Metabolic effects of medium chain triglyceride-enriched total parenteral nutrition in rats bearing Yoshida sarcoma

The ability of medium chain triglyceride-enriched total parenteral nutrition to support host tissue in a model of cancer cachexia was assessed by measuring tumor growth, body weight, nitrogen balance, energy expenditure, leucine kinetics, fractional protein synthetic rate of tumor, liver, and abdominis rectus muscle, and plasma levels of glucose and albumin. Male Sprague-Dawley rats (85-90 gm) received 10(7) cells of viable Yoshida sarcoma subcutaneously on day 0. Control rats received injections of sterile saline. On day 10 rats underwent central venous cannulation and were randomized to one of three isocaloric diets. One group received amino acids and dextrose, while the other two groups were infused with amino acids, dextrose, and fat as either long chain triglyceride or a physical mixture of medium chain triglyceride: long chain triglyceride (3:1). On day 14 L-1-(14)C-leucine was added to the diet to study protein kinetics, and energy metabolism was measured by indirect calorimetry. Both tumor-bearing and nontumor-bearing rats demonstrated improved nitrogen balance when given medium chain triglyceride-enriched total parenteral nutrition. Tumor-bearing rats had reduced resting energy expenditure vs. nontumor-bearing, while rats receiving total parenteral nutrition without fat had significantly greater respiratory quotients. Tumor-bearing rats had lower total body weight vs. nontumor-bearing on day 10, but body weight of tumor-bearing and nontumor-bearing did not differ on day 14. Whole body protein breakdown decreased and leucine balance increased in tumor-bearing rats as compared to nontumor-bearing. Total liver mass was greater in tumor-bearing rats, but liver protein fractional protein synthetic rate decreased in tumor-bearing rats vs. nontumor-bearing. Tumor growth rate and fractional protein synthetic rate were not altered by the parenteral diet. The data confirm an altered metabolism in the tumor-bearing host, and suggest that medium chain triglyceride can better support host tissue.     

Fish oil supplementation in F1 generation associated with naproxen, clenbuterol, and insulin administration reduce tumor growth and cachexia in Walker 256 tumor-bearing rats

Weanling female Wistar rats were supplemented with fish oil (1 g/kg body weight) for one generation. The male offspring received the same supplementation until to adult age. Rats supplemented with coconut fat were used as reference. Some rats were inoculated subcutaneously with a suspension (2 x 10(7) cells/mL) of Walker 256 tumor. At day 3, when the tumor was palpable, rats were treated with naproxen (N) (0.1 mg/mL), clenbuterol (Cb) (0.15 mg/kg body weight), and insulin (I) (10 U/kg body weight). At day 14 after tumor inoculation, the animals were killed. Tumor was removed and weighed. Blood, liver, and skeletal muscles were also collected for measurements of metabolites and insulin. In both tumor-bearing untreated rats and tumor-bearing rats supplemented with coconut fat, tumor growth, triacylglycerol, and blood lactate levels were higher, and glycogen content of the liver, blood glucose, cholesterol and HDL-cholesterol levels were lower as compared with the non-tumor-bearing and fish oil supplemented groups. Fish oil supplementation of tumor-bearing rats led to a partial recovery of the glycogen content in the liver and a full reversion of blood glucose, lactate, cholesterol, and HDL-cholesterol levels. The treatment with N plus Cb plus I attenuated cancer cachexia and decreased tumor growth in both coconut fat and fish oil supplemented rats. In conclusion, chronic fish oil supplementation decreased tumor growth and partially recovered cachexia. This beneficial effect of fish oil supplementation was potentiated by treatment with naproxen plus clenbuterol plus insulin.     

Dietary carbohydrate influences tissue fatty acid and lipid composition in the copper-deficient rat

Fructose and copper have been shown independently to influence long chain fatty acid metabolism. Since fructose feeding exacerbates copper deficiency, their possible interaction with respect to tissue long chain fatty acid and lipid composition was studied. Weanling male Sprague-Dawley rats were given diets containing 0.6 or 6 mg/kg copper. The carbohydrate source (627 g/kg) was either fructose or corn starch. After 3 wk, fatty acid profiles and total lipids in heart and liver were analyzed. Copper-deficient rats fed fructose had more severe signs of copper deficiency than those fed starch, according to heart/body wt ratio, hematocrit, and liver copper content. The fatty acid composition of heart and liver triacylglycerol was significantly different between groups, but the changes did not correlate with the severity of copper deficiency. In heart, phosphatidylinositol and phosphatidylserine, arachidonic acid and docosapentaenoic acid (n-6) were increased 193 and 217%, respectively, p<0.05) in rats given the copper-deficient diet containing fructose. Changes in the long chain fatty acids in heart phospholipids may be related to the higher mortality commonly observed in rats fed a copper-deficient diet containing fructose.     

不同营养支持方式对进展期胃癌术后病人临床结局比较

目的：研究肠内营养、肠外营养、常规补液对胃癌术后患者临床结局的影响。方法：择我院住院治疗并行外科手术治疗的胃癌患者183例,随机分至肠内营养组、肠外营养组、常规补液组,分别行相应的营养支持治疗,比较三组患者术前／后1天及术后8天体重、白蛋白、淋巴细胞计数的变化及术后并发症发生情况、营养支持费用、术后住院时间、总费用。结果：常规补液组术后第8天体重较术前1天明显下降;肠内、肠外营养组患者体重下降幅度均明显低于常规补液组;肠内、肠外营养组术后第8天白蛋白水平升高显著,且明显高于常规补液组;肠内营养组患者术后第8天淋巴细胞明显上升,且较常规补液组有明显升高。肠外营养组、常规补液组患者肝功能损害、血脂升高、血糖升高的发生率均明显高于肠内营养组;肠外营养组患者肝功能损害、血脂升高发生率明显低于常规补液组;肠内营养组患者切口腹腔感染及肺部感染的发生率均明显低于常规补液组。与常规补液组相比,肠外、内营养组患者术后住院时间均明显缩短,肠内营养组患者总费用明显偏高;与肠外营养相比,肠内营养组、常规补液组营养支持费用明显降低,肠内营养组患者总费用显著下降,上述差异均有统计学意义（P〈O．05）。结论：胃癌术后患者行肠内营养可大大降低术后并发症的发生,并减少患者住院费用,缩短术后住院时间。     

不同营养支持方式对进展期胃癌术后病人临床结局比较

摘要目的：研究肠内营养、肠外营养、常规补液对胃癌术后患者临床结局的影响。方法：择我院住院治疗并行外科手术治疗的胃 癌患者183 例,随机分至肠内营养组、肠外营养组、常规补液组,分别行相应的营养支持治疗,比较三组患者术前/ 后1 天及术后 8 天体重、白蛋白、淋巴细胞计数的变化及术后并发症发生情况、营养支持费用、术后住院时间、总费用。结果：常规补液组术后第 8 天体重较术前1 天明显下降;肠内、肠外营养组患者体重下降幅度均明显低于常规补液组;肠内、肠外营养组术后第8 天白蛋白 水平升高显著,且明显高于常规补液组;肠内营养组患者术后第8 天淋巴细胞明显上升,且较常规补液组有明显升高。肠外营养 组、常规补液组患者肝功能损害、血脂升高、血糖升高的发生率均明显高于肠内营养组;肠外营养组患者肝功能损害、血脂升高发 生率明显低于常规补液组;肠内营养组患者切口腹腔感染及肺部感染的发生率均明显低于常规补液组。与常规补液组相比,肠 外、内营养组患者术后住院时间均明显缩短,肠内营养组患者总费用明显偏高;与肠外营养相比,肠内营养组、常规补液组营养支 持费用明显降低,肠内营养组患者总费用显著下降,上述差异均有统计学意义（P＜0.05）。结论：胃癌术后患者行肠内营养可大大 降低术后并发症的发生,并减少患者住院费用,缩短术后住院时间。     

大鼠肝线粒体中的脂肪酸分析

用双 2 乙基己基酚酞酸酯 (DEHP)诱导大鼠肝过氧化物酶体增殖 ,然后用蔗糖密度梯度离心法分离大鼠肝线粒体 ,用毛细管气相色谱法测定肝线粒体中的脂肪酸含量。测定结果 :所测 1 4种脂肪酸的总量 ,青年正常组大于青年诱导组 (P <0 .0 1 ) ,青年正常组大于老年正常组 (P <0 .0 5 )。不饱和脂肪酸与脂肪酸总量的比例 ,老年诱导组大于老年正常组 (P <0 .0 5 ) ,青年正常组大于老年正常组 (P <0 .0 5 )。长链脂肪酸与脂肪酸总量的比例 ,老年正常组小于老年诱导组 (P <0 .0 5 )。结果表明 ,用DEHP诱导大鼠肝过氧化物酶体增值 ,影响肝线粒体脂肪酸正常代谢 ,使线粒体膜结构发生变化 ,这种变化 ,青年鼠与老年鼠不同     

The Nitric Oxide Synthase Inhibitor NG-Nitro-L-Arginine Methyl Ester Diminishes the Immunomodulatory Effects of Parental Arginine in Rats with Subacute Peritonitis

The combined treatment of parenteral arginine and the nitric oxide synthase inhibitor N^G-nitro-L-arginine methyl ester (L-NAME) have been shown to improve liver function and systemic inflammation in subacute peritonitic rats. Here, we investigated the effects of single and combined parenteral arginine and L-NAME treatments on leukocyte and splenocyte immunity. Male Wistar rats were subjected to cecal punctures and were intravenously given total parenteral nutrition solutions with or without arginine and/or L-NAME supplementations for 7 days. Non-surgical and sham-operated rats with no cecal puncture were given a chow diet and parenteral nutrition, respectively. Parenteral feeding elevated the white blood cell numbers and subacute peritonitis augmented the parenteral nutrition-induced alterations in the loss of body weight gain, splenomegaly, and splenocyte decreases. Parenteral arginine significantly increased the B-leukocyte level, decreased the natural killer T (NKT)-leukocyte and splenocyte levels, alleviated the loss in body weight gain and total and cytotoxic T-splenocyte levels, and attenuated the increases in plasma nitrate/nitrite and interferon-gamma production by T-splenocytes. L-NAME infusion significantly decreased NKT-leukocyte level, tumor-necrosis factor (TNF)-alpha production by T-splenocytes and macrophages, and interferon-gamma production by T-leukocytes, monocytes, and T-splenocytes, as well as increased interleukin-6 production by T-leukocytes and monocytes and nitrate/nitrite production by T-leukocytes. Combined treatment significantly decreased plasma nitrate/nitrite, the NKT-leukocyte level, and TNF-alpha production by T-splenocytes. Parenteral arginine may attenuate immune impairment and L-NAME infusion may augment leukocyte proinflammatory response, eliminate splenocyte proinflammatory and T-helper 1 responses, and diminish arginine-induced immunomodulation in combined treatment in subacute peritonitic rats.     

高脂饮食诱导肥胖与肥胖抵抗型非酒精性脂肪肝大鼠模型的建立

目的:利用高脂饲料复制肥胖与肥胖抵抗型非酒精性脂肪肝SD大鼠模型。方法:体质量100±10g的雄性SD大鼠140只,按照体重随机抽取120只用于模型建立,喂食高脂、高能饲料。连续8周后,将体质量大于正常对照组平均体质量+1.96倍标准差的模型大鼠作为肥胖型非酒精性脂肪肝组(NO组),体质量小于正常对照组平均体质量+1.0倍标准差的作为肥胖抵抗型非酒精性脂肪肝组(NOR组)。8周内动态观察大鼠的一般情况、体质量变化,8周末每组随机取8只处死,比较血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆固醇(TC)、甘油三脂(TG)水平变化及肝指数、脂体比,观察肝脏形态学改变。剩余20只作为正常对照组,喂食普通饲料。结果:NO与NOR组大鼠体重增长差距逐渐增大,至8w末,NO组体重显著高于NOR组及正常对照组(P0.01),脂肪重量和脂体比均显著升高,NO组脂肪重量显著高于NOR组(P0.05,0.01),但脂体比间未见显著差异;NO与NOR组TG、ALT显著升高(P0.05),其中NO组大鼠血清TG、TC显著高于NOR组(P0.05);两组肝重量和肝指数均显著升高,NO组肝重量显著高于NOR组(P0.05,0.01),但肝指数间未见显著差异,两组肝细胞内均弥散大量脂肪空泡。结论:利用高脂饲料成功建立肥胖与肥胖抵抗型非酒精性脂肪肝SD大鼠模型,与人类发病特征相似,为肥胖与非酒精性脂肪的研究提供更有针对性的动物模型。     

IGF-I treatment facilitates transition from parenteral to enteral nutrition in rats with short bowel syndrome

The goal of growth factor treatment in patients with short bowel syndrome (SBS) is to facilitate transition from parenteral to enteral feedings. Ideal use of growth factors would be acute treatment that produces sustained effects. We investigated the ability of acute insulin-like growth factor I (IGF-I) treatment to facilitate weaning from total parenteral nutrition (TPN) to enteral feeding in a rat model of SBS. After a 60% jejunoileal resection + cecectomy, rats treated with IGF-I or vehicle were maintained exclusively with TPN for 4 days and transitioned to oral feeding. TPN and IGF-I were stopped 7 days after resection, and rats were maintained with oral feeding for 10 more days. In IGF-I-treated rats, serum concentration of IGF-I and final body weight were significantly greater because of a proportionate increase in carcass lean body mass than in vehicle-treated rats. Acute IGF-I treatment induced sustained jejunal hyperplasia on the basis of significantly greater concentrations of jejunal mucosal protein and DNA without a change in histology or sucrase activity. These results demonstrate that acute IGF-I facilitates weaning from parenteral to enteral nutrition in association with maintenance of a greater body weight and serum IGF-I concentration in rats with SBS.     

A proinflammatory tumor that activates protein degradation sensitizes rats to catabolic effects of endotoxin

Chronic or acute inflammation may participate in the etiology of cancer cachexia. To investigate the interaction between tumor and a secondary inflammatory stimulus on muscle wasting, rats with and without tumors (Yoshida ascites hepatoma) received low doses of endotoxin (LPS, 400 microg/kg sc) or saline. Nitrogen balance was measured 24 h before and after LPS/saline. Epitrochlearis muscle was used to measure in vitro protein metabolism, and gastrocnemius muscle was used for quantification of the mRNA for components of the ubiquitin proteolytic pathway. The YAH reduced muscle mass (P = 0.002), increased muscle protein degradation (P = 0.042), and elevated mRNA expression of components of the ubiquitin proteolytic pathway (P < 0.01) including ubiquitin, ubiquitin-conjugating enzyme E2(14k), and ubiquitin ligases muscle RING Finger 1 and atrogin-1. Although the selected low dose of LPS had no impact on protein metabolism in control rats, LPS in rats bearing YAH caused weight loss (P = 0.0007), lowered nitrogen balance (P = <0.0001), and increased muscle protein degradation (P = 0.0336). In conclusion, the presence of a tumor can potentiate whole body and muscle-specific catabolic losses of protein in response to a stimulus that is not catabolic in healthy animals. This effect might be dependent on the inflammatory nature of the tumor.     

复方高支链氨基酸对肝硬化大鼠肝功能及营养状况的影响

将SD雄性大鼠用四氯化碳处理建立肝硬化大鼠模型,并随机分为A、B、C三组,A组大鼠给予静脉输注生理盐水,B组、C组大鼠分别给予输注等量的普通氨基酸注射液和复方高支链氨基酸注射液,分别于实验第0d、第14d测定大鼠体质量、肝功能指标及营养学指标水平。实验结束后,B、C两组大鼠体质量明显增加,与A组相比,B、C两组大鼠肝功能各指标水平显著降低,血清蛋白水平显著升高,且C组相比,B组大鼠肝功能水平与血清蛋白水平改善作用更为明显(p<0.05)。说明复方高支链氨基酸能改善肝硬化大鼠的肝功能指标,抑制血浆蛋白分解,有效控制肝硬化病症的进一步恶化。     

Experimental arthritis inhibits the insulin-like growth factor-I axis and induces muscle wasting through cyclooxygenase-2 activation

Chronic arthritis induces cachexia associated with an inhibition of the growth hormone (GH)-insulin-like growth factor-I (IGF-I) system and an activation of the E3 ubiquitin-ligating enzymes muscle atrophy F-box (MAFbx) and muscle Ring finger 1 (MuRF1) in the skeletal muscle. The aim of this work was to study the role of cyclooxygenase (COX)-2 in chronic arthritis-induced cachexia. Arthritis was induced in rats by Freund's adjuvant injection, and the effects of two COX inhibitors (indomethacin, a nonspecific inhibitor, and meloxicam, a selective COX-2 inhibitor on pituitary GH and on liver and serum IGF-I levels) were tested. Arthritis decreased body weight gain and GH and liver IGF-I gene expression. In the arthritic rats, both inhibitors, indomethacin and meloxicam, prevented the inhibitory effect of arthritis on body weight gain. Indomethacin and meloxicam administration to arthritic rats increased pituitary GH and liver IGF-I mRNA as well as serum levels of IGF-I. These data suggest that induction of COX-2 during chronic inflammation is involved in the inhibition of the GH-IGF-I axis and in the body weight loss. In the gastrocnemius muscle, arthritis increased the gene expression of tumor necrosis factor (TNF)-alpha, the E3 ubiquitin-ligating enzymes MAFbx and MuRF1, as well as of IGF-I and IGF-binding protein-5 (IGFBP-5). Inhibition of COX-2 by meloxicam administration increased gastrocnemius weight and decreased MAFbx, MuRF1, TNF-alpha, and IGFBP-5 gene expression. In summary, our data indicate that chronic arthritis-induced cachexia and muscle wasting are mediated by the COX-2 pathway resulting in a decreased GH-IGF-I secretion and increased expression of MAFbx and MuRF1 mRNA.     

Stimulatory effect of calcitonin on fatty acid synthesis in the liver of fed rats

The effect of calcitonin (CT) on free fatty acid concentration in the serum and liver of fed rats was investigated. A single subcutaneous administration of CT (synthetic [Asu1,7] eel CT;80 MRC mu/100 g body weight) produced a significant increase in serum free fatty acid concentration. An appreciable effect of CT was observed at a dose of 5 MRC mU/100 g body weight. The hormonal effect was also observed in thyroparathyroidectomized rats. The effect of CT on serum free fatty acid was diminished by fasting. Free fatty acid content in the hepatic cytosol of fed rats was markedly increased by CT administration. The hormonal effect was observed at a dose of 5 MRC mU/100 g body weight. Furthermore, stimulation of fatty acid synthesis caused by intraperitoneal injection of alanine (1.122 mmoles/100 g body weight) was markedly enhanced by administration of CT (5, 20 and 80 MRC mU/100 g body weight). This effect of CT on the liver may be the cause of increased level of fatty acid in the serum. The present results suggest that CT may stimulate synthesis of free fatty acid in the liver of fed rats.     

The effect of pyruvate or dihydroxyacetone on parenterally induced liver lipid accumulation in the rat

Orally fed pyruvate (pyr) and dihydroxyacetone (DHA) have been shown to decrease liver lipid accumulation in animal models. These compounds lessen the degree of fatty liver in ethanol-fed rats and in a genetic strain of hens predisposed to fatty liver. Total parenteral nutrition can result in liver dysfunction, including fatty infiltration of the liver. In this study, rats were assigned to either control, pyr, or DHA groups. All rats were fitted with jugular vein catheters, and following a 3-day recovery, were infused continuously for 7 days. The infusate provided adequate nutrition (including 7% kcal as fat) with 5% pyr or 5% DHA (g/liter) substituted for dextrose in the experimental groups. Plasma triglycerides were lower in the pyr groups relative to controls: 62.2 +/- 34.7 (SE) vs 96.8 +/- 44.3 mg/dl, though this was significant only at P less than 0.10. Neither pyr nor DHA decreased liver lipids. Pyr and DHA were administered intravenously in this study, and therefore passed through the heart and to peripheral tissues first. These compounds may need to be fed orally, passing via the portal system, to produce the liver lipid-lowering effects seen in other studies.     

Effect of pituitary tumor MtT-F4 on carnitine levels in the serum,liver and heart of rats

Implantation of MtT-F4 tumor, a pituitary tumor that secretes large quantities of proclactin, growth hormone and ACTH, enhanced total liver carnitine 9-fold without alteration of the esterified to free carnitine ratio. This ratio increased and the concentration of free and total carnitine decreased in the serum of tumor bearing rats. Cardiac carnitine decreased (23%) when expressed on per unit organ weight but showed an increase on per 100 g body weight basis because of marked cardiac hypertrophy. Besides indicating that lipolytic products of pituitary affect liver carnitine, these results show that hyperlipidemia and fatty livers can exist at times despite elevation of liver carnitine content.     

Further studies on the effects of dehydroepiandrosterone on hepatic metabolism in BHE rats

Two experiments were conducted to determine the effects of dehydroepiandrosterone (DHEA) on de novo fatty acid synthesis and oxygen consumption in BHE rats fed a 65% glucose diet. In Experiment 1, starved glucose-refed rats were injected ip with 120 mg of DHEA/kg body wt and hepatic de novo fatty acid synthesis was measured. DHEA-treated rats synthesized less fatty acid in response to starvation refeeding than nontreated rats. In Experiment 2, weanling rats were fed the glucose diet for 4 weeks. One-hundred twenty milligrams of DHEA/kg were injected daily for 3 weeks. Body weight gain, epididymal fat pad weight, and carcass lipid were less in the DHEA-treated rats than in the control rats. Mitochondrial respiration was less and liver size was greater in DHEA-treated rats compared with control rats. Whole body oxygen consumption was increased in DHEA-treated rats, suggesting that this steroid might be stimulating futile energy cycles involving lipid and protein turnover possibly through its effect on glucocorticoid and thyroid hormone function.     

Chylomicron formation and glucagon-like peptide 1 receptor are involved in activation of the nutritional anti-inflammatory pathway

Enteral administration of lipid-enriched nutrition effectively attenuates inflammation via a cholecystokinin (CCK)-mediated vagovagal anti-inflammatory reflex. Cholecystokinin release and subsequent activation of the vagus are dependent on chylomicron formation and associated with release of additional gut peptides. The current study investigates the intestinal processes underlying activation of the CCK-mediated vagal anti-inflammatory pathway by lipid-enriched nutrition. Rats and mice were subjected to hemorrhagic shock (HS) or endotoxemia, respectively. Prior to the experimental procedures, animals were fasted or fed lipid-enriched nutrition. Pluronic L-81 (L-81) was added to the feeding to investigate involvement of chylomicron formation in activation of mesenteric afferent fibers and the immune-modulating potential of lipid-enriched nutrition. Ob/Ob mice and selective receptor antagonists were used to study the role of leptin, glucagon-like peptide 1 and peptide YY in activation of the nutritional reflex. Electrophysiological analysis of mesenteric afferents in mice revealed that lipid-enriched nutrition-mediated neural activation was abrogated by L-81 (P<.05). L-81 blunted the beneficial effects of lipid-enriched nutrition on systemic inflammation and intestinal integrity in both species (all parameters, P<.01). Ob/Ob mice required a higher dose of nutrition compared with wild-type mice to attenuate plasma levels of TNF-α and ileum-lipid binding protein, a marker for enterocyte damage (both P<.01), suggesting a higher stimulation threshold in leptin-deficient mice. Administration of a glucagon-like peptide 1-receptor antagonist, but not leptin or peptide YY antagonists, suppressed the effects of lipid-enriched nutrition. These data indicate that chylomicron formation is essential and activation of the glucagon-like peptide 1-receptor is involved in activation of the nutritional anti-inflammatory pathway by lipid-enriched nutrition.     

Role of fatty acid in the control of protein synthesis in liver cells

Concentrations of oleate (0.2-1 mM) within the physiological range of plasma free fatty acids induced a dose dependent statistically significant inhibition of protein labelling in isolated liver cells. The inhibitory effect was as high as 50% and it was not impeded when long chain fatty acid oxidation was prevented. Experiments carried out with hepatocytes from 48 h fasted rats, incubated in the absence of any exogenous energy source, show that the inhibition of endogenous long chain fatty acid oxidation induced a decreased rate of protein synthesis apparently related to changes in the cellular energy state. It is concluded that fatty acids play a dual role in the regulation of protein synthesis in liver cells: 1. endogenous fatty acids appear to be the main energy fuel for protein synthesis when no other exogenous substrate is present and the carbohydrate stores are low; 2. exogenous fatty acids seem to control protein synthesis by interacting with some key regulatory step.