Choline Alleviates Parenteral Nutrition–Associated Duodenal Motility Disorder in Infant Rats

Zhu, Jie; Wu, Yang; Guo, Yonggao; Tang, Qingya; Lü, Ting; Cai, Wei; Huang, Haiyan

doi:10.1177/0148607115583674

Cited by 5 publications

(5 citation statements)

References 53 publications

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“…The supplemented choline group had lower values for all PNAC markers; however, the values for direct bilirubin and serum bile acids were slightly elevated compared to an enteral control group. The same research group also found the choline supplemented to TPN can improve intestinal motility [151]. This may be of particular importance given the gut atrophy that occurs during TPN administration.…”

Section: Potential Components To Reduce Pnac Incidence 41 Cholinementioning

confidence: 83%

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Guthrie

Burrin

2021

Nutrients

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Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC.

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Section: Potential Components To Reduce Pnac Incidence 41 Cholinementioning

confidence: 83%

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Guthrie

Burrin

2021

Nutrients

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“…Upon evaluation of their titles, 38 were considered of no relevance (for complete search results see Supplementary Table S1 ). The remaining 47 articles were evaluated in more detail, including a letter pointing to the evidence for choline deficiency in TPN [ 28 ], followed by 9 pre-clinical in vivo studies (1985–2020) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ], 20 human trials (12 observational (1985–2021) [ 18 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ] and 7 interventional studies (1990–2011) [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ] including one editorial [ 51 ] on ref. [ 50 ]), 14 reviews (1986–2019) [ 15 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ] plus 1 in 2024 [ 27 ] and 3 guidelines (2012–2022) [ 26 , 69 , …”

Section: Resultsmentioning

confidence: 99%

“…In 3 weeks old healthy rats, 7 d of choline-free TPN increased the generation of reactive oxygen species (ROS) and tumor necrosis factor alpha (TNFα), whereas plasma choline and antioxidant capacity decreased. Choline-free TPN in rats caused liver pathology and steatosis, increased plasma transaminases, triglycerides, very low-density lipoproteins (VLDL), bile acids and bilirubin as well as peroxisomal proliferator-activated receptor alpha (PPARα) gene promoter methylation, which were reversed by 600 mg/kg/d IV choline chloride (450 mg/kg/d choline) [ 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…Upon evaluation of their titles, 38 were considered of no relevance (for complete search results see Supplementary Table S1). The remaining 47 articles were evaluated in more detail, including a letter pointing to the evidence for choline deficiency in TPN [28], followed by 9 pre-clinical in vivo studies (1985-2020) [29][30][31][32][33][34][35][36][37], 20 human trials (12 observational (1985-2021) [18,[38][39][40][41][42][43][44][45][46][47][48]] and 7 interventional studies [49][50][51][52][53][54][55][56] including one editorial [51] on ref. [50]), 14 reviews (1986-2019) [15,[57][58][59][60][61][62][63][64][65][66][67][68] pl...…”

Section: Resultsmentioning

confidence: 99%

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Evidence and Perspectives for Choline Supplementation during Parenteral Nutrition—A Narrative Review

Bernhard,

Böckmann,

Minarski

et al. 2024

Nutrients

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Choline is an essential nutrient, with high requirements during fetal and postnatal growth. Tissue concentrations of total choline are tightly regulated, requiring an increase in its pool size proportional to growth. Phosphatidylcholine and sphingomyelin, containing a choline headgroup, are constitutive membrane phospholipids, accounting for >85% of total choline, indicating that choline requirements are particularly high during growth. Daily phosphatidylcholine secretion via bile for lipid digestion and very low-density lipoproteins for plasma transport of arachidonic and docosahexaenoic acid to other organs exceed 50% of its hepatic pool. Moreover, phosphatidylcholine is required for converting pro-apoptotic ceramides to sphingomyelin, while choline is the source of betaine as a methyl donor for creatine synthesis, DNA methylation/repair and kidney function. Interrupted choline supply, as during current total parenteral nutrition (TPN), causes a rapid drop in plasma choline concentration and accumulating deficit. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) defined choline as critical to all infants requiring TPN, claiming its inclusion in parenteral feeding regimes. We performed a systematic literature search in Pubmed with the terms “choline” and “parenteral nutrition”, resulting in 47 relevant publications. Their results, together with cross-references, are discussed. While studies on parenteral choline administration in neonates and older children are lacking, preclinical and observational studies, as well as small randomized controlled trials in adults, suggest choline deficiency as a major contributor to acute and chronic TPN-associated liver disease, and the safety and efficacy of parenteral choline administration for its prevention. Hence, we call for choline formulations suitable to be added to TPN solutions and clinical trials to study their efficacy, particularly in growing children including preterm infants.

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“…A study using rats with parenteral nutrition demonstrated that L-glutamine is the preferred fuel for the jejunal smooth muscle, whereas, in the absence of other amino acids, exogenous glutamine prevents the atrophy of the gut musculature in rats [ 294 ]. Zhu et al studied the effect of choline in rats with parenteral nutrition and found that choline supplementation protects the smooth muscle cells from injury, diminishing the progression of duodenal motor disorder [ 295 ]. Vrabcova et al investigated the effect of liquid nutrition in the morphology of the gut, proving that the muscle layer thickness is independent of the form of the food intake [ 296 ].…”

Section: Nutrition Microbiota and Innate Immune Signaling Adapts Gut Morphology And Cell Homeostasismentioning

confidence: 99%

The Interplay between Nutrition, Innate Immunity, and the Commensal Microbiota in Adaptive Intestinal Morphogenesis

et al. 2021

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The gastrointestinal tract is a functionally and anatomically segmented organ that is colonized by microbial communities from birth. While the genetics of mouse gut development is increasingly understood, how nutritional factors and the commensal gut microbiota act in concert to shape tissue organization and morphology of this rapidly renewing organ remains enigmatic. Here, we provide an overview of embryonic mouse gut development, with a focus on the intestinal vasculature and the enteric nervous system. We review how nutrition and the gut microbiota affect the adaptation of cellular and morphologic properties of the intestine, and how these processes are interconnected with innate immunity. Furthermore, we discuss how nutritional and microbial factors impact the renewal and differentiation of the epithelial lineage, influence the adaptation of capillary networks organized in villus structures, and shape the enteric nervous system and the intestinal smooth muscle layers. Intriguingly, the anatomy of the gut shows remarkable flexibility to nutritional and microbial challenges in the adult organism.

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Choline Alleviates Parenteral Nutrition–Associated Duodenal Motility Disorder in Infant Rats

Abstract: The addition of choline to PN may alleviate the progression of duodenal motor disorder through protecting smooth muscle cells from injury, promoting mSCF/c-Kit signaling, and attenuating impairment of interstitial cells of Cajal in the duodenum during PN feeding.

Cited by 5 publications

References 53 publications

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates

Evidence and Perspectives for Choline Supplementation during Parenteral Nutrition—A Narrative Review

The Interplay between Nutrition, Innate Immunity, and the Commensal Microbiota in Adaptive Intestinal Morphogenesis

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