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Effect of Oral Glutamine Administration on Bacterial Tanslocation, Endotoxemia, Liver and Ileal Morphology, and Apoptosis in Rats with Obstructive Jaundice

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Abstract

Postoperative complications in patients with obstructive jaundice remain increased when associated with endotoxemia and the inflammatory response due to gut barrier failure. Administration of glutamine has been proposed to maintain the integrity of the gut mucosa and thus reduce bacterial translocation (BT), but the effects of this pretreatment on apoptosis and histologic morphology of various organs affected by BT in obstructive jaundice have not been studied. We therefore studied the effects of oral glutamine supplementation on endotoxemia, BT, liver and terminal ileal morphology, and apoptosis in an experimental model of obstructive jaundice. A total of 60 male Wistar rats were randomly divided into four groups of 15 each: I, controls; II, sham-operated; III, bile duct ligation (BDL); IV, BDL + glutamine (4.5 g/kg/day in drinking water). Ileal samples for histology, DNA and protein content, liver biopsies, mesenteric lymph nodes (MLNs) for culture, and portal and systemic blood samples for endotoxin measurements were obtained 10 days later. Compared to the controls, a significant increase in contaminated MLN and liver samples and increased endotoxemia were noted in group III (p < 0.01) but were significantly reduced in group IV (p < 0.05). Group IV also had a significantly higher number of mitoses per crypt (M/c) (p < 0.05), less apoptotic body counts (ABCs) (p < 0.05), and a higher DNA content than did group III (p < 0.05). Liver biopsies from group III displayed typical changes of large duct obstruction that significantly improved after glutamine treatment, with decreased ductular proliferation.

We concluded that supplementation of oral glutamine in the presence of obstructive jaundice ameliorates BT, endotoxemia, and apoptosis and improves the ileal and liver histology.

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References

  1. Dixon JM, Armstrong CP, Duffy SW, et al. Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. Gut 1983;24:845

    PubMed  CAS  Google Scholar 

  2. Deitch EA, Sittig K, Li M, et al. Obstructive jaundice promotes bacterial translocation from the gut. Am. J. Surg. 1990;159:79

    PubMed  CAS  Google Scholar 

  3. Deitch EA. Simple intestinal obstruction causes bacterial translocation in man. Arch. Surg. 1989;124:699

    PubMed  CAS  Google Scholar 

  4. Lemaire LC, van Lanschot JJ, Stoutenbeek CP, et al. Bacterial translocation in multiple organ failure: cause or epiphenomenon still unproven. Br. J. Surg. 1997;84:1340

    Article  PubMed  CAS  Google Scholar 

  5. Newsholme P. Why is l-glutamine metabolism important to cells of the immune system in health, postinjury, surgery or infection? J. Nutr. 2001;131:2515S

    CAS  Google Scholar 

  6. Salvalaggio PR, Neto CZ, Tolazzi AR, et al. Oral glutamine does not prevent bacterial translocation in rats subjected to intestinal obstruction and Escherichia coli challenge but reduces systemic bacteria spread. Nutrition 2002;18:334

    PubMed  CAS  Google Scholar 

  7. Souba WW, Klimberg VS, Hautamaki RD, et al. Oral glutamine reduces bacterial translocation following abdominal radiation. J. Surg. Res. 1990;48:1

    PubMed  CAS  Google Scholar 

  8. Lowry OH, Rosenbrough NS, Farr AL, et al. Protein measurement with folin phenol reagent. J. Biol. Chem. 1951;193:265

    PubMed  CAS  Google Scholar 

  9. Giles KW, Myers M. Improved diphenylamine method for estimation of DNA. Nature 1965;206:93

    CAS  Google Scholar 

  10. Lee RG, Nakamura K, Tsamandas AC, et al. Pathology of human intestinal transplantation. Gastroenterology 1996;110:1820

    PubMed  CAS  Google Scholar 

  11. Deitch EA. Bacterial translocation of the gut flora. J. Trauma 1990;30:S184

    PubMed  CAS  Google Scholar 

  12. Scopa CD, Koureleas S, Tsamandas AC, et al. Beneficial effects of growth hormone and insulin-like growth factor I on intestinal bacterial translocation, endotoxemia, and apoptosis in experimentally jaundiced rats. J. Am. Coll. Surg. 2000;190:423

    Article  PubMed  CAS  Google Scholar 

  13. Assimakopoulos SF, Vagianos CE, Patsoukis N, et al. Evidence for intestinal oxidative stress in obstructive jaundice-induced gut barrier dysfunction in rats. Acta Physiol. Scand. 2004;180:177

    Article  PubMed  CAS  Google Scholar 

  14. Wells CL, Jechorek RP, Erlandsen SL. Inhibitory effect of bile on bacterial invasion of enterocytes: possible mechanism for increased translocation associated with obstructive jaundice. Crit. Care Med. 1995;23:301

    PubMed  CAS  Google Scholar 

  15. Reeds PJ, Burrin DG. Glutamine and the bowel. J. Nutr. 2001;131:2505S

    PubMed  CAS  Google Scholar 

  16. Labow BI, Souba WW. Glutamine. World J Surg 2000;24:1503

    PubMed  CAS  Google Scholar 

  17. Kapadia CR, Colpoys MF, Jiang ZM, et al. Maintenance of skeletal muscle intracellular glutamine during standard surgical trauma. J.P.E.N. J. Parenter. Enteral. Nutr. 1985;9:583

    CAS  Google Scholar 

  18. Greig JE, Keast D, Garcia-Webb P, et al. Inter-relationships between glutamine and other biochemical and immunoiogical changes after major vascular surgery. Br. J. Biomed. Sci. 1996;53:116

    PubMed  CAS  Google Scholar 

  19. Aldemir M, Geyik MF, Kokoglu OF, et al. Effects of ursodeoxycholic acid, glutamine and polyclonal immunoglobulins on bacterial translocation in common bile duct ligated rats. A.N.Z.J. Surg. 2003;73:722

    Article  Google Scholar 

  20. Zulfikaroglu B, Zulfikaroglu E, Ozmen MM, et al. The effect of immunonutrition on bacterial translocation, and intestinal villus atrophy in experimental obstructive jaundice. Clin. Nutr. 2003;22:277

    PubMed  CAS  Google Scholar 

  21. Fox AD, Kripke SA, De Paula J. Effect of a glutamine-supplemented enteral diet on methotrexate-induced enterocolitis. J.P.E.N. J. Parenter. Enteral. Nutr. 1988;12:325

    CAS  Google Scholar 

  22. Karatzas T, Scopa S, Tsoni I, et al. Effect of glutamine on intestinal mucosal integrity and bacterial translocation after abdominal radiation. Clin. Nutr. 1991;10:188

    Google Scholar 

  23. Bertok L. Physico-chemical defense of vertebrate organisms: the role of bile acids in defense against bacterial endotoxins. Perspect. Biol. Med. 1977;21:70

    PubMed  CAS  Google Scholar 

  24. Assimakopoulos SF, Scopa CD, Georgiou C, et al. Altered enterocyte occludin expression and intestinal oxidative stress in obstructive jaundice-induced gut barrier dysfunction. Eur. Surg. Res. 2003;35:105

    Google Scholar 

  25. Reynolds JV, Murchan P, Redmond HP, et al. Failure of macrophage activation in experimental obstructive jaundice: association with bacterial translocation. Br. J. Surg. 1995;82:534

    PubMed  CAS  Google Scholar 

  26. Bemelmans MH, Gouma DJ, Greve JW, et al. Cytokines tumor necrosis factor and interleukin-6 in experimental biliary obstruction in mice. Hepatology 1992;15:1132

    PubMed  CAS  Google Scholar 

  27. Steller H. Mechanisms and genes of cellular suicide. Science 1995;267:1445

    PubMed  CAS  Google Scholar 

  28. Potten CS. Stem cells in gastrointestinal epithelium: numbers, characteristics and death. Philos. Trans. R. Soc. Lond. B Biol. Sci. 1998;353:821

    PubMed  CAS  Google Scholar 

  29. Thompson CB. Apoptosis in the pathogenesis and treatment of disease. Science 1995;267:1456

    PubMed  CAS  Google Scholar 

  30. Parks RW, Stuart Cameron CH, Gannon CD, et al. Changes in gastrointestinal morphology associated with obstructive jaundice. J. Pathol. 2000;192:526

    Article  PubMed  CAS  Google Scholar 

  31. Karinch AM, Pan M, Lin CM, et al. Glutamine metabolism in sepsis and infection. J. Nutr. 2001;131:2535S

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, University of Patras, School of Medicine, Patras, 26500 , Greece

    Vassilios G. Margaritis M.D. & Vassiliki N. Nikolopoulou M.D.

  2. Department of Anaesthesiology and Critical Care Medicine, University of Patras, School of Medicine, Patras, 26500, Greece

    Kriton S. Filos M.D.

  3. Department of Endocrinology, University of Patras, School of Medicine, Patras, 26500, Greece

    Marina A. Michalaki M.D.

  4. Department of Pathology, University of Patras, School of Medicine, Patras, 26500 , Greece

    Chrisoula D. Scopa M.D.

  5. Department of Microbiology, University of Patras, School of Medicine, Patras, 26500 , Greece

    Iris Spiliopoulou M.D.

  6. Department of Surgery, University of Patras, School of Medicine, Patras, 26500 , Greece

    Constantine E. Vagianos M.D.

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  1. Vassilios G. Margaritis M.D.
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  2. Kriton S. Filos M.D.
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  3. Marina A. Michalaki M.D.
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  4. Chrisoula D. Scopa M.D.
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  5. Iris Spiliopoulou M.D.
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  6. Vassiliki N. Nikolopoulou M.D.
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  7. Constantine E. Vagianos M.D.
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Correspondence to Constantine E. Vagianos M.D..

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Margaritis, V.G., Filos, K.S., Michalaki, M.A. et al. Effect of Oral Glutamine Administration on Bacterial Tanslocation, Endotoxemia, Liver and Ileal Morphology, and Apoptosis in Rats with Obstructive Jaundice. World J. Surg. 29, 1329–1334 (2005). https://doi.org/10.1007/s00268-005-7721-4

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  • DOI: https://doi.org/10.1007/s00268-005-7721-4

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