Small bowel adaptation with growth hormone and glutamine after massive resection of rat's small bowel.

The use of glutamine (GLN) and growth hormone (GH) improves intestinal adaptation in short bowel syndrome (SBS). The present study aimed to assess the effect of a diet rich in glutamine and the use of GH on intestinal adaptation in experimental SBS. 80 Wistar rats (240 g) were randomized into 6 groups: 1) RGLN (20)--95% small bowel resection and fed on GLN diet; 2) RGLNGH (20)--95% SBR, GLN diet and GH; 3) RC (10)--95% SBR and fed on a low GLN control diet (C); 4) RCGH (10)--95% SBR and C diet and GH; 5) TAGLIN (10)--intestinal transection and anastomosis (Ta) and fed on a GLN diet; 6) TAGLNGH (10)--Ta and GLN diet and GH. GH was given SC at a dose of 0.14 mg/kg/day. The rats were weighed daily and nitrogen balance was made. Rats were sacrificed after 15 days and mucosa cell proliferation was studied with PC10 antibody. Statistical analysis was performed. All SBR rats lost weight as compared to their initial weight (8% to 13%). GH improved Ta rats weight (18.98 x 5.04%). The use of GLN diet and GH improved nitrogen balance and bowel growth on SBR groups, as compared to controls, but not cell proliferation. In conclusion, the use of GLN enriched diet and GH improves intestinal adaptation after massive resection of the small bowel in rats.

[Technical and histological standardization of experimental colitis with trinitrobenzenosulfonic acid (TNBS)]. / Padronização técnica e histológica de colite experimental com ácido trinitrobenzenosulfônico (TNBS).

Attempts to reproduce inflammatory colitis have created many experimental models. Since the pioneer work of Morris et al. (1989), trinitrobenzenosulfonic (TNBS) solutions have been used with different dosages. The aims of this work were standardize the induction of colitis, evaluate the clinical and intestinal effects of different doses and verify the reproducibility of the intestinal inflammatory process. Wistar rats were inoculated endo rectally with 2.5 ml solutions of different concentrations of TNBS and ethanol, and the rats were sacrificed after 14 days. According to the solution concentrations of TNBS (mg) and ethanol (%), six groups of animals were established: Control (saline), 30 mg/30%, 30 mg/40%, 30 mg/50%, 50 mg/10% and 50 mg/30%. Statistical analysis of food ingestion showed no differences between groups (p = 0.247). The 30/50 group presented greater weight loss when compared to 50/10 and 50/30 groups (p = 0.012). Groups 30/50 and 30/40 showed greater degrees of macroscopic lesion than control and 50/10 group (p < 0.05). Histologic lesion was not uniform to all rats regardless of the solution employed. Group 50/10 presented the less severe histologic alterations; on the other hand, 30/40 and 30/50 groups had important changes on mucosal thickness, on vascularization and ulceration. The authors conclude that experimental colitis with TNBS 1) cause intestinal lesions that are not uniform to all animals, although they may be reproduced in many of them; 2) with the same doses of TNBS, the increase in ethanol concentrations leads to a greater inflammatory process, intestinal thickness, vascularization, abscess formation and intestinal ulceration; 3) 50/10 and 50/30 solutions make less severe lesions when compared to 30/40 and 30/50 solutions; 4) 30/50 solution was the best one, as it produces inflammation 90% of the animals, increases in wall thickness in 50%, abscess in 70% and ulceration in 38%.

Protective effects of glutamine enriched diets on acute actinic enteritis.

Radiotherapy plays an important role in cancer treatment, although it may cause collateral effects and sever complications due to cellular damage of peritumoral tissues. Recently different nutritional resources have been indicated to achieve intestinal protection during cancer irradiation. The aim of this study was to set the role of glutamine in acute actinic enteritis prevention. Sixty-five Wistar male rats (200 g) were maintained in individual metabolic cages, where body weight and food ingestion were carefully monitored daily. The animals were chosen at random in three groups and fed isocaloric and isoproteid diets: 1) CRt (23)-polymeric-casein diet (CD); 2) GRt (22)-polymeric-casein diet supplemented with 2% glutamine (GD), and 3) ERt (20)--elemental diet supplemented with 2% glutamine (ED). After an adaptation period (seven days), all rats received 1500 cGy of abdominal radiation in five equal daily doses of 300 cGy. After three days post radiation the rats were submitted to jejunal perfusion test with polyethylene-glicol 4000. Finally, small bowel and colon were resected for histological evaluation. It was observed that ERt group had greater average daily food intake than CRt and GRt groups during all periods (p < 0.05). All rats had equal weight gain during adaptation period; during irradiation all the animals had weight loss, but ERt group had smaller weight loss than CRt. All rats recovered weight after irradiation, and ERt group presented better results than the others (p < 0.05). Sodium transepithelial transport average values (mEq/min/cm) were negative and not statistically different in all groups. Small bowel histological evaluation in ERt and GRt rats were better than CRt rats, by preserving mucosal cellularity and increasing mitosis number and villi length (p < 0.05). Simultaneously, ERt group had greater number of rats with normal villuscrypt relation than CRt of CRt groups (p < 0.05). Large bowel histological data showed that the average crypt's length in ERt and GRt rats were greater than in CRt ones (p < 0.05). By the present work, an elemental diet enriched with 2% glutamine favored greater food ingestion and lessened weight loss during and after radiotherapy. Glutamine-supplemented polymeric or elemental diets given to rats before, during and after abdominal radiotherapy showed protective effects against radiation injury, by supporting mucosal structure and recovery.

[The role of glutamine in nutrition in clinical practice]. / Importância da glutamina em nutrição na prática clínica.

Nutritional therapy using nutrients with pharmacological properties has been intensively discussed in the recent literature. Among these nutrients, glutamine has gained special attention. Glutamine is the most abundant amino acid in the blood stream of the mammals and, besides it has been considered a non-essential amino acid, glutamine is a non-dispensable nutrient in catabolic states. In this situation, there are alterations in its inter-organic flux, leading to lower plasmatic concentrations. Glutamine is the main fuel to enterocytes and it has an important role in the maintenance of intestinal structure and functions. Moreover, supplementation with glutamine has proved to be beneficial to the immunological system functions, improves nitrogen balance and nutritional parameters in the post-operative period and lessens protein loss in severe catabolic states. For these reasons, glutamine enriched-diets must be considered in the nutritional support of many diseases; new controlled, prospective and randomized studies will help to define what group of patients can really benefit from glutamine supplementation.

Alteraçöes histopatológicas do intestino delgado após preservaçäo hipotérmica com as soluçöes da Universidade de Wisconsin e Euro-Collins. Estudo experimental / Histopathological changes of the small bowel after hypothermic preservation with University of Wisconsin and Euro-Collins solutions. Experimental study

Existe interesse em prolongar o tempo de isquemia hipotérmica do intestino delgado (ID) com o uso de soluçöes de preservaçäo. OBJETIVO. Oobjetivo deste trabalho foi comparar as alteraçöes do ID isolado sob preservaçäohipotérmica com as soluçöes da Universidade de Wisconsin (UW) e Euro-Collins (EC) utilizando método de análise histopatológica. MÉTODO. Utilizaram-se 40 ratos Wistar (250-300g) cujo ID foi retirado por meio de técnica microcirúrgica e tratado com soluçäo UW ou soluçäo EC. Realizaram-se biópsias do jejuno proximal e íleo distal periodicamente, de 8 em 8 horas, a partir da retirada do ID (tempo 0) até 48 horas. Classificaram-se as alteraçöes histopatológicas encontradas no ID, quantitativamente, em 4 graus de gravidade de lesäo. De acordo com a progressäo de degeneraçäo hidrópica na vilosidade, os resultados obtidos foram analisados por estatística näo-paramétrica (p<0,05). RESULTADOS. Observou-se aumento significante da freqüência do acometimento do ID por lesöes isquêmicas ao longo dos períodos de tempo analisados para ambos os grupos. A freqüência e a gravidade das lesöes foram significantemente maiores no grupo EC do que no grupo UW, para os segmentos jejunais no tempo 8 horas, no jejuno e íleo no tempo 24 horas, e no jejuno e íleo no tempo 48 horas. CONCLUSÄO. concluiu-se que a soluçäo UW näo impediuo aparecimento de lesöes isquêmicas do ID, porém apresentou melhor açäo protetora, ao longo do tempo, nos segmentos jejunal e ileal, reduzindo a gravidade e a freqüência das lesöes histopatológicas, quando comparada com a soluçäo EC

[Histopathological changes in the small intestine after hypothermic preservation with University of Wisconsin and Euro-Collins solutions. Experimental study]. / Alterações histopatológicas do intestino delgado após preservação hipotérmica com as soluções da Universidade de Wisconsin e Euro-Collins. Estudo experimental.

PURPOSE: The objective of this study is to compare small bowel histopathologic alterations under hypothermic preservation with University of Wisconsin (UW) and Euro-Collins (EC) solutions. METHODS: In 40 Wistar rats (250-300g) the small bowel was microsurgically withdrawn and randomly treated with UW solution or EC solution. Periodic intestinal biopsies were taken from the proximal jejunum and distal ileum each 8 hours after small bowel withdrawing (time 0) until 48 hours. The histopathologic alterations were semiquantitatively classified in 4 degrees of severity and the obtained results were analysed statistically by appropriated tests (p < 0.05). RESULTS: There was a significant increase of the small bowel ischaemic lesions over the time for both experimental groups. The lesions frequency and severity were significantly more increased in the EC group than in the UW group, for jejunal segments at 8 hours, in jejunal and ileal segments at 24 and in jejunal and ileal segments at 48 hours. CONCLUSION: The UW solution did not avoid the development of small bowel ischaemic lesions but, with time, it protected better jejunal and ileal segments, decreasing frequency and severity of histopathological alterations, when compared to EC solution.

Efeitos protetores da glutamina e dieta elementar na enterocolite actínica aguda: avaliaçäo histológica / Protective effects of glutamine and elemental diet in acute actinic enterocolitis: histological evaluation

O emprego da radioterapia abdominal pode ocasionar a enterite actínica aguda. A utilizaçäo de formulaçöes nutricionais especiais tem sido proposta a fim de proteger o intestino durante e após a irradiaçäo. OBJETIVO. Avaliar histologicamente o efeito protetor de dietas polimétricas e elementares enriquecidas com glutamina na prevençäo da enterite actínica aguda. MÉTODOS. Foram estudados 65 ratos machos, adultos, da raça Wistar, monitorizados diariamente quanto à ingestäo e às variaçöes de peso corpóreo. Os animais foram randomizados em três grupos e alimentados com dietas isocalóricas e isonitrogenadas: 1) CRt - dieta polimérica com caseína enriquecida com glutamina a 2 por cento; e 3) ERt - dieta elementar enriquecida com glutamina a 2 por cento. O experimento constou de períodos de adaptaçäo (7 dias), de irradiaçäo (5 dias) e de recuperaçäo (3 dias). Após a adapataçäo alimentar, todos os ratos receberam irradiaçäo abdominal fracionada em 5 doses diárias de 300cGy.quatro dias após o término da irradiaçäo, os ratos foram operados para ressecar o intestino delgado e o cólon para estudo histopatológico. RESULTADOS. Os grupos ERt e GRt apresentaram número significativamente maior de ratos com aumento da celularidade, do número de mitoses e médias superiores de altura das vilosidades em comparaçäo à CRt no intestino delgado. O grupo ERt apresentou, ainda maior número de ratos com relaçäo das alturas vilosidade-cripta normal do que os grupos CRt ou GRt, que näo apresentaram diferença estatística entre si. No intestino grosso, as médias de altura das criptas dos grupos ERt e GRt foram iguais e superiores às de CRt; os três grupos näo apresentaram, porém, diferença significante em relaçäo à celularidade epitelial e ao número de mitoses nas criptas do cólon. CONCLUSAO. Nas condiçöes do presente trabalho, a suplementaçäo alimentar com glutamina antes, durante e após a irradiaçäo abdominal em ratos, em dieta polimérica ou elementar, determinou efeitos protetores sobre o intestino irradiado, preservando sua arquitetura morfológica e a capacidade de recuperaçäo, sobretudo no intestino delgado

[Protective effects of glutamine and elemental diet in acute actinic enterocolitis: histological evaluation]. / Efeitos protetores da glutamina e dieta elementar na enterocolite actínica aguda: avaliação histológica.

Radiotherapy plays nowadays an important role in malignancies treatment. However, collateral effects and severe complications owing to cellular damage of peritumoral tissues may occur. Different nutritional resources have been recently indicated to achieve intestinal protection during cancer irradiation. PURPOSE--The aim of this study was to set the role of glutamine and elemental diets in acute actinic enteritis prevention. METHOD--Sixty-five adult male Wistar rats with average weight of 200g were maintained in individual metabolic cages; daily body weight and food ingestion were carefully monitored. The animals were randomized into three groups and fed isocaloric and isonitrogenous diets: 1) CRt-polymeric-casein diet; 2) GRt-polymeric-casein diet supplemented with 2% glutamine and 3) ERt-elemental diet supplemented with 2% glutamine. After an adaptation period (seven days), all rats received abdominal radiation in five daily doses of 300cGy. Four days after the rats were operated on to resect the small intestine and colon for histological evaluation. RESULTS--Small intestine histological data in ERt and GRt rats were better than CRt rats, by preserving mucosal cellularity and increasing mitosis number and villi length. Simultaneously, ERt group had greater number of rats with normal villus-crypt relation than CRt or GRt groups. Large intestine histological data showed that the average crypts length in ERt and GRt rats were greater than in CRt ones. CONCLUSION--Glutamine-supplemented polymeric or elemental diets given to rats before, during and after abdominal radiotherapy showed protective effects against radiation injury, by supporting mucosal structure and recovery.