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Švagždys S, Smolskaitė I, Vindžigalskytė R. Parenteral nutrition: a life-saving intervention for 4 months in short bowel syndrome-a case report and review of the literature. J Med Case Rep 2024; 18:122. [PMID: 38509559 PMCID: PMC10956210 DOI: 10.1186/s13256-024-04442-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Short bowel syndrome (SBS) in adults is defined as having less than 180 to 200 cm of remaining small bowel. Many literature sources do not provide precise epidemiological data, and challenges in estimating the prevalence of SBS include its multifactorial etiology and varying definitions. The most common pathologies leading to SBS include Crohn disease, mesenteric ischemia, radiation enteritis, post-surgical adhesions, and post-operative complications. CASE PRESENTATION This article presents a clinical case of a 76-year-old Lithuanian patient who underwent parenteral nutrition for four months due to SBS. Before the following diagnosis, the patient had undergone two surgeries. During the hospitalization, life-threatening conditions such as stercoral peritonitis, septic shock, and acute respiratory failure, were observed and treated. As a result of SBS, hypoproteinemia and hypoalbuminemia developed, leading to the prescription of full parenteral nutrition. After correcting the malnutrition, a third surgery was performed, resulting in the discontinuation of parenteral nutrition and the resumption of a regular diet. CONCLUSIONS Parenteral nutrition is the sole effective method for preserving the lives of patients with a short segment of the intestine. While on parenteral nutrition, patients can be prepared for reconstructive surgery.
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Affiliation(s)
- Saulius Švagždys
- Department of Abdominal Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Ieva Smolskaitė
- Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rūta Vindžigalskytė
- Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Žilinskas J, Stukas D, Jasukaitienė A, Šapauskienė J, Banienė R, Trumbeckaitė S, Švagždys S, Cicciu M, Dambrauskas Ž, Gulbinas A, Tamelis A. HAMLET effect on cell death and mitochondrial respiration in colorectal cancer cell lines with KRAS/BRAF mutations. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04777-0. [PMID: 37099199 PMCID: PMC10374481 DOI: 10.1007/s00432-023-04777-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/10/2023] [Indexed: 04/27/2023]
Abstract
PURPOSE Treatment of advanced colorectal cancer (CRC) depends on the correct selection of personalized strategies. HAMLET (Human Alpha-lactalbumin Made LEthal to Tumor cells) is a natural proteolipid milk compound that might serve as a novel cancer prevention and therapy candidate. Our purpose was to investigate HAMLET effect on viability, death pathway and mitochondrial bioenergetics of CRC cells with different KRAS/BRAF mutational status in vitro. METHODS We treated three cell lines (Caco-2, LoVo, WiDr) with HAMLET to evaluate cell metabolic activity and viability, flow cytometry of apoptotic and necrotic cells, pro- and anti-apoptotic genes, and protein expressions. Mitochondrial respiration (oxygen consumption) rate was recorded by high-resolution respirometry system Oxygraph-2 k. RESULTS The HAMLET complex was cytotoxic to all investigated CRC cell lines and this effect is irreversible. Flow cytometry revealed that HAMLET induces necrotic cell death with a slight increase in an apoptotic cell population. WiDr cell metabolism, clonogenicity, necrosis/apoptosis level, and mitochondrial respiration were affected significantly less than other cells. CONCLUSION HAMLET exhibits irreversible cytotoxicity on human CRC cells in a dose-dependent manner, leading to necrotic cell death and inhibiting the extrinsic apoptosis pathway. BRAF-mutant cell line is more resistant than other type lines. HAMLET decreased mitochondrial respiration and ATP synthesis in CaCo-2 and LoVo cell lines but did not affect WiDr cells' respiration. Pretreatment of cancer cells with HAMLET has no impact on mitochondrial outer and inner membrane permeability.
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Affiliation(s)
- Justas Žilinskas
- Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių Street 2, 50161, Kaunas, Lithuania.
| | - Darius Stukas
- Institute of Digestive Research, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Aldona Jasukaitienė
- Institute of Digestive Research, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jurgita Šapauskienė
- Department of Biochemistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Banienė
- Department of Biochemistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Sonata Trumbeckaitė
- Laboratory of Biochemistry, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Pharmacognosy, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Saulius Švagždys
- Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių Street 2, 50161, Kaunas, Lithuania
| | - Marco Cicciu
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, Messina, Italy
| | - Žilvinas Dambrauskas
- Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių Street 2, 50161, Kaunas, Lithuania
- Institute of Digestive Research, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Antanas Gulbinas
- Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių Street 2, 50161, Kaunas, Lithuania
- Institute of Digestive Research, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Algimantas Tamelis
- Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, Eivenių Street 2, 50161, Kaunas, Lithuania
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