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Effect of timing of glutamine-enriched enteral nutrition on intestinal damage caused by irradiation

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Abstract

Intestinal mucosal damage and bacterial translocation are clinical problems that may be caused by the use of ionizing radiation. Glutamine (Gln) support reduces the mucosal barrier in several ways. This study was undertaken to investigate the effect of timing of Gln-enriched enteral nutrition (EN) on bacterial translocation and mucosal damage due to radiotherapy (RT). A rat model of whole body irradiation was designed in which a single dose of 485 cGy was given. A total of 50 rats were randomly assigned to the following 5 groups, each of which comprised 10 rats: (1) balanced rat chow given for 8 days without RT (group 1); (2) balanced rat chow given 4 days before and 4 days after RT (group 2); (3) Gln-enriched EN given 4 days before RT (group 3); (4) Gln-enriched EN given 4 days after RT (group 4); and (5) Gln-enriched EN given 4 days before and 4 days after RT (group 5). Mesenteric lymph node and ileum samples were removed for evaluation of bacterial translocation (BT) and histopathologic investigation, respectively. BT and intestinal mucosal injury scores in all rats that received RT were higher than in rats without RT. No difference was seen in parameters between groups 3 and 4 (P>.05, P>.016, respectively); BT and intestinal mucosal injury scores of group 5 were significantly lower than those of groups 3 and 4 (P<.05, P<.016, respectively). Meanwhile, the BT and mesenteric injury scores of group 5 were significantly lower than those of group 2 (P<.05, P<.016, respectively). As a result, intestinal injury due to RT was significantly decreased by Gln-enriched EN support given before and after whole body RT.

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Authors and Affiliations

  1. Department of General Surgery, Gazi University Faculty of Medicine, Besevler, 06500, Ankara, Turkey

    Bülent Salman MD (Fellow), Mehmet Oguz MD (Prof), Mustafa Kerem MD (Fellow) & Utku Yilmaz MD (Resident)

  2. Department of Radiation Oncology, Gazi University Faculty of Medicine, Turkey

    Müge Akmansu MD (Prof)

  3. Department of Biochemistry, Zübeyde Hanim Maternity Hospital, Turkey

    Ilhan Bebitoglu MD (Pathologist)

  4. Department of Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey

    Gülcin Akca MD (Fellow) & Nedim Sultan MD (Prof)

  5. Department of General Surgery, Karaelmas University Faculty of Medicine, Zonguldak, Turkey

    Ugur Emre MD (Fellow)

Authors
  1. Bülent Salman MD
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  2. Mehmet Oguz MD
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  3. Müge Akmansu MD
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  4. Ilhan Bebitoglu MD
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Correspondence to Bülent Salman MD.

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Salman, B., Oguz, M., Akmansu, M. et al. Effect of timing of glutamine-enriched enteral nutrition on intestinal damage caused by irradiation. Adv Therapy 24, 648–661 (2007). https://doi.org/10.1007/BF02848790

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