Effects of glutamine enriched enteral feeding on immunoregulation in burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effects of glutamine enriched enteral feeding on immunoregulation in burn patients.</p><p><b>METHODS</b>Twenty burn patients were randomly divided into enteral nutrition (EN) group and enteral immune nutrition (EIN) group, with 12 patients in each group. Patients in EN group received a standard enteral formula, while those in EIN group received an enteral formula enriched with glutamine after hospital admission. Nutritional support was continued for 10 days. Blood samples were obtained to determine plasma level of total protein (TP), albumin (ALB), prealbumin (PAB) and transferrin (TF) at 1, 4, 7, 10 post-burn days (PBD). At the same time the concentration of immunoglobulin (IgA, IgG and IgM) were determined, the percentage of CD3+, CD4+, CD8+ subpopulations of T lymphocytes, and the ratio of CD4+/CD8+ were determined by FCM.</p><p><b>RESULTS</b>(1) There were no obvious difference of the plasma level of TP, ALB, TF, CD3+, IgM between the two groups at each time-point (P > 0.05). (2) The plasma PAB contents in EIN group were significant higher than that in EN group on 4 PBD [(90 +/- 14 vs 60 +/- 15) mg/L, P < 0.05], 7 PBD [(92 +/- 16 vs 64 +/- 13) mg/L, P < 0.05] and 10 PBD [(106 +/- 21 vs 72 +/-16) mg/L, P < 0.05]. (3) The percentage of CD4+ subpopulation and ratio of CD4+/CD8+ in EIN group were obviously higher than those in EN group on 7 PBD [CD4+ (55 +/- 5 vs 45 +/- 5)%, CD4+/CD8+ (1.92 +/- 0.31 vs 1.53 +/- 0.27)%, P < 0.05] and 10 PBD [CD4+ (56 +/- 5 vs 49 +/- 5)%, CD4+/CD8+ (2.36 +/- 0.36 vs 1.72 +/- 0.42), P < 0.05]. (4) The concentration of IgA and IgG in EIN group were markedly higher than that in EN group on 7 PBD [IgA (2.8 +/- 0.6 vs 2.2 +/- 0.5) g/L, IgG (12.1 +/- 1.3 vs 9.8 +/- 1.2) g/L, P < 0.05] and 10 PBD [IgA (3.1 +/- 0.6 vs 2.5 +/- 0.5) g/L, IgG (14.2 +/- 1.3 vs 10.4 +/- 1.3) g/L, P < 0.05].</p><p><b>CONCLUSION</b>These findings suggest that glutamine enriched enteral feeding can improve nutritional status by promoting the synthesis of IgA, IgG, and increasing the PAB concentration, and corrected immunologic dysfunction in burn patients.</p>

The influence of apoptosis of lymphocytes of Peyer's patches on the pathogenesis of gut barrier damage in severely scalded mice / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the changes in cellular apoptosis of Peyer's patches in severely scalded mice, and to explore its role in the pathogenesis of gut barrier damage.</p><p><b>METHODS</b>Forty BALB/c mice were randomly divided into normal control, 12 post-scald hour (12PSH), 24PSH and 72PSH groups, with 10 in each group. The mice in all PSH groups were inflicted with 20% TBSA full-thickness scald on the back. The mice in all the groups were sacrificed at different time points, and Peyer's patches were harvested from all the mice for HE staining, DNA gel electrophoresis, and flow cytometry ( FCM) examination with FITC conjugated Annexin-v and propidium iodide( PI) staining of cells.</p><p><b>RESULTS</b>HE staining revealed that there were relatively abundant apoptotic cells scattering in Peyer's patches of scalded mice . DNA electrophoresis of Peyer's patches revealed typical " ladder" pattern at all indicated time points in scalded mice. Apoptotic percentage of detached Peyer's patches cells in control and scalded group were (4. 9+/-2. 1)% , (26.7+/-3. 1)% , (21.6 +/-4.0)% ,(12. 8 +/-2.0)% , respectively, and the percentage reached the peak at 12 PSH.</p><p><b>CONCLUSION</b>Apoptosis is a principle modality of cell death of small intestinal Peyer's patches lymphocytes in severely scalded mice, and it might contribute to immunity barrier failure of intestinal wall after severe thermal injury.</p>

Changes in the calcitonin content after inhalation injury in dogs / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the changes in the serum content of immunoreactive calcitonin (iCT) after burns or inhalation injury, and to explore its diagnostic significance.</p><p><b>METHODS</b>Twenty-four dogs were randomized into 4 groups, i. e. A (n = 6, with moderate degree inhalation injury) , B ( n = 6, with severe inhalation injury), C (n = 6, with most severe inhalation injury) and D (n = 6, with severe burns) groups. The serum content of iCT and blood gas analysis before and after injury were determined at different time points. The degree of inhalation injury was determined with fibrobronchoscopic examination at 6 post-inhalation injury hour (PIH).</p><p><b>RESULTS</b>(1) Fiber bronchoscopic examination showed that the degree of inhalation injury in each group was coincident with the anticipation. (2) The serum content of iCT in each group at 1 PIH was obviously higher than that before injury, and it was evidently higher in A, B and C groups than that in D group at 4 PIH. The peak value of iCT in group A at 24 PIH was (453+/-224) ng/L, and it increased gradually in B and C groups at 48 PIH. The serum content of iCT increased continually from 2 PIH on, and it reached (125+/-41) ng/L at 48 PIH. (3) Compared with PaO2 value before injury (109+/-8) mmHg, there was no obvious difference of the PaO, in A and D groups. PaO2 value in B and C group began to descend continually at 8 PIH (65+/-6) mmHg, and that in C group began to descend at 4 PIH (71+/-9) mmHg. PaCO2 value in C group began to increase at 24 PIH(52+/-11) mmHg when compared with that before injury(38+/-5 ) mmHg.</p><p><b>CONCLUSION</b>The changes in the serum level of iCT within 8 PIH occurred much earlier than PaO2 and PaCO2, thus it has the same diagnostic significance as fibers bronchoscopic examination.</p>

Maturation regulation of dendritic cells pulsed with hepatocellular carcinoma cell soluble antigens / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To research the maturation regulation of dendritic cells (DCs) pulsed with hepatocellular carcinoma (HCC) cell soluble antigens.</p><p><b>METHODS</b>BCG HSP 70 was purified by SDS-PAGE electrophoresis and its biological activity was determined with ELISA. Phenotypes of DCs pulsed with antigens or with both antigens and BCG HSP 70 were analysed with flow cytometry. MTT assay was used to estimate the proliferation of self lymphocytes and the mixed lymphocyte reaction (MLR) of BCG HSP 70 primed DCs.</p><p><b>RESULTS</b>The characteristics of DCs had changed after loaded with soluble antigens of HCC. There were about 10% DCs which had lost their specific markers. The expression levels of CD54, CD83, CD86 molecules and the stimulatory ability in allogeneic MLR decreased. However, after being activated by BCG HSP 70, the DCs pulsed with antigens could keep their special markers and the expression levels of CD54, CD83, CD86 molecules increased too. The stimulatory abilities in allogeneic MLR and proliferation of self lymphocytes also improved.</p><p><b>CONCLUSION</b>This study shows that BCG HSP 70 can induce DCs pulsed with antigens maturation and improve their antigen-presenting ability, which may be a useful maturation inducer for dendritic cells.</p>