Fluorescence imaging in vivo visualizes delayed gastric emptying of liquid enteral nutrition containing pectin

BMC Gastroenterology

Goro Ebisu²  Naoyuki Endo²  Takeshi Kikuchi¹  Ippei Yamaoka² 

[1] Naruto Research Institute, R & D Center, Otsuka Pharmaceutical Factory, Inc, 115 Kuguhara, Tateiwa, Muya-cho, Naruto, Tokushima 772-8601, Japan;Medical Foods Research Institute, OS-1 Division, Otsuka Pharmaceutical Factory, Inc, 115 Kuguhara, Tateiwa, Muya-cho, Naruto, Tokushima 772-8601, Japan

关键词: Gastrosense;    Gelation;    Semi-solid;    IVIS;    Mouse;   

Others  :  1121804
DOI  :  10.1186/1471-230X-14-168

 received in 2014-04-09, accepted in 2014-09-22,  发布年份 2014

【 摘 要 】

Background

Semi-solidification by gelation or increased viscosity could slow the influx of liquid enteral nutrition (EN) into the small intestine. A liquid EN formula containing pectin that gels under acidic conditions such as those found in the stomach has been developed. A new near-infrared fluorescent imaging reagent was used to non-invasively acquire real time images of gastric emptying in a murine model in vivo. We postulated that the EN formula delays gastric emptying and tested this hypothesis using imaging in vivo.

Methods

Male BALB/c mice were given an oral bolus injection of a liquid EN containing the fluorescence reagent GastroSense750 with or without pectin. The EN in the stomach was visualized in vivo at various intervals using a non-invasive live imaging system and fluorescent signals were monitored from the stomach, which was removed at 60 min after EN ingestion.

Results

The fluorescence intensity of signals in stomachs in vivo and in resected stomachs was lower and attenuated over time in mice given EN without, than with pectin.

Conclusions

Adding a gelling agent such as pectin delayed the transit of liquid EN from the stomach. Fluorescence imaging can visualize the delayed gastric emptying of EN containing pectin.

【 授权许可】

   
2014 Yamaoka et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Hunt JN, Knox MT: Regulation of Gastric Emptying. In Handbook of Physiology. Edited by Code CF, Heidel W. Washington DC: American Physiological Society; 1968:1917-1935.
• [2]Vecht J, Masclee AA, Lamers CB: The dumping syndrome. Current insights into pathophysiology, diagnosis and treatment. Scand J Gastroenterol Suppl 1997, 223:21-27.
• [3]Zaloga GP, Chernow B: Postprandial hypoglycemia after Nissen fundoplication for reflux esophagitis. Gastroenterology 1983, 84:840-842.
• [4]Abell TL, Minocha A: Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci 2006, 331:214-218.
• [5]Barrett JS, Shepherd SJ, Gibson PR: Strategies to manage gastrointestinal symptoms complicating enteral feeding. JPEN J Parenter Enteral Nutr 2009, 33:21-26.
• [6]Tack J, Arts J, Caenepeel P, De Wulf D, Bisschops R: Pathophysiology, diagnosis and management of postoperative dumping syndrome. Nat Rev Gastroenterol Hepatol 2009, 6:583-590.
• [7]Brejnholt SM: Pectin. In Food Stabilisers, Thickeners and Gelling Agents. Edited by Imeson A. Chichester, UK: Blackwell Publishing Ltd; 2010:237-265.
• [8]Sandhu KS, Samahi MM, Mena I, Dooley CP, Valenzuela JE: Effect of pectin on gastric emptying and gastroduodenal motility in normal subjects. Gastroenterology 1987, 92:486-4892.
• [9]Sanaka M, Yamamoto T, Anjiki H, Nagasawa K, Kuyama Y: Effects of agar and pectin on gastric emptying and post-prandial glycaemic profiles in healthy human volunteers. Clin Exp Pharmacol Physiol 2007, 34:1151-1155.
• [10]Shimoyama Y, Kusano M, Kawamura O, Zai H, Kuribayashi S, Higuchi T, Nagoshi A, Maeda M, Mori M: High-viscosity liquid meal accelerates gastric emptying. Neurogastroenterol Motil 2007, 19:879-886.
• [11]Teramoto H, Shimizu T, Yogo H, Nishimiya Y, Hori S, Kosugi T, Nakayama S: Assessment of gastric emptying and duodenal motility upon ingestion of a liquid meal using rapid magnetic resonance imaging. Exp Physiol 2012, 97:516-524.
• [12]Schwarz R, Kaspar A, Seelig J, Künnecke B: Gastrointestinal transit times in mice and humans measured with 27Al and 19F nuclear magnetic resonance. Magn Reson Med 2002, 48:255-261.
• [13]Griffith GH, Owen GM, Kirkman S, Shields R: Measurement of rate of gastric emptying using chromium-51. Lancet 1966, 287:1244-1245.
• [14]Bennink RJ, De Jonge WJ, Symonds EL, van den Wijngaard RM, Spijkerboer AL, Benninga MA, Boeckxstaens GE: Validation of gastric-emptying scintigraphy of solids and liquids in mice using dedicated animal pinhole scintigraphy. J Nucl Med 2003, 44:1099-1104.
• [15]Wang SC, Lu KY, Chen SM, Young TK: Gastric emptying and intestinal transit of liquid and solid markers in rats with chronic uremia. Chin J Physiol 2001, 44:81-87.
• [16]El-Salhy M: Gastric emptying in an animal model of human diabetes type 1: relation to endocrine cells. Acta Diabetol 2001, 38:139-144.
• [17]Symonds EL, Butler R, Omari TI: A mouse model for assessing the impact of ingested nutrients on gastric emptying rate. Clin Exp Pharmacol Physiol 2007, 34:132-133.
• [18]Shah N, Mahoney RR, Pellett PL: Effect of guar gum, lignin and pectin on proteolytic enzyme levels in the gastrointestinal tract of the rat: a time-based study. J Nutr 1986, 116:786-794.
• [19]Holt S, Heading RC, Carter DC, Laurence FP, Tothill P: Effect of gel fibre on gastric emptying and absorption of glucose and paracetamol. Lancet 1979, 8117:636-639.
• [20]Iftikhar SY, Washington N, Wilson CG, Macdonald IA, Homer-Ward MD: The effect of pectin on the gastric emptying rates and blood glucose levels after a test meal. J Pharm Pharmacol 1994, 46:851-853.
• [21]Nakae Y, Onouchi H, Kagaya M, Kondo T: Effects of aging and gastric lipolysis on gastric emptying of lipid in liquid meal. J Gastroenterol 1999, 34:445-449.
• [22]Atia A, Girard-Pipau F, Hébuterne X, Spies WG, Guardiola A, Ahn CW, Fryer J, Xue F, Rammohan M, Sumague M, Englyst K, Buchman AL: Macronutrient absorption characteristics in humans with short bowel syndrome and jejunocolonic anastomosis: starch is the most important carbohydrate substrate, although pectin supplementation may modestly enhance short chain fatty acid production and fluid absorption. JPEN J Parenter Enteral Nutr 2011, 35:229-2240.
• [23]Kim M: High-methoxyl pectin has greater enhancing effect on glucose uptake in intestinal perfused rats. Nutrition 2005, 21:372-377.
• [24]Torjman MC, Joseph JI, Munsick C, Morishita M, Grunwald Z: Effects of isoflurane on gastrointestinal motility after brief exposure in rats. Int J Pharm 2005, 294:65-71.