Protection from radiation-induced enteropathy by elemental diet feeding: The role of free radicals

Free radicals have been implicated in intestinal reperfusion injury following ischemia and in epithelial cell damage resulting from ionizing radiation. Elemental diets (ED) have been shown to afford significant prophylaxis to the intestine from these injuries. The purpose of the present study was to investigate whether ED alters the activity of the defense mechanisms necessary for free radical removal. Six female dogs, fed on normal dog chow, had a 30 cm resection of terminal ileum to form Thiry-Vella loops. The main intestine was biopsied and anastomosed. Two weeks later, biopsies were taken from the lips of the loops. Following this, the loops were fed daily with ED another 2 weeks and biopsied again. The dogs were then placed on ED for 3 days before and during 4 days of pelvic irradiation, and the loops also were fed ED daily; after which the animals were again anesthetized, and the loops and main intestine were biopsied. All biopsies were processed for histology, and assayed for xanthine oxidase (XO), superoxide dismutase (SOD), glutathione peroxidase (GSP) and catalase (CAT). The XO and SOD pathway of free oxygen radical generation and scavenging are not affected by radiation. However, ED lowers both XO and SOD activity and may result in a reduced production of peroxides. The significantly increased activity of GSP and CAT when ED is fed improves the scavenging capacity of the free hydroxyl radicals generated by the radiation, and is an important adjunct to an understanding of ED prophylaxis