Alterations in Intestinal Barrier Function Do Not Predispose to Translocation of Enteric Bacteria in Gastroenterologic Patients

OBoyle, Colm; MacFie, John; Dave, K. N.; Sagar, P.; Poon, Philip; Mitchell, C. J.

doi:10.1016/s0899-9007(97)00488-7

Cited by 54 publications

(45 citation statements)

References 18 publications

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“…This presumption overlooked the fact that the mechanisms responsible for paracellular permeability and bacterial translocation are most likely not the same. Adult animal and human studies and the current newborn model confirm that these measures of gut barrier function are not strongly related (22,40). Furthermore, despite finding slightly over half the piglets with translocation in both groups, we did not observe any clinical signs of sepsis.…”

Section: Bacterial Translocationsupporting

confidence: 64%

Total parenteral nutrition adversely affects gut barrier function in neonatal piglets

Kansagra¹,

Stoll²,

Rognerud³

et al. 2003

American Journal of Physiology-Gastrointestinal and Liver Physi

119

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Sepsis is the most common morbidity in preterm infants, who often receive total parenteral nutrition (TPN). We hypothesized that gut barrier function is compromised in TPN-fed compared with enterally fed newborn piglets (ENT pigs). Colostrum-deprived newborn pigs were implanted with jugular venous and bladder catheters under general anesthesia. Pigs were either administered TPN (n ϭ 15) or fed formula (ENT pigs, n ϭ 15). After 6 days, pigs were gavaged a solution of mannitol, lactulose, and polyethylene glycol 4000 (PEG 4000) and urine was collected for 24 h. At 7 days, small bowel samples were assayed for myeloperoxidase activity, morphometry, and tight junction protein abundance. Intestinal contents and peripheral organ sites were cultured for bacteria. Urinary recovery (%dose) of mannitol (53 vs. 68) was lower, whereas that of lactulose (2.93 vs. 0.18) and PEG 4000 (12.78 vs. 0.96) were higher in TPN vs. ENT pigs, respectively (P Ͻ 0.05). Incidence of translocation was similar in TPN and ENT pigs. Myeloperoxidase activity was increased in TPN vs. ENT pigs in the jejunum (P Ͻ 0.001) and was weakly correlated with lactulose (R 2 ϭ 0.32) and PEG 4000 (R 2 ϭ 0.38) recovery. Goblet cell counts did not change, but intraepithelial lymphocyte numbers decreased with TPN. Only claudin-1 protein abundance was increased in the TPN group. We conclude that TPN is associated with impairment of neonatal gut barrier function as measured by permeability but not translocation.

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Section: Bacterial Translocationsupporting

confidence: 64%

Total parenteral nutrition adversely affects gut barrier function in neonatal piglets

Kansagra¹,

Stoll²,

Rognerud³

et al. 2003

American Journal of Physiology-Gastrointestinal and Liver Physi

119

View full text Add to dashboard Cite

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“…Neonates were stratified for gestational age: [25][26][27] ϩ6 (group A, n ϭ 18), 28 -29 ϩ6 (group B, n ϭ 24), and 30 -32 wk gestation (group C, n ϭ 17). Clinical characteristics of the infants are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Although the assumption has been made that alterations in gut barrier function as assessed by changes in intestinal permeability predispose to bacterial translocation and septic complications, there is yet no evidence in humans to support this view (27,28). A direct relation between increased permeability and enhanced passage of luminal factors has thus far only been demonstrated for IgA immune complexes, ovalbumin, and bacterial chemotactic peptides (29 -31).…”

Section: Discussionmentioning

confidence: 99%

Intestinal Permeability and Carrier-Mediated Monosaccharide Absorption in Preterm Neonates during the Early Postnatal Period

et al. 2002

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“…This observation supports the potential effect of systemic LPS to itself worsen gut barrier function. However, data correlating gut permeability changes to sugar markers with infection or bacterial translocation in humans have been inconsistent (5,18,19,38). Previous in vivo studies indicate that administration of both purified flagellin and LPS can induce organ failure and acute-phase cytokine responses (6,15,21).…”

Section: Discussionmentioning

confidence: 99%

Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome

Ziegler

Luo²,

Estívariz³

et al. 2008

American Journal of Physiology-Regulatory, Integrative and Comp

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DP, Gewirtz AT. Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome. Am J Physiol Regul Integr Comp Physiol 294: R402-R410, 2008. First published November 14, 2007 doi:10.1152/ajpregu.00650.2007.-Gut barrier dysfunction may occur in short bowel syndrome (SBS). We hypothesized that systemic exposure to flagellin and lipopolysaccharide (LPS) in SBS might regulate specific immune responses. We analyzed serial serum samples obtained from parenteral nutrition (PN)-dependent patients with SBS versus non-SBS control serum. Serum from 23 adult SBS patients was obtained at baseline and 4, 8, 12, 16, 20, and 24 wk in a trial of modified diet with or without growth hormone. Control serum was obtained from 48 healthy adults and 37 adults requiring PN during critical illness. Serum flagellin was detected by an ELISA recognizing an array of gram-negative flagellins, and LPS was detected by limulus assay. Serum flagellin-and LPS-specific immunoglobulin levels (IgM, IgA, and IgG) were determined by ELISA. Serum flagellin and LPS were undetectable in control subjects. In contrast, serum flagellin, LPS, or both were detected in 14 SBS patients (61%) during one or more time points [flagellin alone, 5/23 (22%); LPS alone, 6/23 (26%); or flagellin ϩ LPS, 3/23 (13%)]. Flagellin-specific serum IgM, IgA, and IgG levels were markedly increased in SBS patients compared with both control populations and remained elevated during the 6-mo study period. LPS-specific IgA was significantly higher in SBS patients compared with healthy controls; LPS-specific IgM, IgA, and IgG levels each decreased over time in association with PN weaning. We conclude that adults with PN-dependent SBS are systemically exposed to flagellin and LPS, presumably from the gut lumen. This likely regulates innate and adaptive immune responses to these specific bacterial products. parenteral nutrition; intestinal barrier function SHORT BOWEL SYNDROME (SBS) occurs after massive small bowel resection and is an important clinical entity, with significant morbidity and mortality (13,36). SBS is characterized by chronic diarrhea and malabsorption, dehydration and malnutrition, and, in patients requiring parenteral nutrition (PN), frequent infections (13,36). Unfortunately, SBS and PN administration are each associated with infection by enteric gramnegative bacteria, suggesting that failure of the gut barrier occurs (2,4,5,18,20,22,24,25,33,34).

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Alterations in Intestinal Barrier Function Do Not Predispose to Translocation of Enteric Bacteria in Gastroenterologic Patients

Cited by 54 publications

References 18 publications

Total parenteral nutrition adversely affects gut barrier function in neonatal piglets

Total parenteral nutrition adversely affects gut barrier function in neonatal piglets

Intestinal Permeability and Carrier-Mediated Monosaccharide Absorption in Preterm Neonates during the Early Postnatal Period

Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome

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