The effect of early enteral nutrition on intestinal mucosal barrier and remote organs in rats with severe acute pancreatitis

Background The mechanism of early enteral nutrition on intestinal mucosal barrier is still not fully understood and the direct evidence to demonstrate the protective effects of early enteral nutrition against remote organs injury induced by severe acute pancreatitis is lacking. Methods Rats were randomly divided into three groups: 1) only flip pancreas and free diet (n = 8); 2) severe acute pancreatitis and total parenteral nutrition (n = 15); 3) severe acute pancreatitis and early enteral nutrition (n = 15). Severe acute pancreatitis was induced by the retrograde injection of pancreaticobiliary duct with sodium taurocholate. Nutritional supplementation was administered starting 12 hours after induction of pancreatitis. The samples were obtained after the treatment of nutrition 72 hours. Results The mortality was not significant difference between the experimental groups. The pathology of ileum and the content of serum diamine oxidase were significantly lower in early enteral nutrition group than total parenteral nutrition group. The expression of tight junction ZO-1, Occludin and Claudin-1 proteins and the intraepithelial CD8+ and TCRγδ+ lymphocytes were significantly higher in early enteral nutrition group than total parenteral nutrition group. The content of the serum amylase and endotoxin were significantly lower in early enteral nutrition group than total parenteral nutrition group. There was a tendency of decreased pancreas and lung pathology scores in early enteral nutrition group, but the difference between total parenteral nutrition and early enteral nutrition groups was not significant. Conclusion The early enteral nutrition could significantly improve the expression of the tight junctions and intraepithelial lymphocytes, accompanied by improved intestinal mucosal barrier and endotoxin, but failed to the pancreas and lung injury compared to total parenteral nutrition in the rat model of severe acute pancreatitis.

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