Nutritional and pharmacological strategy in children with short bowel syndrome

Höllwarth, Michael E.; Solari, Valeria

doi:10.1007/s00383-020-04781-2

Cited by 5 publications

(4 citation statements)

References 116 publications

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“…Esta estrategia de soporte nutricio permite lograr un crecimiento, desarrollo y una calidad de vida lo más cercano a lo normal. 8 Sin embargo, la NPT presenta múltiples complicaciones, entre ellas, el riesgo de desarrollar enfermedad ósea metabólica caracterizada por deficiencia en la concentración de 25-hidroxivitamina D, balance negativo de calcio y disminución de la mineralización ósea.…”

Section: Discussionunclassified

Síndrome de intestino ultra-corto y enfermedad ósea metabólica en un paciente con nutrición parenteral total

Anaya-Flórez,

Barbosa-Cortés,

Barraza Tinajero

2023

Revista Mexicana De Pediatría

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RESUMENIntroducción: los pacientes pediátricos con síndrome de intestino corto (SIC) que reciben nutrición parenteral total (NPT) prolongada pueden desarrollar enfermedad mineral ósea por diferentes mecanismos. Caso clínico: adolescente femenino de 16 años quien ha recibido apoyo con NPT durante más de un año, resultado de la resección de una tumoración abdominal, así como de una porción amplia del intestino, por lo cual la paciente solamente tenía 5 cm de yeyuno, sin válvula ileocecal ni colon ascendente, y con la mitad de colon transverso. A seis meses de NPT presentó deficiencia de vitamina D (12.9 ng/mL), por lo que se incrementó en la dosis en NPT a 400 UI. Después de cinco meses, los valores de vitamina D se mantenían bajos (21.9 ng/dL), por la que se agregó colecalciferol, llegando a niveles normales. Durante este periodo se determinó que la densidad mineral ósea era baja, pero mejoró con la suplementación de vitamina D. Conclusiones: los datos de esta paciente indican la necesidad de mantener un seguimiento de la salud ósea en los pacientes con SIC dependientes de NPT prolongada.Palabras clave: síndrome de intestino corto, nutrición parenteral total, enfermedad ósea metabólica, 25-hidroxivitamina D.

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Section: Discussionunclassified

Síndrome de intestino ultra-corto y enfermedad ósea metabólica en un paciente con nutrición parenteral total

Anaya-Flórez,

Barbosa-Cortés,

Barraza Tinajero

2023

Revista Mexicana De Pediatría

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“…The promotion of intestinal adaptation is essential for restoring enteral autonomy and reducing long-term dependence on PN support. Thus, the primary goal of treatment of patients with SBS is to promote intestinal adaptation by using the gastrointestinal tract as much as possible ( 8 , 9 ). Developing ideal treatments to promote intestinal adaptation is important for improving the survival rate and quality of life of patients with SBS.…”

Section: Popular Scientific Summarymentioning

confidence: 99%

Inositol hexaphosphate promotes intestinal adaptation in short bowel syndrome via an HDAC3-mediated epigenetic pathway

Wang

et al. 2023

Food & Nutrition Research

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Background: Short bowel syndrome (SBS) has high morbidity and mortality rates, and promoting intestinal adaptation of the residual intestine is a critical treatment. Dietary inositol hexaphosphate (IP6) plays an important role in maintaining intestinal homeostasis, but its effect on SBS remains unclear. This study aimed at investigating the effect of IP6 on SBS and clarified its underlying mechanism. Methods: Forty male Sprague–Dawley rats (3-week-old) were randomly assigned into four groups (Sham, Sham + IP6, SBS, and SBS + IP6 groups). Rats were fed standard pelleted rat chow and underwent resection of 75% of the small intestine after 1 week of acclimation. They received 1 mL IP6 treatment (2 mg/g) or sterile water daily for 13 days by gavage. Intestinal length, levels of inositol 1,4,5-trisphosphate (IP3), histone deacetylase 3 (HDAC3) activity, and proliferation of intestinal epithelial cell-6 (IEC-6) were detected. Results: IP6 treatment increased the length of the residual intestine in rats with SBS. Furthermore, IP6 treatment caused an increase in body weight, intestinal mucosal weight, and IEC proliferation, and a decrease in intestinal permeability. IP6 treatment led to higher levels of IP3 in feces and serum, and higher HDAC3 activity of the intestine. Interestingly, HDAC3 activity was positively correlated with the levels of IP3 in feces (r = 0.49, P = 0.01) and serum (r = 0.44, P = 0.03). Consistently, IP3 treatment promoted the proliferation of IEC-6 cells by increasing HDAC3 activity in vitro. IP3 regulated the Forkhead box O3 (FOXO3)/Cyclin D1 (CCND1) signaling pathway. Conclusion: IP6 treatment promotes intestinal adaptation in rats with SBS. IP6 is metabolized to IP3 to increase HDAC3 activity to regulate the FOXO3/CCND1 signaling pathway and may represent a potential therapeutic approach for patients with SBS.

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“…At the time of first assessment, data for personalized management are collected (neonatal history, surgical history, nutritional status, status of the anatomy and physiology of the remaining bowel, and potential metabolic and/or central line complications) [19][20][21][22]. In fact, a 360-degree multidisciplinary evaluation of the patient state is key to orienting management.…”

Section: Intestinal Rehabilitation Programmentioning

confidence: 99%

Current Surgical Concepts and Indications in the Management of the Short Bowel State: A Call for the Use of Multidisciplinary Intestinal Rehabilitation Programs

et al. 2021

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The mainstay of management for short bowel syndrome (SBS) is to promote access to the best quality of care provided by the intestinal rehabilitation program (IRP) in specialized centres. When treating SBS patients, the main goal is to minimize disease-associated complications, as well as achieve enteral autonomy. Surgical strategies should be selected cautiously upon the actual state of the bowel with respect to what it is clinically relevant for that specific patient. To this aim, a personalized and multidisciplinary approach for such a complex syndrome is needed.

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Nutritional and pharmacological strategy in children with short bowel syndrome

Cited by 5 publications

References 116 publications

Síndrome de intestino ultra-corto y enfermedad ósea metabólica en un paciente con nutrición parenteral total

Síndrome de intestino ultra-corto y enfermedad ósea metabólica en un paciente con nutrición parenteral total

Inositol hexaphosphate promotes intestinal adaptation in short bowel syndrome via an HDAC3-mediated epigenetic pathway

Current Surgical Concepts and Indications in the Management of the Short Bowel State: A Call for the Use of Multidisciplinary Intestinal Rehabilitation Programs

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