Effects of glutamine-supplemented enteral or parenteral nutrition on apoptosis of intestinal mucosal cells in rats with severe acute pancreatitis.

BACKGROUND Hhigh mortality of the severe acute pancreatitis (SAP) is caused by the damage of intestinal mucosal barrier. Glutamine (Gln) has been used to protect the intestinal mucosal barrier in the treatments of many severe diseases. AIM To explore the impact of glutamine on the apoptosis of intestinal mucosa and Bax expression in rats with SAP. MATERIALS AND METHODS Eighty male SD rats were randomly divided into five groups: sham-operated group, SAP + parenteral nutrition (PN) group, SAP + enteral nutrition (EN) group, SAP + EN + Gln group, and SAP + PN + Gln group. Rats were sacrificed 4 days and 7 days after nutritional support. The intestinal epithelial apoptosis and the expression of Bax were examined by TUNEL assay and immunohistochemical staining, respectively. RESULTS The apoptotic index (AI) of SAP groups was higher than that of sham-operated group. After 7 days treatment, the AI of SAP + EN + Gln group was significantly lower than that of the SAP + EN or SAP + PN group. In addition, the AI of the SAP groups after 7 days treatment was significantly lower than that of the same groups at 4 days after treatment. Furthermore, the Bax expression of SAP + EN + Gln group was significantly lower than that in the SAP + EN or SAP + PN group. However, no significant differences were observed between SAP + EN + Gln group and SAP + PN + Gln group in AI and Bax expression. CONCLUSIONS Combination of Gln and parenteral nutrition or enteral nutrition inhibits the apoptosis of intestinal epithelial cells and maintains the integrity of the intestinal mucosal barrier.