Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage

J. de Haan, T. Lubbers, M. Hadfoune, M.D. Luyer, C.H. Dejong, W.A. Buurman, J.W. Greve

    Research output: Contribution to journalArticleAcademicpeer-review

    39 Citations (Scopus)

    Abstract

    OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.
    Original languageEnglish
    Pages (from-to)842-8
    JournalAnnals of Surgery
    Volume248
    Issue number5
    DOIs
    Publication statusPublished - 1 Jan 2008

    Cite this

    @article{aef48d4b2602434d9d8c8c1f075c3c85,
    title = "Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage",
    abstract = "OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.",
    author = "{de Haan}, J. and T. Lubbers and M. Hadfoune and M.D. Luyer and C.H. Dejong and W.A. Buurman and J.W. Greve",
    year = "2008",
    month = "1",
    day = "1",
    doi = "10.1097/SLA.0b013e318188752c",
    language = "English",
    volume = "248",
    pages = "842--8",
    journal = "Annals of Surgery",
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    }

    Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage. / de Haan, J.; Lubbers, T.; Hadfoune, M.; Luyer, M.D.; Dejong, C.H.; Buurman, W.A.; Greve, J.W.

    In: Annals of Surgery, Vol. 248, No. 5, 01.01.2008, p. 842-8.

    Research output: Contribution to journalArticleAcademicpeer-review

    TY - JOUR

    T1 - Postshock intervention with high-lipid enteral nutrition reduces inflammation and tissue damage

    AU - de Haan, J.

    AU - Lubbers, T.

    AU - Hadfoune, M.

    AU - Luyer, M.D.

    AU - Dejong, C.H.

    AU - Buurman, W.A.

    AU - Greve, J.W.

    PY - 2008/1/1

    Y1 - 2008/1/1

    N2 - OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.

    AB - OBJECTIVE: To investigate the effects of high-lipid enteral nutrition in a setting of developing inflammation and tissue damage. BACKGROUND: An excessive inflammatory response following severe trauma is associated with poor clinical outcome. Currently, therapies directed at attenuation of an ongoing inflammatory cascade are lacking. Administration of high-lipid enteral nutrition before hemorrhagic shock has been shown to effectively inhibit early and late proinflammatory cytokines by activation of the autonomic nervous system via cholecystokinin (CCK)-receptors. METHODS: A rat model of hemorrhagic shock was used in which animals were either fasted or treated with high-lipid or control low-lipid enteral nutrition. CCK-receptor antagonists were administered before feeding. Tissues and plasma were collected to assess inflammation and intestinal integrity. RESULTS: Administration of high-lipid enteral nutrition after shock reduced plasma interferon-gamma (IFN-gamma) significantly in comparison with those in low-lipid-treated and fasted animals (P < 0.01 and P < 0.001, respectively). Also, interleukin (IL)-10 levels in plasma were decreased in comparison with those in fasted animals (P < 0.001). Enterocyte damage, expressed as circulating ileal lipid-binding protein (ILBP), was prevented by early high-lipid nutrition in comparison with that in low-lipid-treated and fasted animals (P = 0.05 and P < 0.001, respectively). Furthermore, high-lipid feeding preserved intestinal integrity in comparison with that observed in low-lipid-treated and fasted animals, as assessed by bacterial translocation (BT) to distant organs (P < 0.05 and P < 0.001, respectively) and ileal permeability to horseradish peroxidase (HRP) (P = 0.05 and P < 0.001, respectively). The protective effects of high-lipid intervention were nullified by CCK-receptor antagonists (IFN-gamma; IL-10; BT; and HRP; P < 0.05). CONCLUSION: High-lipid enteral nutrition given postshock reduces inflammation and preserves tissue integrity via a CCK-receptor-dependent mechanism. These findings implicate that intervention with high-lipid enteral nutrition following events such as severe trauma is a potential therapy to attenuate the developing inflammatory response.

    U2 - 10.1097/SLA.0b013e318188752c

    DO - 10.1097/SLA.0b013e318188752c

    M3 - Article

    VL - 248

    SP - 842

    EP - 848

    JO - Annals of Surgery

    JF - Annals of Surgery

    SN - 0003-4932

    IS - 5

    ER -