Organ Transplantation: From Myth to Reality

Short bowel syndrome comprises the sequel of nutrient, fluid, and weight loss that occurs subsequent to greatly reduced functional surface area of the small intestine. The aim of this study is to investigate the trophic and functional effects of bombesin on remaining gut in rats with experimentally induced short bowel syndrome. Thirty-two rats were allocated randomly and experimental short bowel syndrome was induced by 80% bowel resection in all rats. A regular enteral diet and isocaloric elemental enteral nutrition for 12 days were given in the control group and the elemental nutrition group, respectively. In the bombesin group 10 μg/kg subcutaneous bombesin (tid) for 10 days with regular enteral diet for 12 days was given. In the elemental nutrition and bombesin group the diet consisted of 10 μg/kg subcutaneous bombesin (tid) for 10 days with isocaloric elemental enteral nutrition for 12 days was given. All rats underwent physical, histological, and biochemical evaluation. Reduction in weight loss, bowel diameter, fecal fat content, and glycemia, increase in cellularity, and d-xylose absorption were observed in all treatment groups. These changes were more evident in the bombesin treatment groups. Increases in serum protein and albumin levels were seen with bombesin treatment with or without elemental diet, whereas reductions in villous height and crypt depth were observed only with bombesin treatment without elemental diet. Serum calcium, iron, and vitamin B₁₂levels were not affected with any treatment. It is concluded that bombesin may be a useful trophic agent contributing to increased absorptive capacity and improved biochemical values even in the absence of elemental nutrition.     

Bombesin improves survival from methotrexate-induced enterocolitis.

OBJECTIVE: The authors determined whether bombesin could improve survival from methotrexate (MTX)-induced enterocolitis. SUMMARY BACKGROUND DATA: Bombesin prevents gut mucosal atrophy, which is produced by feeding rats an elemental diet. Administration of MTX produces a lethal enterocolitis in rats fed an elemental diet. METHODS: On treatment day 0, 60 rats were divided randomly into three groups and fed an elemental diet (Vivonex TEN, Sandoz, Minneapolis, MN) as the only source of nutrition. Groups were subdivided further to receive either saline or bombesin (10 micrograms/kg, subcutaneously, three times a day) beginning either on day 0 or day 14. Methotrexate (20 mg/kg, intraperitoneally) was given to all rats 14 days after the start of an elemental diet. RESULTS: Bombesin prevented the mucosal atrophy in the ileum produced by the elemental diet and significantly decreased mortality in rats given MTX (whether given as a pretreatment or at the time of MTX administration). CONCLUSION: Bombesin significantly improved survival in a lethal model of MTX-induced enterocolitis, possibly by maintaining gut mucosal structure. Administration of bombesin to patients receiving chemotherapy may be clinically useful in preventing the severe enterocolitis induced by various chemotherapeutic agents.     

Role of bombesin on gut mucosal growth.

OBJECTIVE: The authors examined the effects of exogenous bombesin (BBS) on gut mucosal growth in chow-fed rats and the mucosal regeneration after gut atrophy brought about by feeding an elemental diet and after intestinal injury produced by methotrexate (MTX). SUMMARY BACKGROUND DATA: Bombesin is one of many gastrointestinal peptides implicated in the regulation of gut mucosal growth. Although BBS is known to stimulate growth of normal pancreatic tissue, the trophic effect of BBS on gut mucosa is less clear and its exact role in gut mucosal regeneration and repair is not known. METHODS: Rats were fed a regular chow diet (control) or an elemental diet plus either saline or BBS (10 micrograms/kg). In another experiment, rats fed a chow diet and treated with saline or BBS were given MTX (20 micrograms/kg) or a single intraperitoneal injection. In all experiments, small and large bowel mucosa and pancreas were removed and analyzed for BBS-mediated proliferation. RESULTS: Bombesin produced significant mucosal proliferation of the small bowel at day 14, but not at day 7, in rats fed regular chow. In contrast, BBS treatment for 7 days produced significant proliferation in both the atrophic and injured gut mucosa of rats given elemental diet or MTX. CONCLUSIONS: Bombesin may be an important enterotrophic factor for normal mucosal proliferation and may be clinically beneficial as an agent to restore or maintain gut mucosa during periods of atrophy or injury.     

Glutamine enhances the gut-trophic effect of growth hormone in rat after massive small bowel resection.

Background. Bowel-specific nutrient, glutamine, growth hormone, and modified diet have been reported to jointly improve nutrient absorption in patients with short bowel syndrome. However, controversy exists about the exact treatment factor. In this study we attempted to analyze the individual and combined effect of glutamine supplementation and growth hormone on small bowel adaptation by using tube feeding to control luminal nutrition supply. Materials and methods. Thirty-two adult male Sprague-Dawley rats (278 +/- 8 g) underwent 85% mid-small bowel resection and were randomly assigned to four groups: Control, receiving control liquid diet via a gastrotomy tube; GLN, receiving liquid diet enriched with 20 g. L(-1) glutamine; GH, receiving subcutaneous growth hormone (GH) (0.3 IU, bid); and GLN + GH, receiving both glutamine supplementation and GH treatment. All animals were provided with isocaloric (60 kcal/day) and isonitrogenous (0.686 g/day) nutrition. Absorption tests were performed in the form of oral nutrient tests with (14)C-labeled glucose and (3)H-labeled palmitic acid on the Postoperative Day 12. Results. GH treatment significantly increased the plasma insulin-like growth factor I (IGF-I) level, body weight, jejunal and ileal villous height and mucosal thickness, and peak plasma (14)C and (3)H levels. Glutamine supplementation did not produce a significant difference; however, combined with GH treatment, glutamine supplementation further increased body weight, plasma IGF-I level, jejunal and ileal villous height and mucosal thickness, and peak plasma (14)C and (3)H levels significantly. Conclusions. After massive small bowel resection, enteral glutamine supplementation alone has no remarkable beneficial effect on bowel adaptation. However, glutamine supplementation enhanced the gut-trophic effect of GH.     

肠内免疫营养对创伤后大鼠肠屏障功能的影响

目的:研究肠内免疫营养对创伤后大鼠肠道屏障功能的影响.方法: 将30只Wistar大鼠随机分为3组,即对照组、普通肠内营养组、肠内免疫营养组.行胃造瘘术后早期分别给予普通饲料、肠内营养剂、肠内免疫营养剂等,行肠内营养7 d,测量小肠黏膜形态和小肠黏膜IgA+、CD3+、CD4+和CD8+细胞数量.结果:小肠绒毛高度、肠腺隐窝深度、黏膜厚度以及绒毛表面积等相关的形态学参数测量值显示,肠内免疫组均优于对照组(P＜0.05),与普通营养组相比差异无统计学意义 (P＞0.05).对照组和普通肠内营养组大鼠小肠黏膜IgA+、CD3+、CD4+和CD8+细胞数低于肠内免疫营养组 (P＜0.05).结论:肠内免疫营养能较好的改善术后大鼠的小肠机械屏障功能,促进小肠黏膜屏障功能的恢复,增强其肠道免疫功能.     

Glutamine prevents pancreatic atrophy and fatty liver during elemental feeding

Rats fed an elemental, enteral diet (STD) developed pancreatic atrophy and hepatic steatosis following 60% jejunoileal intestinal resection. An isonitrogenous, isocaloric 2 g/100 ml glutamine-supplemented diet (GLN) significantly attenuated the development of pancreatic atrophy and hepatic steatosis associated with elemental feeding. Pancreatic weight, DNA, and protein were 27, 22, and 40% increased, respectively, in GLN animals. The pancreata of all animals appeared normal by light and electron microscopic examination. GLN animals had 12% less total liver wet weight, 3% less hepatic water content, and 47% less hepatic fat relative to STD rats. Histologic examination of the liver revealed extensive centrilobular fatty vacuolization in STD animals whereas GLN rats had normal looking hepatic parenchyma. Glutamine should be viewed as an important nutrient in elemental diets with trophic effects on the pancreas and protective effects against the development of hepatic steatosis.     

短肠综合征康复治疗的实验与临床研究

目的 研究生长激素对大部小肠切除后残存小肠粘膜增殖活性的影响;评价短肠康复治疗的临床疗效。方法 利用病理图象分析、流式细胞分析、免疫组化法和ＲＴ－ＰＣＲ法观察比较对照组（假手术组）、短肠组（８０％小肠切除）和生长激素组（８０％小肠切除加１Ｕ．ｋｇ＾－１．ｄ＾－１生长激素皮下注射２８ｄ）ＳＤ大鼠小肠粘膜的增殖状况。观察肠康复治疗（肌注生长激素８～１２Ｕ．ｄ＾－１加静脉滴注加谷氨酰胺０．６ｇ．ｋｇ＾－     

Differential effects of gut hormones on pancreatic and intestinal growth during administration of an elemental diet.

Liquid elemental diets (ED) will, in time, cause atrophy of the gut. Pentagastrin (PG), neurotensin (NT), and bombesin (BBS) are peptides that have trophic effects on the gut of normal rats. This study examined the effect of these three agents on gut atrophy produced by ED. Four groups of rats were given an ED and injected with either saline (control), PG (250 micrograms/kg), NT (300 micrograms/kg), or BBS (10 micrograms/kg) subcutaneously every 8 hours for 5 or 10 days. A fifth group was fed rat chow ad libidum. The rats were killed on day 6 or 11; the pancreas and segments of small intestine were removed. Atrophy of ileal mucosa was apparent on days 6 and 11, and atrophy of jejunal mucosa was manifest by day 11. Bombesin prevented jejunal mucosal atrophy and significantly increased ileal mucosal growth (compared with control). Neurotensin prevented the jejunal, but not the ileal, mucosal atrophy produced by ED. Pentagastrin had no effect on gut mucosa. Bombesin and PG, but not NT, stimulated pancreatic growth. Neurotensin stimulates pancreaticobiliary secretions (PBS), which are known to stimulate gut growth. Jejunoileal bypass was performed to determine whether trophic effects of NT on gut mucosa were mediated through stimulation of PBS. After 1 week treatment, animals were killed and segments of intestine removed. As expected NT was trophic for gut mucosa in continuity with the luminal stream; furthermore NT produced significant stimulation of growth of gut mucosa in the bypassed segment. We conclude that both BBS and NT are trophic for intestinal mucosa of rats given ED; both agents have a more pronounced effect on jejunum. The trophic effect of NT is mediated, in part, by a mechanism unrelated to stimulation of PBS. Bombesin and NT may have important regulatory functions in the adaptive growth of small bowel mucosa and in the maintenance of gut mucosal integrity.     

Continuous enteral nutrition during the early adaptive stage of the short bowel syndrome

Sixty-two patients with the short bowel syndrome (30-150 cm) were managed by continuous enteral nutrition (CEN) in the early adaptive phase. In all, 82 per cent were referrals from other units and 85 per cent of referrals had failure of one or more organ systems on admission. There were intra-abdominal abscesses in 41 per cent of patients and 37 per cent had an enterocutaneous fistula. The diet included polysaccharides, medium chain triglycerides and protein hydrolysates, mixed with a high-viscosity tapioca suspension. An elemental diet was used initially in 15 per cent of patients. Thirty-three patients had an interruption of the gastrointestinal tract by a temporary enterostomy. Chyme was re-infused into the distal intestine in 20 cases. 'Zero-time' was taken as the time of operation or, for referred patients treated conservatively, the date of admission. CEN was commenced at a mean of 14 days from zero-time. Total parenteral nutrition could be discontinued at a mean of 36 days and exclusive oral alimentation was resumed at a mean of 87 days. Patients with small bowel longer than 80 cm attained enteral autonomy earlier than patients with a shorter length. Mean faecal volume did not increase following institution of CEN, suggesting tolerance to the high-viscosity diet. In cases with re-infusion of enteric content, the distal circuit (length of distal small intestine 46 cm) was able to absorb 70 per cent of the volume re-infused (mean volume 2700 ml). Body weight and nutritional markers increased significantly during the course of CEN. This study suggests that enteral autonomy can be attained early in the short bowel syndrome, even under challenging conditions. Elemental formulae do not appear to offer a benefit over polymeric diets.     

术前肠内营养支持应用于伴营养风险胃癌患者的临床观察

目的评价术前肠内营养支持应用于伴营养风险胃癌患者的临床疗效和安全性。方法前瞻性入组2012年5—10月间四川大学华西医院收治的60例伴营养风险的胃癌患者,按随机数字表法分为试验组（30例）和对照组（30例）。试验组以安素作为肠内营养制剂,术前连续服用10d,对照组进食等热量等氮的匀浆膳。检测患者入院时、术前1d和术后3d营养相关指标及肝肾功能指标,并记录恶心、呕吐等围手术期不良反应的发生情况。结果两组患者入院时基线水平一致（均P〉0．05）。术后3d,试验组较对照组患者血清白蛋白[（33．9±5．6）g／L比（31．0±5．3）g／L,P〈O．05]和血红蛋白水平[（103．4±7．7）g／L比（96．6±10．5）g／L,P〈0．01]均明显升高;而体质量指数、淋巴细胞计数、血糖浓度、血钾、血钠及肝、肾功能指标两组差异均无统计学意义（均P〉0．05）。两组各有2例患者出现恶心症状．各有1例出现呕吐症状,试验组患者未出现肠内营养相关的严重不良临床事件。结论术前肠内营养支持应用于伴营养风险胃癌患者疗效显著,安全性高,是临床纠正营养风险的合理选择。     

Enteral and parenteral nutrition in patients with enteric fistulas and short bowel syndrome

Significant advances in the use of enteral and parenteral nutrition in patients with either enteric fistulas or short bowel syndrome include increased usage of enteral nutrition because of its trophic effects on the gut and increased usage of both enteral and parenteral nutrition in the home setting. Current investigations are directed toward identifying gut-specific fuels and dietary and pharmacologic enhancement of nutrient utilization.     

中药和肠内营养在胰十二指肠切除术后早期应用研究

目的探讨中药和肠内营养在胰十二指肠切除术后早期应用的意义.方法41例胰十二指肠切除患者分为治疗和对照两组.治疗组22例,术后早期小肠内滴注中药,待肠鸣音恢复后同时滴注营养液;对照组19例,术后早期不用中药,待肠鸣音恢复后同样滴注营养液,两组供给热量和氮量相同.术后分别观察两组胃液胆汁胰液引流量、胃肠功能恢复情况、营养状况改善、免疫功能提高和术后并发症发生率.结果术后1～3d两组平均消化液引流量无显著差别(P＞0.05);4～6d治疗组平均消化液引流量略高于对照组,但无统计学意义(P＞0.05);7～9d两组平均消化液引流量无显著差别(P＞0.05).治疗组术后胃肠功能恢复明显早于对照组(P＜0.05～0.01);治疗组术后第14d营养状况和免疫功能较术后第1d明显改善(P＜0.05～0.01);治疗组术后并发症发生率也明显低于对照组(P＜0.05).结论胰十二指肠切除术后早期实施中药和肠内营养支持治疗,有助于胃肠功能的早日恢复、营养状况的改善和免疫功能的提高,并有助于减少术后并发症的发生.     

Elemental diet-induced bacterial translocation can be hormonally modulated.

BACKGROUND: The authors have previously documented that feeding mice an elemental diet resulted in bacterial translocation (BT) that could be prevented by the provision of dietary fiber. To test whether the protective effect of fiber was related to the stimulation of trophic gut hormones, the effects of sandostatin and bombesin were tested. METHODS: Mice fed either chow or the elemental diet were stratified into several groups and the ability of bombesin (10 micrograms/kg, tid) or sandostatin (100 micrograms/kg bid) to modulate BT was examined. After 14 days, mice were sacrificed and BT, cecal bacterial population levels, mucosal protein, and small bowel weight was measured. Segments of the ileum and jejunum were examined histologically. RESULTS: Incidence of elemental diet-induced BT (75%) was reduced by fiber (9%) or the administration of bombesin (13%) (p < 0.01). Although sandostatin did not promote BT in chow-fed mice, it reversed the protective effect of fiber on BT (75%) (p < 0.01). CONCLUSION: Elemental diet-induced bacterial translocation can be modulated hormonally and the beneficial effects of fiber on diet-induced BT appears to be hormonally mediated.     

Effectiveness of Bombesin and Saccharomyces boulardii Against the Translocation of Candida albicans in the Digestive Tract in Immunosuppressed Rats

Purpose We investigated the effects of bombesin on disseminated candidiasis, and compared the effectiveness of bombesin with Saccharomyces boulardii against Candida albicans translocation from the gastrointestinal tract in immunosuppressed rats.Methods Sixty rats were divided into five groups of 12. Group 1 was given only a laboratory pellet diet and water during the experiments; the other four groups were orally inoculated with C. albicans; and groups 3, 4, and 5 were also given prednisolone intraperitoneally. The treatment groups consisted of group 4, given S. boulardii orally, and group 5, given bombesin subcutaneously. The rats were killed after 10 days, and the large bowel, liver, spleen, and kidneys were removed for microbiological and histopathological examination. Blood samples were taken to measure tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β) levels, and the results were compared.Results The number of translocated C. albicans colonies from the gastrointestinal tract and the serum TNF-α and IL-β levels were significantly lower in groups 4 and 5 than in group 3 (P < 0.05). Histological analysis revealed that the bombesin-treated group (group 5) had significantly less mucosal ulceration and submucosal inflammation in the large bowel, less inflammation and necrosis in the liver, and less inflammation of the Bowman capsules in the kidney than the S. boulardii-treated group (group 4) (P < 0.05).Conclusions These findings show that both S. boulardii and bombesin inhibit the translocation of C. albicans from the gastrointestinal tract, although mucosal ulceration, submucosal inflammation in the large bowel, and dissemination in the liver and kidneys were significantly less severe in the bombesin-treated immunosuppressed rats.     

肠内营养剂在结直肠癌术前肠道准备中的应用

目的 探讨肠内营养剂在结直肠癌术前肠道准备中的应用效果.方法 结直肠癌择期手术患者52例,随机分为两组:实验组(EN组)26例,采用术前口服瑞素行肠内营养支持;对照组(传统方法组)26例,采用传统流食.比较两组患者的肠道清洁度、不良反应及术后并发症;分别记录并比较两组患者肠道准备前(术前3 d晨)及肠道准备后(手术当天晨)的血淋巴细胞总数、总蛋白、清蛋白、前清蛋白及转铁蛋白.结果 实验组患者肠道清洁程度明显优于对照组(P＜0.05);术前头晕、心悸等不良反应及术后并发症略低于对照组,但无显著性差异(P＞0.05).实验组的血淋巴细胞总数、总蛋白、清蛋白、前清蛋白及转铁蛋白在肠道准备前后无显著性差异(P＞0.05);对照组的血淋巴细胞总数、前清蛋白及转铁蛋白肠道准备后下降明显(P＜0.05).实验组肠道准备后血淋巴细胞总数、前清蛋白及转铁蛋白明显高于对照组(P＜0.05).结论 结直肠癌患者术前应用肠内营养制剂行肠道准备,能保证良好的肠道清洁;与传统流食相比,可以改善患者的营养状况和细胞免役功能.     

短肠综合征时结肠的代偿研究

目的　观察及评价短肠大鼠结肠代偿性增生及结肠对营养物质吸收的促进作用。　方法　制作切除（80～85）%的超短肠大鼠模型,用百普素(Pepti-2000)做肠内营养（EN）治疗,观察全身营养状况和结肠形态学的改变,并在术后第21天用木糖和15N-甘氨酸混合液对带血管蒂的结肠进行封闭式灌注,观察结肠对水、碳水化合物和氨基酸的吸收情况。　结果　EN组于术后第21天净氮平衡与对照组（CONT）无差异,体重仅比术前减轻(10±18)g。结肠壁明显增厚,皱襞增大增粗,结肠壁的厚度、粘膜厚度、皱襞高度和皱襞表面积与CONT组相比差异具有非常显著性意义（P＜0.01）。EN组与CONT组相比DNA指数1.21±0.11vs.1.01±0.15(P＜0.05),S期细胞百分比（52.6±5.5）%vs.（42.9±4.1）%（P＜0.05）。连续循环灌注3h之后EN组对水、木糖和氨基酸的吸收明显高于CONT组（P＜0.05）。　结论　大鼠结肠在短肠综合征时发生了明显的形态和功能上的代偿。早期适当的肠内营养不但可使超短肠大鼠获得足够营养支持,并且能够促进短肠大鼠结肠代偿。     

Bombesin stimulates mucosal growth in jejunal and ileal Thiry-Vella fistulas.

OBJECTIVE: The authors determined whether the trophic effects of bombesin (BBS) on the small bowel mucosa are mediated by either nonluminal factors or endogenous luminal secretion. SUMMARY BACKGROUND DATA: The gut hormone bombesin stimulates growth of small bowel mucosa. The mechanisms responsible for this trophic effect are not known. METHODS: Rats underwent construction of a Thiry-Vella fistula (TVF) of either the jejunum or ileum. On postoperative day 10, the two groups were subdivided to receive either saline (control) or bombesin (10 micrograms/kg, subcutaneously, three times a day). After 14 days, rats were killed and the TVF was removed. The mucosa was scraped and weighed, and DNA and protein content was determined. RESULTS: Bombesin significantly increased mucosal weight and DNA and protein content of both the jejunal and ileal TVF compared with the control rats. CONCLUSIONS: Bombesin-mediated stimulation of small bowel mucosal growth is mediated by factors that are independent of luminal contents and pancreaticobiliary secretion. Bombesin may prove to be an important enterotrophic factor for gut mucosal proliferation.     

管饲全肠内营养在大肠癌术前应用的临床研究

目的研究大肠癌病人术前管饲全肠内营养的效果及其肠道清洁的作用。方法对2004年1~12月收治的40例大肠癌病人随机分为两组(各20例),试验组术前予管饲全肠内营养7d;对照组行传统肠道准备。比较两组在血清蛋白、术中肠清洁度、术后感染性并发症发生及肠道功能恢复时间等方面的差异。结果试验组术前1d和术后7d血清白蛋白、前白蛋白、转铁蛋白均高于对照组,肛门排气时间则短于对照组(P<0·01),两组差异有显著性。但两组术中肠道清洁度、住院天数和术后感染性并发症发生率差异无显著性意义。结论大肠癌病人术前应用管饲全肠内营养能获得有效的营养支持和肠道清洁,该方法可替代大肠癌术前传统的肠道准备。     

谷氨酰胺和ω—3多不饱和脂肪酸对大鼠肠道缺血再灌注损伤时肠道通透性和肺细胞凋亡的影响

目的研究大鼠肠道缺血再灌注损伤时,肠淋巴管结扎和不同肠内营养对肠道通透性、系统炎性反应和肺损伤的影响。方法SPF级雄性大鼠胃造瘘术后随机分为正常饮食组、普通肠内营养组、谷氨酰胺（Gin）肠内营养组、ω-3多不饱和脂肪酸（ω-3PUFA）肠内营养组和假手术组．前4组根据淋巴管是否结扎又各分为结扎和不结扎组．共9组．每组8只。所有肠内营养组均经胃造瘘给予等氮（1．8gN·kg-1·d-1）等热卡（1046kJ·kg-1·d-1）的营养支持,7d后除假手术组外其他8组实施肠道缺血60min,结扎组在缺血前同时进行淋巴管结扎：然后继续原营养再灌注3d。在胃造瘘术后第5、7和9天测定肠道通透性（尿中乳果糖／甘露醇浓度值．L／M）：术后第11天取血检测血清二胺氧化酶、内毒素、细胞因子及ALT、AST的水平：取小肠黏膜检测黏膜厚度和绒毛高度;取肺组织检测髓过氧化物酶（MPO）、NO和NO合酶（NOS）浓度及细胞凋亡指数。结果肠道缺血60min可引起肠道损伤;缺血后第1天,各组L／M均显著增加（P〈0．05）;缺血后第3天L／M明显下降（P〈0．05）,其中Gin肠内营养组和（ω-3PUFA肠内营养组已恢复至接近缺血前水平（P〉0．05）．且淋巴管结扎组L／M明显低于不结扎组（P〈0．05）。在肠道缺血再灌注损伤时．与普通肠内营养和正常饮食组比较,Gln肠内营养组和ω-3PUFA肠内营养组血清内毒素和细胞因子水平显著降低．小肠黏膜厚度和绒毛高度明显增高（P〈0．05）;且淋巴管结扎后效果更为明显（P〈0．05）。予以Gln或（ω-3PUFA肠内营养以及淋巴管结扎后,肺组织MPO、NO、NOS及细胞凋亡指数都有不同程度的下降（P〈0．05）。结论肠道缺血再灌注损伤引起的肺等远隔组织损伤及系统性炎性反应可能与肠淋巴液中的某些因子有关．阻断“肠-淋巴途径”和（或）补充Gln和ω-3PUFA的肠内营养可以降低缺血引起的肠道通透性增加．降低循环内毒素水平．增加肠黏膜的厚度．减轻系统炎性反应和肺组织损伤。     

Protein intake and 5-fluorouracil toxicity in tumor-bearing animals

The administration of chemotherapy is limited in clinical situations by lack of selective antineoplastic activity resulting in significant host toxicity. Although it has been suggested that nutrition support can reduce chemotherapy-related toxicity, few controlled studies exist to document this clinical impression. This study was performed to determine the effect of enteral protein intake on 5-fluorouracil toxicity in tumor-bearing animals. Seventy-nine female Lewis/Wistar rats with subcutaneous mammary tumor implants (AC-33) were randomized to receive either standard protein (22.0% protein; 4.27 kcal/g) or an isocaloric, protein-depleted diet (0.03% protein; 4.20 kcal/g). One-half of the animals in each group received daily injections of 5-fluorouracil (15- or 25 mg/kg ip) or placebo (saline) for 4 or 5 days. Standard protein intake significantly increased host body weight and decreased leukopenia at low (15 mg/kg) and high (25 mg/kg) 5-fluorouracil therapy. At high-dose 5-Fluorouracil (25 mg/kg), the incidence and duration of diarrhea were decreased in animals receiving standard protein intake. Thus, enteral protein intake significantly reduced clinical and objective 5-fluorouracil toxicity and improved body weight in this tumor-bearing animal model.