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15th
World Congress Clinical Nutrition
19th
– 22nd September 2010 El Sokhna Resort - Egypt
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Copyright © 2010.
WCCN2010.COM
All rights reserved |
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JA Brunton, ME Dodge, RF
Bertolo
Department of Biochemistry, Memorial
University of Newfoundland, St.
John’s, NL, Canada, A1B 3X9
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Objectives: To characterize
the timing and extent of small
intestinal (SI) adaptation following
massive surgical resection of the
proximal SI in a novel piglet model.
Methods: Yucatan miniature piglets
(n = 32, 12–13 d old) were
randomized to either 1) 80% SI
resection with total parenteral
nutrition (TPN) feeding (R-TPN), 2)
80% SI resection with a combination
of TPN + enteral feeding (R-EN) or
3) sham SI transection with TPN +
enteral feeding (Sham-EN). In the
resected piglets, the distal 100 cm
of ileum (“residual SI”) and 30 cm
of proximal SI were left intact. All
piglets received TPN immediately
after surgery (d 0). Starting on d
3, R-EN and Sham-EN piglets received
continuous enteral infusions of an
elemental diet that provided 60% of
the total nutrient intake. Piglets
were killed either 4, 6 or 10 d
post-surgery.
Results: Cell
proliferation in the residual SI,
assessed by incorporation of
5-bromo-2'-deoxyuridine was
significantly greater in R-EN
piglets (29.5 ± 4.7 %) compared to
Sham-EN (13.6 ± 5.7 %) and R-TPN
(13.0 ± 8.9 %) groups at d 4
(P<0.05). R-EN killed on day 4 also
had higher rates of mucosal protein
synthesis than Sham-EN (P<0.001) or
R-TPN animals (P<0.05), (87.2 ± 3.2
vs 53.2 ± 2.1 and 59.7 ± 9.7 %/d,
respectively). The R-EN piglets had
significantly greater residual
mucosal weight (per cm length) than
the Sham-EN (P<0.001) and R-TPN
(P<0.05) groups at 6 and 10 days
post-op. Remarkably, the mean
residual SI length in the d 10 R-EN
group was more than 40% longer than
the Sham-EN or R-TPN groups
(P<0.05). Both resected groups (R-EN
and R-TPN) maintained growth rates
similar to the sham treated piglets.
Conclusions: The
initiation of enteral feeding
rapidly stimulated crypt cell
proliferation and mucosal protein
synthesis, which translated into
greater intestinal length and mass
within 10 d of resection. Growth
rates (similar to sham piglets)
suggest that adaptive responses
enhanced the functional/absorptive
capacity of the shortened SI. Our
piglet model will be highly useful
for investigating nutrients or
trophic factors targeted at
enhancing SI adaptation. (SickKids
Foundation)
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