Early enteral nutrition improves intestinal immune barrier in a rat model of severe acute pancreatitis.

BACKGROUND: The aim of the present study was to investigate the role of early enteral nutrition (EEN) in the intestinal immune barrier in severe acute pancreatitis (SAP), and to explore its potential mechanisms.

METHODS: Sixty rats were randomly assigned to three groups: sham-operated group (SO group, n = 20), SAP group receiving EEN (SAP + EEN group, n = 20), and SAP group receiving total parental nutrition (SAP + TPN group, n = 20). SAP was induced by infusion of sodium taurocholate. Rats were killed 5 days after nutritional support. The pathological damage of the intestine was determined using HE staining. The expression of MAdCAM-1, CD(4+) , and CD(8+) in Peyer's lymph nodes of the distal ilium was examined by immunohistochemistry. Serum levels of endotoxin and bacterial translocation were determined.

RESULTS: The survival rate in the SAP + TPN (50%) and SAP + EEN (75%) groups was significantly lower than in the SO group (100%) (P < 0.05). The survival rate in the SAP + EEN group was significantly higher than in the SAP + TPN group (P < 0.05). The expression of MAdCAM-1, CD(4+) and CD(8+) in the intestine was decreased in SAP rats. EEN significantly increased the expression of MAdCAM-1, CD(4+) and CD(8+) compared with TPN, accompanied by a decrease in the serum levels of endotoxin and bacterial translocation.

CONCLUSIONS: Early enteral nutrition improves intestinal immune barrier, thus reducing bacterial and endotoxin translocation and improving the survival rate in SAP rats.