Postoperative complications in patients with
obstructive jaundice remain increased when associated with
endotoxemia and the inflammatory response due to gut barrier failure. Administration of
glutamine has been proposed to maintain the integrity of the gut mucosa and thus reduce bacterial translocation (BT), but the effects of this pretreatment on apoptosis and histologic morphology of various organs affected by BT in
obstructive jaundice have not been studied. We therefore studied the effects of oral
glutamine supplementation on
endotoxemia, BT, liver and terminal ileal morphology, and apoptosis in an experimental model of
obstructive jaundice. A total of 60 male Wistar rats were randomly divided into four groups of 15 each: I, controls; II,
sham-operated; III, bile duct
ligation (BDL); IV, BDL +
glutamine (4.5 g/kg/day in
drinking water). Ileal samples for histology,
DNA and
protein content, liver biopsies, mesenteric lymph nodes (MLNs) for culture, and portal and systemic blood samples for
endotoxin measurements were obtained 10 days later. Compared to the controls, a significant increase in contaminated MLN and liver samples and increased
endotoxemia were noted in group III (p < 0.01) but were significantly reduced in group IV (p < 0.05). Group IV also had a significantly higher number of mitoses per crypt (M/c) (p < 0.05), less apoptotic body counts (ABCs) (p < 0.05), and a higher
DNA content than did group III (p < 0.05). Liver biopsies from group III displayed typical changes of large duct obstruction that significantly improved after
glutamine treatment, with decreased ductular proliferation. We concluded that supplementation of oral
glutamine in the presence of
obstructive jaundice ameliorates BT,
endotoxemia, and apoptosis and improves the ileal and liver histology.