Aim:
To investigate the mechanism underlying intestinal barrier function damage after severe trauma and the therapeutic effect of glutamine.
Methods:
Burned patients, and animal models of severe trauma replicated by hemorrhagic shock combined with endotoxin infusion and burn injury, were included in a serial experiment. Effects of oral glutamine on intestinal barrier function were observed in scalded rats. Parameters measured in these experiments were as follows: plasma levels of diamine oxidase (DAO), tumor necrosis factor (TNFalpha), endotoxin (LPS), and lactate as well as D-lactate by biochemical methods, lactose/mannitol (L/M) ratio in urine by SP-3400, and pathological examination of intestinal mucosa under light microscopy.
Results:
Plasma DAO activity was significantly increased after injury. There was a negative correlation between plasma DAO and intestinal mucosal DAO or pHi (r=-0.93, plasma 0.80+/-0.93,2.83+/-1.71, 1.14+/-0.64,2.36+/-2.06 and 2.49+/-1.67 vs intestinal 0.52+/-0.12,0.34+/-0.03,0.45+/-0.18,0.37+/-0.26 and 0.41+/-0.07 r=-0.533, plasma 0.87+/-0.75, 1.89+/-1.13,1.21+/-0.23,3.03+/-2.61 and 4.70+/-1.22 vs pHi 7.03+/-0.05,7.05+/-0.06,7.14+/-0.096, 7.20+/-0.08 and 7.05+/-0.07 P<0.01-0.05). Positive correlations were found between DAO activity and plasma TNFalpha, LPS, lactate, L/M and D-lactate (r=0.817, 0.842, 0.872, and 0.951 plasma DAO 0.87+/-0.75,1.89+/-1.13,1.21+/-0.23,3.03+/-2.61 and 4.70+/-1.22 vs TNF 0.08+/-0.02,0.03+/-0.25, 0.17+/-0.09,0.34+/-0.15 and 0.33+/-0.18 vs LPS 0.14+/-0.03,0.16+/-0.04,0.21+/-0.02,0.18+/-0.16 and 0.37+/-0.10 vs lactate 9.03+/-2.19,18.30+/-2.56, 9.81+/-2.83,12.01+/-6.83,12.01+/-6.84 and 43.61+/-11.27 vs L/M 0.03+/-0.01,0.41+/-0.27,0.62+/-0.20, 1.70+/-0.60 r=0.774, plasma DAO 1.25+/-0.41 2.17+/-0.71 2.29+/-0.87 1.23+/-0.55 and 1.11+/-0.47 vs D-lactate 8.37+/-2.48,18.25+/-6.18, 13.96+/-4.94,8.93+/-3.00 and 12.39+/-4.94 all P<0.01), respectively. Damage of intestinal mucosa was found by pathological examination. Intestinal barrier function was improved to a certain extent by oral glutamine in scalded rats.
Conclusion:
Intestinal barrier function was damaged in the early stage after trauma. Plasma DAO activity, D-lactate content, intestinal pHi and urine L/M may be sensitive markers of intestinal mechanical injury, and glutamine may protect against intestinal barrier dysfunction after severe trauma.
Citing Articles
Impact of Glutamine-Enhanced Parenteral Nutrition on Postoperative Outcomes in Colorectal Cancer Patients.
Huang Y, Yin C, Wang J, Wang M, Zheng X, Xie M
Cancer Manag Res. 2024; 16:1329-1344.
PMID: 39372706
PMC: 11456277.
DOI: 10.2147/CMAR.S476648.
Tannic acid-chelated zinc supplementation alleviates intestinal injury in piglets challenged by porcine epidemic diarrhea virus.
Zhang Z, Wang S, Zheng L, Hou Y, Guo S, Wang L
Front Vet Sci. 2022; 9:1033022.
PMID: 36299630
PMC: 9589514.
DOI: 10.3389/fvets.2022.1033022.
Effects of Immobilized Antimicrobial Peptides on Growth Performance, Serum Biochemical Index, Inflammatory Factors, Intestinal Morphology, and Microbial Community in Weaning Pigs.
Liu N, Ma X, Jiang X
Front Immunol. 2022; 13:872990.
PMID: 35422808
PMC: 9001916.
DOI: 10.3389/fimmu.2022.872990.
Dietary Lycopene Supplementation Could Alleviate Aflatoxin B Induced Intestinal Damage through Improving Immune Function and Anti-Oxidant Capacity in Broilers.
Sarker M, Wan X, Yang H, Wang Z
Animals (Basel). 2021; 11(11).
PMID: 34827896
PMC: 8614560.
DOI: 10.3390/ani11113165.
Effects of Dietary Zeolite Supplementation as an Antibiotic Alternative on Growth Performance, Intestinal Integrity, and Cecal Antibiotic Resistance Genes Abundances of Broilers.
Qu H, Cheng Y, Chen Y, Li J, Zhao Y, Zhou Y
Animals (Basel). 2019; 9(11).
PMID: 31683981
PMC: 6912609.
DOI: 10.3390/ani9110909.
Effects of dietary supplementation with on the performance, intestinal physical barrier function, and the expression of NOD-like receptors in weaned piglets.
Wang S, Li H, Du C, Liu Q, Yang D, Chen L
PeerJ. 2018; 6:e6060.
PMID: 30588399
PMC: 6302781.
DOI: 10.7717/peerj.6060.
l-Glutamine Attenuates Apoptosis Induced by Endoplasmic Reticulum Stress by Activating the IRE1α-XBP1 Axis in IPEC-J2: A Novel Mechanism of l-Glutamine in Promoting Intestinal Health.
Jiang Q, Chen J, Liu S, Liu G, Yao K, Yin Y
Int J Mol Sci. 2017; 18(12).
PMID: 29206200
PMC: 5751220.
DOI: 10.3390/ijms18122617.
Injury and mechanism of recombinant E. coli expressing STa on piglets colon.
Lv Y, Li X, Zhang L, Shi Y, Du L, Ding B
J Vet Med Sci. 2017; 80(2):205-212.
PMID: 29187713
PMC: 5836754.
DOI: 10.1292/jvms.17-0528.
Effects of lactadherin on plasma D-lactic acid and small intestinal MUC2 and claudin-1 expression levels in rats with rotavirus-induced diarrhea.
Xu R, Lei Y, Shi J, Zhou Y, Chen Y, He Z
Exp Ther Med. 2016; 11(3):943-950.
PMID: 26998017
PMC: 4774346.
DOI: 10.3892/etm.2016.3015.
GABA selectively increases mucin-1 expression in isolated pig jejunum.
Braun H, Sponder G, Pieper R, Aschenbach J, Deiner C
Genes Nutr. 2015; 10(6):47.
PMID: 26471792
PMC: 4607675.
DOI: 10.1007/s12263-015-0497-8.
Changes in intestinal microflora in rats with acute respiratory distress syndrome.
Li Y, Liu X, Ma M, Qi Z, Zhang X, Li Z
World J Gastroenterol. 2014; 20(19):5849-58.
PMID: 24914345
PMC: 4024794.
DOI: 10.3748/wjg.v20.i19.5849.
Are there any different effects of Bifidobacterium, Lactobacillus and Streptococcus on intestinal sensation, barrier function and intestinal immunity in PI-IBS mouse model?.
Wang H, Gong J, Wang W, Long Y, Fu X, Fu Y
PLoS One. 2014; 9(3):e90153.
PMID: 24595218
PMC: 3940848.
DOI: 10.1371/journal.pone.0090153.
Effects of penehyclidine hydrochloride on rat intestinal barrier function during cardiopulmonary bypass.
Sun Y, Cao H, Jin Q, Diao Y, Zhang T
World J Gastroenterol. 2011; 17(16):2137-42.
PMID: 21547135
PMC: 3084401.
DOI: 10.3748/wjg.v17.i16.2137.
Safety and efficacy of Qingre Buyi Decoction in the treatment of acute radiation proctitis: a prospective, randomized and controlled trial.
Wang L, Zhang Z, Tu X, Zou Z, Liu J, Wang Y
Chin J Integr Med. 2009; 15(4):272-8.
PMID: 19688315
DOI: 10.1007/s11655-009-0272-z.
Recombinant human growth hormone improves survival and protects against acute lung injury in murine Staphylococcus aureus sepsis.
Yi C, Cao Y, Mao S, Liu H, Ji L, Xu S
Inflamm Res. 2009; 58(12):855-62.
PMID: 19536455
DOI: 10.1007/s00011-009-0056-0.
Prevention and treatment of gastrointestinal dysfunction following severe burns: a summary of recent 30-year clinical experience.
Xiao S, Zhu S, Xia Z, Lu W, Wang G, Ben D
World J Gastroenterol. 2008; 14(20):3231-5.
PMID: 18506931
PMC: 2712858.
DOI: 10.3748/wjg.14.3231.
Effects of glutamine supplementation on gut barrier, glutathione content and acute phase response in malnourished rats during inflammatory shock.
Belmonte L, Coeffier M, Le Pessot F, Miralles-Barrachina O, Hiron M, Leplingard A
World J Gastroenterol. 2007; 13(20):2833-40.
PMID: 17569119
PMC: 4395635.
DOI: 10.3748/wjg.v13.i20.2833.
Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity.
Lin M, Kung S, Yeh S, Liaw K, Wang M, Kuo M
World J Gastroenterol. 2005; 11(39):6197-201.
PMID: 16273650
PMC: 4436640.
DOI: 10.3748/wjg.v11.i39.6197.
Risk factors of development of gut-derived bacterial translocation in thermally injured rats.
Wang Z, Yao Y, Xiao G, Sheng Z
World J Gastroenterol. 2004; 10(11):1619-24.
PMID: 15162536
PMC: 4572765.
DOI: 10.3748/wjg.v10.i11.1619.
Gut in diseases: physiological elements and their clinical significance.
Ding L, Li J
World J Gastroenterol. 2003; 9(11):2385-9.
PMID: 14606061
PMC: 4656506.
DOI: 10.3748/wjg.v9.i11.2385.
