Effects of Immune-enhancing Enteral Nutrition on Inflammatory Reaction and Immune Function in the Early Phase of Severe Acute Pancreatitis in Rats

Objective To evaluate the effects of immune-enhancing enteral nutrition therapy on the inflammatory reaction and immune function in the early phase of severe acute pancreatitis (SAP) in rats. Methods SAP rat model was established by retrograde injection of sodium taurocholate into the biliopancreatic duct.Sixty SAP rats were randomly divided into total parenteral nutrition group (TPN group,n=20),traditional enteral nutrition group (EN group, n=20), and immune-enhancing enteral immunonutrition group (SEN group, n=20). After a baseline therapy with octreotide for 14 days,specimen were collected at different time points.Serum amylase,plasma cytokines including TNF-α,and IL-10,as well as CD3+,CD4+,CD8+ in peripheral bloodwere measured. Results (1) After 24 h of modeling,TNF-α levels in all three groups were high while IL-10 levels were low.At the fourth day,TNF-α levels decreased sharply,while IL-10 levels increased to the highest level; after that,IL-10 levels also decreased.At the seventh day,TNF-α and IL-10 levels were significantly lower in the SEN group than those in the TPN and EN groups (all P0.05). There was no significant difference between TPN group and EN group (P0.05). (2) CD3+,CD4+,and CD4+ / CD8+ were all significantly higher in the SEN group than those in the TPN group and EN group at the seventh day and at the fourteenth day (P0.05). (3) Blood amylase level was normal in the SEN group at the seventh day and was significantly lower than those in TPN group and EN group (P0.05). At the ninth day,blood amylase levels were also normal in the TPN group and EN group.At the fourteen day,the mortality of severe acute pancreatitis rats was also significantly lower in the SEN group than those in TPN group and EN group. Conclusion Immune-enhancing enteral nutrition can reduce cytokines,strengthen immune function,shorten disease course,and decrease the mortality in rats with severe acute pancreatitis.