Intestinal permeability in the critically ill

Harris, Clair; Griffiths, Richard D.; Freestone, NS; Billington, David C.; Atherton, Stephen; Macmillan, R. R.

doi:10.1007/bf01706424

Cited by 104 publications

(46 citation statements)

References 31 publications

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“…This is in keeping with previously published reports of permeability in critically ill patients (Harris et al, 1992). Our results suggested that LP administration had good effect on intestinal permeability of the patients with AP.…”

Section: Discussionsupporting

confidence: 93%

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

et al. 2007

Eur J Clin Nutr

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Objective: To study the effect of the Lactobacillus plantarum (LP) enteral feeding on the gut permeability and sepsis in the patients with acute pancreatitis. Subjects: Seventy-six subjects who stayed over 1 week in the hospital completed the study. Subjects were not treated with any lactobacillus supplement before the intervention. Methods: Seventy-six patients with acute pancreatitis were randomly divided into two groups, parenteral nutrition (PN) group (n ¼ 38) and ecoimmunonutrition (EIN) group supplied by LP enteral feeding (n ¼ 36). The acute physiology and chronic health evaluation score, Balthazar CT score, CRP, fecal bacterial species and DNA fingerprint profiles as well as the potentially pathologenic organisms in nasogastric aspirate were determined on the day of admission and on the 8 day. The intestinal permeability was assessed by measurement of the ratio of lactulose/rhamnose on the day of admission and on days 5 and 8. The rate of organ failure, septic complications and death cases were evaluated at the 8 day. Results: Following 7 days treatment, 38.9% patients in the EIN group were colonized with multiple organisms compared to 73.7% in the PN group (Po0.01), and 30.6% patients in the EIN grew potentially pathogenic organisms compared to 50% patients in PN group (Po0.05). The fecal bacterial DNA fingerprint profiles were less, the amount of lactobacteria and bifydobacteria decreased, and the amount of enterococci increased in PN group as compared with EIN group, Po0.05. By day 8, the lactulose/rhamnose ratio in EIN group were lower than that in PN group at days 5 and 8, Po0.05. The patients with LP got a better clinical outcomes as compared with the patients with PN. Conclusion: EIN enteral feeding can attenuate disease severity, improve the intestinal permeability and clinical outcomes.

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Section: Discussionsupporting

confidence: 93%

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

et al. 2007

Eur J Clin Nutr

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“…The importance of the gut epithelium in human health is demonstrated by the growing number of disorders that have been linked to defects in intestinal barrier function, including intestinal or extraintestinal inflammatory disorders (32,33), multiple sclerosis (34), chronic heart failure (35), cancer (36,37), and Parkinson's disease (38). In terms of mortality in humans, intestinal barrier dysfunction is reportedly common in critically ill patients and linked to development of the multiple organ dysfunction syndrome (39)(40)(41). Moreover, a chronic state of inflammation (4) and the development of insulin resistance (5) are underlying factors in a wide range of aging-related human diseases.…”

Section: Discussionmentioning

confidence: 99%

Intestinal barrier dysfunction links metabolic and inflammatory markers of aging to death in Drosophila

Rera¹,

Clark²,

Walker

2012

Proc. Natl. Acad. Sci. U.S.A.

520

747

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Aging is characterized by a growing risk of disease and death, yet the underlying pathophysiology is poorly understood. Indeed, little is known about how the functional decline of individual organ systems relates to the integrative physiology of aging and probability of death of the organism. Here we show that intestinal barrier dysfunction is correlated with lifespan across a range of Drosophila genotypes and environmental conditions, including mitochondrial dysfunction and dietary restriction. Regardless of chronological age, intestinal barrier dysfunction predicts impending death in individual flies. Activation of inflammatory pathways has been linked to aging and age-related diseases in humans, and an age-related increase in immunity-related gene expression has been reported in Drosophila. We show that the age-related increase in expression of antimicrobial peptides is tightly linked to intestinal barrier dysfunction. Indeed, increased antimicrobial peptide expression during aging can be used to identify individual flies exhibiting intestinal barrier dysfunction. Similarly, intestinal barrier dysfunction is more accurate than chronological age in identifying individual flies with systemic metabolic defects previously linked to aging, including impaired insulin/insulin-like growth factor signaling, as evidenced by a reduction in Akt activation and upregulation of dFOXO target genes. Thus, the age-dependent loss of intestinal integrity is associated with altered metabolic and immune signaling and, critically, is a harbinger of death. Our findings suggest that intestinal barrier dysfunction may be an important factor in the pathophysiology of aging in other species as well, including humans.ging involves the accumulation of damage to molecules, cells, and tissues, resulting in a decline in physiological functions and ultimately leading to an increased probability of death (1). Considerable progress has been made toward identifying genetic and environmental factors that modulate aging and lifespan, mainly as a result of pioneering work in invertebrate models, such as the nematode Caenorhabditis elegans and the fruit fly Drosophila melanogaster (2). Our understanding of the integrative pathophysiology of aging and age-onset mortality remains very limited, however (3). A number of markers of human aging and age-onset disease have been identified, including a chronic state of inflammation (4) and the development of insulin resistance (5). In a similar fashion, Drosophila aging is also associated with the increased expression of immunity-related genes (6, 7) and characteristics of insulin/insulin-like growth factor signaling (IIS) impedance (8). The relationships between these different metabolic and inflammatory markers of aging and how they relate to age-related pathological changes remain unexplored, however. Moreover, although Drosophila is an important model for studying the genetics of aging, the ability to predict the age at which a fly will die based on a decline in organ function has proven elusive.The inte...

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“…Bacteria can escape the IMB causing fatal syndromes [17] and BT has been linked to SIRS, acute respiratory distress syndrome and MODS [18]. Mucosal barrier permeability is increased in sepsis, trauma, burns and vascular or major abdominal surgery [19,20,21,22]. …”

Section: Bacterial Translocationmentioning

confidence: 99%

Artificial Nutrition and Intestinal Mucosal Barrier Functionality

Anastasilakis¹,

Ioannidis

Gkiomisi

et al. 2013

Digestion

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The gastrointestinal tract has a major role in digestion and absorption of nutrients while playing a leading role in defense of the body. It forms a shield against the invasion of various microorganisms or their products (e.g. antigens, toxins) and therefore it is important to establish its integrity and functionality. That depends on the route of administration and the composition of the artificial nutrition. This study concentrates on the influences of different kinds of artificial nutrition in the functionality of the intestinal mucosal barriers. It seems that full macromolecular solutions of enteral nutrition ensure an adequate mucous immune response, while a lack of nutritional stimulus in the lumen leads rapidly to a dysfunction of gastric-associated lymphatic tissue and mucosal immune system. This dysfunction renders the patients susceptible to infections in distant organs, hospital pneumonia, and multiorgan failure of non-infectious etiology. In patients with indication of total parenteral nutrition administration, addition of bombesin or glutamine preserves mucosal immune response and may limit the adverse effects.

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Intestinal permeability in the critically ill

Cited by 104 publications

References 31 publications

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis

Intestinal barrier dysfunction links metabolic and inflammatory markers of aging to death in Drosophila

Artificial Nutrition and Intestinal Mucosal Barrier Functionality

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