Are we doing wrong by providing nutritional support in sepsis treatment? Is physiological starving the key solution ?

Background and Aim: Sepsis; It can be defined as the body's excessive response to infection and is a life-threatening condition. Autophagy is one of the pathways that play an important role in intracellular homeostasis, it is known to be activated by hunger and sepsis. In our study, it was aimed to prove that autophagic activity is suppressed in rats given nutritional support during the disease period and to observe its effect on survival. Materials and Methods: 90-150 gr 3-4 week old Wistar-Albino strain male rats, randomly, divided into nine groups: Control group (n: 9), 3 mg / kg LPS + SF group (n: 7), 3 mg / kgLPS + SF + follow-up group (n: 7), 3 mg / kg LPS + food group (n: 7), 3 mg / kg LPS + food + follow-up group (n: 7), 1.5 mg / kg LPS + SF group (n: 7), 1 5 mg / kg LPS + SF + follow-up group (n: 3), 1.5 mg / kg LPS + food group (n: 7), 1.5 mg / kg LPS + food + follow-up group (n: 4) The sepsis model was created by intraperitoneal injection with serotype LPS E. coli O5: B5 with 3 mg / kg / dose and 1.5 mg / kg / dose. It was recorded by monitoring sepsis scoring, body temperature measurement, weight follow-up and average food and water consumption at close intervals for 48 hours after endotoxin administration. At the end of the 48th hour, rats outside the follow-up group were sacrificed under ether anesthesia and gastrocnemius muscle tissue and blood samples were taken, and the autophagic activity was planned to be determined by determining beclin-1, LC3-I / LC3-II caspase-1, IL-1β, NLRP3 proteins in the tissue. The follow-up groups were evaluated daily for 12 days and monitored for mortality. At the end of the 12th day, the rats were sacrificed. Findings: It was observed that the effects of endotoxin weight loss, hypothermia and feed, water consumption reduction in rats treated with LPS were significantly different than the control group. Control and LPS-treated rat groups were evaluated with two different sepsis scores, and both scoring scores were found to be significantly higher in the LPS-treated groups compared to the control group. 1st sepsis scoring was significantly lower in the sepsis scoring at the 24th hour among rats that received 1.5 mg / kg / dose of LPS. When 2nd sepsis scoring was evaluated, it was observed that the sepsis score was significantly more severe in the group receiving food support among the groups of rats administered 3 mg / kg / dose LPS. All sepsis scores of the group who received food support of 1.5 mg / kg / dose LPS of rats were significantly lower than the group without food support until 48th hour. Although there was a significant difference between body temperature measurements between control and LPS treated groups, there was no difference between LPS treated rat groups. There was no difference in survival between the groups. Result:It is important to support the clinical findings with autophagy markers to be studied in the tissue. Nutritional support was found to have a significant effect on the severity of sepsis.