Volume 10,Issue 5
Effects of Enemas with Short-Peptide-Based Enteral Nutritional Formulas of Different Osmotic Pressures on the Structure and Immune Barrier of the Excluded Ileum in Patients with Colorectal Cancer
This study investigated the effects of isosmotic and hyperosmotic short-peptide enteral nutritional formula enemas on the structure and immune barrier of the excluded ileum in patients with colorectal cancer. Eighty-six patients with preventive terminal ileum double-barrel stomas were randomized to receive isosmotic formula, hyperosmotic formula, or normal saline for 2 weeks. Ileal mucosal tissues were collected before enema and at ileostomy reversal. Villus height (VH), crypt depth (CD), VH/CD ratio, histopathology, mucosal addressin cell adhesion molecule-1 (MAdCAM-1), CD4⁺, and CD8⁺ expression were assessed. VH and CD increased after enema, with greater improvements in the isosmotic group than in the hyperosmotic and control groups, whereas VH/CD showed no significant between-group difference after treatment. MAdCAM-1, CD4⁺, and CD8⁺ expression also increased after enema; pairwise comparisons showed greater increases in MAdCAM-1 and CD8⁺ levels in the isosmotic group than in the hyperosmotic and control groups. These findings suggest that short-peptide formula enemas may support repair of the excluded ileal mucosa
and partial recovery of mucosal immune activity, with the isosmotic formula showing more favorable effects on mucosal structure and selected immune markers.
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