The effect of enteral glutamine on hepatic regeneration, hepatic functions and bacterial translocation in rats following partial hepatectomy
Hikmet Aktaş1, A. Sadık Kılıçturgay1, Ersin Öztürk1, Özgen Işık1, İbrahim Şehitoğlu2
1Uludağ Üniversitesi Tıp Fakültesi, Genel Cerrahi AD, Bursa, Türkiye
2Uludağ Üniversitesi Tıp Fakültesi, Patoloji AD, Bursa, Türkiye
Purpose: The effects of enteral glutamine on bacterial translocation and hepatic regeneration have been investigated in this study.
Materials and Methods: Thirty female Wistar-Albino rats were divided into three groups: 1. Sham Group (n=10); laparotomy followed by liver exploration, was performed and then abdomen was closed. For the following 7 days, the rats were fed with standard food and water. 2. Control group (n=10); following 70% hepatectomy, the rats were fed with standard food and water for 7 days. 3. Trial group (n=10) following 70% hepatectomy, the rats were fed with standard food and water for 7 days and in addition with 0.5gr/ kg/day glutamine via orogastric catheter. On the 7th day, the rats were sacrificed. Hepatic regeneration and enterocyte proliferation were evaluated by tissue Ki-67 immune-histochemistry. To evaluate the macroscopic hepatic growth rate, the wet weight of remnant liver tissue was measured. Serum AST/ALT were measured. Bacterial translocation was evaluated by blood samples taken from portal vein and, tissue samples from mesenteric lymph nodes, liver, spleen and lungs. Group values were compared using Kruskal-Wallis (for comparison of three groups) or Mann-Whitney U tests (for comparison of two groups). P<0,05 was accepted as significant.
Results: Liver Ki-67 proliferation index (PI) showed significant difference between groups (p=0,001). It was higher in the trial group when compared with the control group (p<0,01). It was also higher in the control group when compared with the sham group (p<0,05). Small intestine Ki-67 PI was significantly higher in the trial group than other groups (p<0,01). The weight of remnant liver tissue was significantly higher in the trial group than in the control group (p<0,01). AST\ALT levels and bacterial translocation rates were comparable between groups.
Conclusion: Positive effects of enteral glutamine supplementation on hepatic regeneration was observed. However, no effect was noted on liver functions or bacterial translocation.
Keywords: Liver regeneration, glutamine, bacterial translocation, hepatic regeneration, hepatectomy