GLUTAMINE STABILIZES THE INTESTINAL BARRI ER AND REDUCES PANCREATIC INFECTION IN ACUTE EXPERIMENTAL PANCREATITIS

Translocation of bacteria from the colon is the principle cause of pan creatic infection and septic complications after severe pancreatitis. One factor promoting bacterial translocation in acute pancreatitis is increased gut permeability. Recent studies have suggested that glutami ne (GLN), an amino acid not contained in standard solutions for total parenteral nutrition (TPN), stabilizes mucosal integrity and reduces b acterial translocation in critically ill patients. The present study e valuates whether adding GLN to standard TPN reduces gut permeability a nd bacterial infection in a model of acute necrotizing pancreatitis in the rat which has been shown to closely mimic the morphological and b acteriological features of severe human pancreatitis. Acute necrotizin g pancreatitis was induced in 50 rats under sterile conditions by an i ntraductal infusion of glycodeoxycholic acid and an iv. infusion of ce rulein. Six hrs after induction of pancreatitis animals were randomize d for standard TPN or TPN containing 0.5 g/kg/d GLN. After 96 hours, a nimals were sacrificed; the pancreas was prepared for bacteriological examination; the ascending colon was excised and mounted in a Ussing c hamber for determining transmucosal resistance (R) and Mannitol Flux ( J) as indicators of intestinal permeability. Adding GLN to standard TP N reduced intestinal permeability and pancreatic infections. This conf irms previous reports that GLN decreases bacterial translocation by st abilizing the mucosal barrier. The present findings provide first evid ence suggesting that stabilizing the intestinal barrier can reduce pan creatic infection in acute pancreatitis and that GLN may be useful in preventing septic complications in clinical pancreatitis.