This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ruiz-Santana, S. Articles by Díaz-Chico, B. N. Search for Related Content PubMed PubMed Citation Articles by Ruiz-Santana, S. Articles by Díaz-Chico, B. N. Social Bookmarking                         What's this?

Prevention of Dexamethasone-Induced Lymphocytic Apoptosis in the Intestine and in Peyer Patches by Enteral Nutrition

Intensive Care and Research Unit, Hospital Universitario General de Gran Canaria Dr. Negrin, srviz{at}correo.hpino.rcanaria.es

Antonio López, MD, PhD

Departments of Medical/Surgical Sciences and Biochemistry and Physiology of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

Santiago Torres, PhD

Departments of Medical/Surgical Sciences and Biochemistry and Physiology of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

Agustin Rey, MD, PhD

Department of Pathology, Hospital Universitario General de Gran Canaria Dr. Negrin

Antonio Losada, PharmD

Department of Clinical Chemistry, Hospital Universitario General de Gran Canaria Dr. Negrin

Leonor Latasa, PharmD

Department of Pharmacy, Hospital Universitario General de Gran Canaria Dr. Negrin

José L. Manzano, MD, PhD

Intensive Care and Research Unit, Hospital Universitario General de Gran Canaria Dr. Negrin

Bonifacio N. Díaz-Chico, PhD

Departments of Medical/Surgical Sciences and Biochemistry and Physiology of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

Background: Apoptosis is a programmed cell death, genetically controlled, that can be activated by physiological and pathophysiological events and by the administration of several drugs, including the exogenous administration of corticosteroids. The aim of this study was to develop a rat model of intestinal lymphocytic apoptosis induced by dexamethasone to determine if apoptosis could be prevented by enteral or parenteral nutrition. Methods: Male Sprague-Dawley rats were used. On day 0, the right internal jugular vein was catheterized for parenteral nutrition, and a silicone tube was inserted into the duodenum for enteral feeding. Animals (n = 6/group) were randomly assigned to one of the following 3 feeding regimens: an immune-enhancing enteral diet; its placebo (the same formula without immunonutrients); and isocaloric isonitrogenous parenteral nutrition. On the seventh day, 200 µg of dexamethasone or vehicle were administered by IV bolus, and the diets were continued for 1 more day. Intestinal Peyer patches and thymic lymphocytic apoptosis were determined both by flow-cytometry and immunohistochemistry. Results: A single dexamethasone dose (200 µg/rat) administered to surgically treated rats fasted for 18 hours, 24 hours later, caused massive intestinal and Peyer patches lymphocytic apoptosis (96 ± 2% and 85 ± 5%, respectively; p < .0001 versus vehicle in both kinds of tissue). Lymphocytic apoptosis was reduced to almost indetectable levels in intestinal and lamina propia lymphocytes (from 96 ± 2% to <0.6%; p < .0001). Peyer patches lymphocytic apoptosis was reduced as well (from 85 ± 5% to 15 ± 7.1%; p < .001) in animals prefed the 2 enteral nutrition formulas. Those prefed parenteral nutrition only showed a partial decrease of lymphocytic apoptosis in the intestine (from 96 ± 2% to 53 ± 23%; p < .001). Nutrition had no effect on the dexamethasone-induced thymus involution. Conclusions: Enteral nutrition prevents intestinal intraepithelial and lamina propia lymphocytic apoptosis due to dexamethasone. These findings support the use of early enteral nutrition in critically ill patients treated with corticosteroids. (journal of Parenteral and Enteral Nutrition 25:338-345, 2001)

Journal of Parenteral and Enteral Nutrition, Vol. 25, No. 6, 338-345 (2001)
DOI: 10.1177/0148607101025006338


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?