AP, Ferwerda CC, Cuesta MA, Meyer S, Wesdorp RIC (1994) Clinical significance of translocation. Gut [Suppl.] 1:S28-S34Google Scholar
  16. 16.
    Deitch EA, Berg R, Specian R (1987) Endotoxin promotes the translocation of bacteria from the gut. Arch Surg 122:185–190PubMedGoogle Scholar
  17. 17.
    Higashiguchi T, Ito A, Kitagawa M, Mizumoto R (1994) New nutritional management during sepsis (in Japanese). Syucyuchiryo (Intensive Crit Care Med) 6:283–292Google Scholar
  18. 18.
    Windmueller HG, Spaeth AE (1974) Uptake and metabolism of plasma glutamine by the small intestine. J Biol Chem 249:5070–5079PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • Takashi Higashiguchi
    • 1
  • Akihiro Ito
    • 1
  • Masato Kitagawa
    • 1
  • Hiroki Taoka
    • 1
  • Yoshifumi Kawarada
    • 1
  1. 1.First Department of SurgeryMie University School of MedicineTsu, MieJapan

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