Abstract
from anesthesia. Sham burn rats served as controls. Apoptosis was quantified by immunohistochemical staining (TUNEL) in paraffin-embedded sections and mucosal proliferation was determined by either bromodeoxyuridine (BrdU) incorporation or proliferative cell nuclear antigen binding (PCNA). Results were analyzed by Wilcoxon's rank sum analysis and t-test. Results: The apoptotic index (TUNEL positive cells/100 villous epithelial cells) in burned rats was higher than controls at 12 hours. At 24 and 48 hours, apoptosis was highest in the starved groups, with no difference between sham and burn. Burn and starvation were not additive (see figure). Mucosal proliferation (BrdU incorporation positive cells/100 crypt cells) was not different between groups at any time point. Conclusion: Burn and starvation cause an increase in apoptosis in the small bowel mucosa, however, the effects are not additive. Starvation appears to be the greater stimulus of small bowel mucosal apoptosis. These results provide strong support for early enteral feeding after injury to maintain mucosal integrity.
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