添加精胺酸對腹膜炎引致敗血症老鼠腸道及全身性 免疫反應之影響

添加精胺酸對腹膜炎引致敗血症老鼠腸道及全身性 免疫反應之影響

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、四組輸入含 2% Arg 之營養輸液，四組分別為第一組：敗血致前後均無補充 Arg 組。

第二組：敗血症後給予 Arg 補充組。第三組：敗血症前給予 Arg 補充組。第四組：敗 血症前後均補充 Arg 組。在引致敗血症後第三天犧牲老鼠，取血液、腹腔灌洗液、脾 臟及小腸做分析。結果顯示在營養素代謝方面， Arg 之補充對於血糖並無影響，但第 三組及第四組其血中三酸甘油酯及游離脂肪酸濃度明顯較第一組及第二組低，顯示在敗 血症前補充 Arg 可使脂肪組織分解的情形獲得改善；在蛋白質代謝方面， Arg 之補充 可使血中 Arg 濃度顯著增高，但支鏈胺基酸和 glutamine 之濃度，在四組間並無顯著之 差異，顯示補充 Arg 對肌肉組織異化作用影響並不明顯。在免疫反應方面，以第三組

、第四組與第一組、第二組比較，其腹腔灌洗液中好氧菌或厭氧菌之總菌落數明顯降低

，而巨噬細胞之吞噬能力明顯較強；第四組小腸上 Peyer’s patches 之總顆粒數和其中淋 巴細胞數量、小腸灌洗液中 total immunoglobulin A 濃度，以及脾臟細胞經刺激後產生 I nterleukin-10 之濃度均明顯高於第一組及第二組；不論添加的時間，補充 Arg 的 3 組其 Interferon-γ 濃度明顯較第四組為低。以上之結果顯示，在敗血症前補充 Arg 之組別可 促進發炎局部之體液性及非特異性免疫反應，但 Arg 在敗血症後補充效果並不顯著，

由於只在敗血症前補充 Arg 與敗血症前後均補充 Arg 的組別在各項分析結果均無統計 上之差異，顯示在敗血症前後均補充 Arg 並無加成之效果。

Effects of Arginine Supplementation on the Systemic and Mucosal Immunity in Rats with Gut-derived Sepsis

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This study investigated the effect of arginine (Arg) supplementation before or/and after sepsis on nutrient metabolism and mucosal immunity in rats. Male Wistar rats were assigned to four groups. Group 1 and 2 fe d with semipurified diet, group 3 and 4 replaced part of casein with 2% of total calorie as Arg. After feedin g the experimental diets for 10 days, sepsis was induced by cecal ligation and puncture (CLP), at the same t ime internal jugular vein was cannulated. All rats were maintained with total parenteral nutrition (TPN) for 3 days. Group 1 and 2 infused conventional TPN, while group 3 and 4 was supplemented with Arg, replaci ng 10% of total amino acid in TPN solution. The 4 groups were: group 1: without Arg supplementation bef ore and after CLP, group 2: Arg supplemented after CLP, group 3: Arg supplemented before CLP, group 4:

Arg supplemented before and after CLP. The experimental diets and TPN solutions were isonitogenous am

ong the groups. All rats were sacrificed 3 days after CLP. The results showed that plasma glucose did not d

iffer among groups, however, plasma triglyceride and free fatty acids were significantly lower in the group

3 and 4 than the other groups. Arg supplementation effectively increased plasma Arg levels, whereas there

were no differences in branch chain amino acid and glutamine concentrations among the groups. These res

ults suggest that Arg supplementation before CLP might have effect on reducing lipolysis induced by sepsi

s, but no beneficial effect was observed on attenuating muscle protein breakdown. Aerobic and anaerobic b

acteria colony counts were significantly reduced and phagocytic activity of macrophage in peritoneal lavag

e fluid was enhanced in group 3 and 4 than the other 2 groups. Total number of Peyer’s patches on the inte

stine, lymphocyte counts in the Peyer’s patches, and total immunoglobulin A in intestinal lavage fluid were

significantly higher in the group 4 than group 1 and 2. Also, interleukin-10 concentrations in mitogen-stim

ulated splenocytes were higher in the group 4 than the group 1 and 2. These results suggest that Arg supple

mentation before sepsis may enhance humoral and nonspecific immune response at the site of injury. Since

there were no differences in various analytic measurements between group 3 and group 4, it seemed that sy

nergistic effect was not obvious with Arg supplementation before and after CLP.