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Lack of Enteral Nutrition Delays Nuclear Factor Kappa B Activation in Peritoneal Exudative Cells in a Murine Glycogen-Induced Peritonitis Model

Chikara Ueno, MD^*, Kazuhiko Fukatsu, MD, Woodae Kang, MD, Yoshinori Maeshima, MD^*, Hidetoshi Nagayoshi, MD^*, Jiro Omata, MD^*, Hideaki Saito, MD, Hoshio Hiraide, MD and Hidetaka Mochizuki, MD^*

From the ^* Department of Surgery I, National Defense Medical College, Saitama, Japan; Division of Basic Traumatology, National Defense Medical College Research Institute, Saitama, Japan; Department of Digestive Surgery, School of Medicine, Nihon University, Tokyo, Japan; and the Department of Clinical Management, University of Kyorin, Tokyo, Japan

Correspondence: Kazuhiko Fukatsu, MD, Division of Basic Traumatology, National Defense Medical College Research Institute, 3–2 Namiki, Tokorozawa, Saitama, Japan. Electronic mail may be sent to fukatsu{at}ndmc.ac.jp.

Background: Early enteral nutrition is associated with a lower incidence of intraabdominal abscess in severely injured patients than parenteral nutrition (PN). We explored the underlying mechanisms by examining the influence of nutrition route on nuclear factor B (NFB) activation in peritoneal exudative cells (PECs) and peritoneal cytokine levels. Methods: Thirty male Institute Cancer Research mice were randomized to chow (n = 10), IV PN (n = 10), or intragastric (IG) PN (n = 10) and fed for 5 days. PECs were harvested at 2 or 4 hours after intraperitoneal injection of 2 mL of 1% glycogen. Intranuclear NFB activity in PECs was examined by laser scanning cytometry. Cytokine (tumor necrosis factor- [TNF-], macrophage inflammatory protein-2 [MIP-2], interleukin-10 [IL-10]) levels in peritoneal lavaged fluid were determined by enzyme-linked immunosorbent assay. Results: Intranuclear NFB at 2 hours was significantly higher in the chow and IG-PN groups than in the IV-PN group. TNF- and IL-10 levels of the chow group were significantly higher than those of IV-PN mice at 2 hours, whereas those of IG-PN mice were midway between those of the chow and IV-PN groups. MIP-2 was significantly higher in the chow group than in the IG-PN and IV-PN mice at 2 hours. TNF- levels correlated positively with intranuclear NFB activity in PECs. Conclusions: Enteral nutrition may improve peritoneal defense by preserving early NFB activation in PECs and cytokine responses.

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