Ulus Travma Acil Cerrahi Derg. 2022; 28(11): 1541-1548 | DOI: 10.14744/tjtes.2022.36903

Effect of glutamine use on the formation of intestinal neomucosa on peritoneal surface in rats

Ahmet Akbaþ¹, Osman Bilgin Gülcicek², Erkan Yavuz², Hakan Yigitbas², Ali Solmaz², Yigit Ulgen³, Nadir Adnan Hacým², Gulcin Ercan², Yuksel Altinel², Aysegul Kýrankaya⁴, Atilla Çelik^2
1Department of General Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon-Türkiye
²Department of General Surgery, University of Health Sciences Ýstanbul Baðcýlar Training and Research Hospital, Ýstanbul-Türkiye
³Department of Pathology, University of Health Sciences Ýstanbul Baðcýlar Training and Research Hospital, Ýstanbul-Türkiye
⁴Department of Biochemistry, University of Health Sciences Ýstanbul Baðcýlar Training and Research Hospital, Ýstanbul-Türkiye

BACKGROUND: Short bowel syndrome (SBS) is a clinical condition with high mortality and morbidity, which leads to the lack of absorption of fluids or nutrients necessary for the body due to the decrease in the length of the small bowel (SB). Glutamine is an amino acid essential for the nutrition and proliferation of intestinal mucosa cells. The main aim of the present study was to investigate the effect of glutamine on intestinal neomucosa formation in rats which developed SBS.
METHODS: Sixteen Wistar Hannover rats were randomly divided into two groups of eight rats. Saline was applied to the rats in Group 1 (control) following the enteroperitoneal anastomosis between mucosal surface of the ileum and the parietal peritoneum surface (adherent to abdominal wall) while glutamine was applied to the rats in Group 2 following the same anastomosis. Fourteen days later, the rats were euthanatized and blood samples were taken. Simultaneously, en bloc resection of the anastomosis part was performed and histopathological examination was carried out to observe neomucosa formation. The effects of glutamine on anastomosis were determined by microscopic and biochemical evaluations.
RESULTS: Biochemical analyses were performed by measuring serum oxidant (malondialdehyde [MDA] and 8-hydroxy-2’-deoxyguanosine [8-OHdG]) and antioxidant (superoxide dismutase [SOD] and glutathione peroxidase [GPx]) parameters. Based on the biochemical evaluation results of the antioxidant values of the control and glutamine groups, it was found that while the serum antioxidant level (SOD and GPx activity) was significantly higher (p<0.05) in the glutamine-administered rats compared to the control group, the oxidative damage (MDA and 8-OHdG) was lower (p<0.05). In terms of the histological evaluations made for the neomucosa formation, the number of neomucosa formation was higher in the glutamine group, but the difference was not significant (p=0.315).
CONCLUSION: The use of glutamine in patients with SBS may increase surface absorption by increasing neomucosa formation. However, additional studies of large statistical power are needed.

Keywords: Glutamine, neomucosa, peritoneal surface, short bowel syndrome.

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Sýçanlarda Glutamin kullanýmýnýn peritoneal yüzeyde intestinal neomokoza oluþumuna etkisi

Ahmet Akbaþ¹, Osman Bilgin Gülcicek², Erkan Yavuz², Hakan Yigitbas², Ali Solmaz², Yigit Ulgen³, Nadir Adnan Hacým², Gulcin Ercan², Yuksel Altinel², Aysegul Kýrankaya⁴, Atilla Çelik^2
1Karadeniz Teknik Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Trabzon
²Saðlýk Bilimleri Üniversitesi Ýstanbul Baðcýlar Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ýstanbul
³Saðlýk Bilimleri Üniversitesi Ýstanbul Baðcýlar Eðitim ve Araþtýrma Hastanesi, Patoloji Kliniði, Ýstanbul
⁴Saðlýk Bilimleri Üniversitesi Ýstanbul Baðcýlar Eðitim ve Araþtýrma Hastanesi, Biyokimya Kliniði, Ýstanbul

AMAÇ: Kýsa baðýrsak sendromu (SBS) ince baðýrsaklarýn uzunluðunun azalmasýna baðlý vücut için gerekli olan sývý veya besinlerin emilim eksikliðine yol açan mortalitesi ve morbiditesi yüksek klinik durumdur. Glutamin ise baðýrsak mukoza hücrelerinin beslenmesini ve proliferasyonunu artýran bir proteindir. Bu çalýþmanýn temel amacý SBS geliþen ratlarda Glutaminin intestinal neomucosa oluþumu üzerine olan etkisini araþtýrmaktýr.
GEREÇ VE YÖNTEM: On altý wistar-Hannover sýçan üzerinde ileumun mukozal yüzeyi ile parietalperiton yüzeyinin (karýn duvarýna yapýþýk) arasýnda enteroperitoneal anastomoz yapýldýktan sonra rastgele iki eþit gruba bölündü. Grup 1 (kontrol grubu), Salin ile tedavi edilirken grup 2 Glutamin ile tedavi edildi. On dört gün sonra tüm sýçanlara ötenazi uygulandý ve kan alýndý. Eþ zamanlý olarak anastomoz parçasýnýn en blok rezeksiyonu yapýlarak neomukoza oluþumu yönü ile histopatolojik inceleme yapýldý. Glutaminin anastomoz üzerine olan etkileri mikroskobik ve biyokimyasal analizler yapýlmak sureti ile belirlendi.
BULGULAR: Biyokimyasal analizler serumda oksidan (MDA ve 8-OHdG), antioksidan (SOD ve GPx) parametrelerin ölçümü ile yapýldý. Kontrol grubu ve Glutamin verilen grubun antioksidan deðerlerinin biyokimyasal deðerlendirme sonuçlarýna göre Glutamin verilen sýçanlarda serum anti-oksidan seviyesi (SOD ve GPx aktivitesi) kontrol grubuna göre anlamlý ölçüde yüksek (p<0.05) iken oksidatif hasarýn (MDA ve 8-OHdG) kontrol grubuna göre düþük olduðu (p<0.05) gözlendi. Neomukoza oluþumu yönü ile yapýlan histolojik deðerlendirme sonucunda ise Glutamin verilen grupta neomukoza oluþumu sayýca fazla olmasýna raðmen kontrol grubuna göre istatistiksel olarak anlamlý çýkmamýþtýr (p=0.315).
TARTIÞMA: Kýsa baðýrsak sendromu geliþen hastalarda Glutamin kullanýmý neomukoza oluþumunu artýrarak yüzey emilimini artýrabilir. Ancak bunun yeterince güçlü klinik deneylerle belirlenmesi gerekiyor.

Anahtar Kelimeler: Glutamin, kýsa baðýrsak sendromu, neomokoza, peritoneal yüzey.

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