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Albumin Infusion After Reperfusion Prevents Gut Ischemia-Reperfusion-Induced Gut-Associated Lymphoid Tissue Atrophy

Fumie Ikezawa, MD^*, Kazuhiko Fukatsu, MD^*, Tomoyuki Moriya, MD, Yoshinori Maeshima, MD, Koichi Okamoto, MD, Etsuko Hara, MT^* and Hoshio Hiraide, MD^*

From the ^* Division of Basic Traumatology, National Defense Medical College Research Institute, Tokorozawa, Japan; Department of Surgery I, National Defense Medical College, Tokorozawa, Japan; and the Department of Surgery I, Chiba University, Chiba, Japan

Correspondence: Kazuhiko Fukatsu, MD, Division of Basic Traumatology, National Defense Medical College Research Institute, 3–2 Namiki, Tokorozawa-City, Saitama 359-8513, Japan. Electronic mail may be sent to fukatsu{at}ndmc.ac.jp.

Background: Our recent study clarified that gut ischemia-reperfusion (I/R) causes gut-associated lymphoid tissue (GALT) mass atrophy, a possible mechanism for increased morbidity of infectious complications after severe surgical insults. Because albumin administration reportedly reduces hemorrhagic shock–induced lung injury, we hypothesized that albumin treatment prevents GALT atrophy due to gut I/R. Methods: Male mice (n = 37) were randomized to albumin, normal saline, and sham groups. All groups underwent jugular vein catheter insertion. The albumin and normal saline groups underwent 75-minute occlusion of the superior mesenteric artery. During gut ischemia, all mice received normal saline infusions at 1.0 mL/h. The albumin group was given 5% bovine serum albumin in normal saline at 1.0 mL/h for 60 minutes after reperfusion, whereas the normal saline group received 0.9% sodium chloride at 1.0 mL/h. The sham group underwent laparotomy only. Mice were killed on day 1 or 7, and the entire small intestine was harvested. GALT lymphocytes were isolated and counted. Their phenotypes (βTCR, TCR, CD4, CD8, B220) were determined by flow cytometry. Results: On day 1, the gut I/R groups showed significantly lower total lymphocyte and B cell numbers in Peyer's patches and the lamina propria than the sham group. However, the albumin infusion partially but significantly restored these cell numbers. On day 7, there were no significant differences in any of the parameters measured among the 3 groups. Conclusions: Albumin infusion after a gut ischemic insult may maintain gut immunity by preventing GALT atrophy.

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Journal of Parenteral and Enteral Nutrition, Vol. 30, No. 5, 380-387 (2006)
DOI: 10.1177/0148607106030005380


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