Protective Effects Of DIPEPTIVEN Enriched Parenteral Nutrition On Mucosa Of The Small Intestine Grafts In The Rats

Small intestine transplantation (SBT) has made great advances for the reasonable application of anti-rejection measures and the progress in the transplantation technique. But the atrophy and the hypofunction of transplanted intestinal is still a problem that remained unsolved. Total parenteral nutrition (TPN) is one of the most important achievements of modern surgery but long-termed TPN may cause intestinal mucosa atrophy and bacterial translocation (BT). Glutamine (GLN) is the major energy source of small intestine mucosal cells and it helps to keep the integrity of the mucosal structure and function of small bowel. GLN enriched parenteral nutrition can decrease BT. DIPEPTIVEN?Alanyl-Glutamine is biologically stable and can effectively provide GLN.Objective: This study is to investigate the effects of SBT itself as well as the effects of standard TPN and Dipeptiven enriched TPN during the postoperation nutritional support on the serum and mucosal GLN concentrations, mucosa membrane structures and bacterial translocation in the rats.Method:1. Grouping: 10 SD rats underwent virtual operations as controls and received standard rat chow. Small intestine transplantation was performed in 30 rats, and animals were randomly divided into three groups: Chow group (n=10) receiving standard rat chow; Standard TPN group (n=10) receiving traditional parenteral nutrition solution ; and Dipeptiven group (n=10) receiving DIPEPTIVEN?enriched parenteral nutrition solutions.2. Studied indexes: All rats were maintained on their respective diets for 8 days before further investigation. High Performance Liquid Chromatography (HPLC) were used to evaluate GLN concentrations in serum and intestinal mucosa. Mesenteric lymph node (MLN) were resected and used as target tissue of bacteria culture. The BT rates were calculated as well.Results:1. Serum and intestine mucosal concentrations of GLN in Chow group and standard TPN group were lower than that of the control, while no difference was found between Dipeptiven group and control. GLN concentrations in serum and intestine grafts increased in the following order: chow group, standard TPN group and Dipeptiven group.2. Histological study of the graft intestine found that: mucosal morphology in the experiment groups were notably inferior to the control. And as is consistent with the GLN concentrations in serum and intestine mucosa, morphological indications increased as the following order: Standard TPN group, Chow group and Dipeptiven enriched TPN group.3. BT rates in the standard TPN group, chow group and the Dipeptiven TPN group are 60%, 30% and 10% respectively. The differences between groups arestatistically significant. Conclusion:1. In rats, intestine transplantation caused decrease of GLN concentrations in serum and intestinal mucosa and could damage the mucosal barrier.2. During the postoperation nutritional supports standard TPN could not make up for the GLN lack, might cause sever damages to mucosal structure and resulted in bacteria translocation.3. The Dipeptiven enriched parenteral nutrition solutions can maintain GLN levels in serum and intestine graft mucosa. It could improve the mucosal structure of the transplanted intestine and decrease the bacterial translocation rate.