SADIK YILDIRIM1, ALİ BURAK ÇULHAOĞLU1, NURAY ÇULHAOĞLU2, ADİL BAYKAN1

1Şişli Etfal Hastanesi, 1. Cerrahi Kliniği, İSTANBUL
2Taksim Hastanesi Biyokimya Laboratuarı, İSTANBUL

Abstract

Glutamine is a major fuel for rapidly growing enterocytes and lymphocytes In critical care patients and patients under stress, enteral glutamine supplements was recommended in order to enhance host immunity. Enteral feeding was demonstrated to be superior in these patients. In this experimental study immune parameters in response to peritonitis in rats fed by glutamine enriched formula and rat chow were compared.

Twenty Wistar rats (230-350 gr) were allocated in two groups; Group A, which were fed by Glotamine enriched diet (AlitraQ) and Group B which were fed by rodent chow suspension. All rats were operated for effecting tube gastroscopy and before closing abdominal wound 10.000 cfu/ml E.Coli suspention was given intraperitoneally. Enteral formula and rat chow suspension feeding started 2nd postoperative day. Body weight, white blood cell count (WBC) C-Reactive Protein (CRP), Blood urea nitrogen (BUN), total protein, albumin, IgG, IgA, IgM levels and blood culture of all rats were obtained on 2nd,7th,and 13th postoperative day (POD). On 13th POD, ileal mucosal wash obtained for secretory IgA determination and 5 cm ileum weight were taken after sacrification of rats and peritoneal swab obtained for culture. And results were compared.

No significant difference in body weight were observed between two groups, IgG levels were significantly high in group A on 7th POD (p<0.05) but non-significant on 13th POD. Serum IgM levels were elevated in both groups but no difference noted. Serum IgA levels were significantly high in Group A on 2nd and 7th POD, but non-significant on 13th POD. Secretory IgA obtained from mucosal wash were lower in Group B than Group A (p<0.05). Isolated ileum weight were higher in Group A than Group B (p<0.05). No difference in serum protein and CRP levels noted.

Serum IgG and IgA levels of glutamine enriched formula group (group A) rats increased on 7th POD. Secretory IgA which is known to have significant role in preventing bacterial translocation and endotoxin release was significantly elevated in rats fed by glutamine enriched formula, isolated ileum weight increased in GEF group due to increased proliferation. Peritoneal swabs were positive for E.Coli in all rats in both groups. This study demonstrates that glutamine is an important immmunonutrient.

Keywords: GLUTAMINE, PERITONITIS, IMMUNE RESPONSE