The effects of long-term total parenteral nutrition on gut mucosal immunity in children with short bowel syndrome: a systematic review

Duran, Beyhan

doi:10.1186/1472-6955-4-2

Cited by 50 publications

(39 citation statements)

References 154 publications

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“…There is no direct evidence in human models that TPN promotes bacterial overgrowth, impairs neutrophil functions, inhibits blood's bactericidal effect, or causes villous atrophy. Thus TPN may be more expensive than EN, but it does not seem to be less safe [8]. It is probably the lack of EN rather than reduced GI immunity or the absolute caloric intake that is responsible for many of the adverse effects of TPN such as induction of villus atrophy, epithelial cell apoptosis, and increasing of mucosal permeability [9].…”

Section: Deprivation Of Enteral Nutritionmentioning

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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Section: Deprivation Of Enteral Nutritionmentioning

confidence: 99%

Artificial Nutrition and Intestinal Mucosal Barrier Functionality

Anastasilakis¹,

Ioannidis

Gkiomisi

et al. 2013

Digestion

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“…On the other hand, gutassociated lymphoid tissue (GALT) plays a critical role in the maintenance of gut structures, function, metabolism, and immunity [16]. It has been shown that glutamine supplementation protects the GALT atrophy and IgA depletion that result from long-term TPN and enhances nutrient absorption [17,18].…”

Section: Some Trophic Factors (Ie Growth Hormone [Gh] Insulinlike mentioning

confidence: 99%

The effects of parenteral glutamine on intestinal adaptation in a rat model of short bowel syndrome

et al. 2010

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AbstractShort bowel syndrome (SBS) is characterized by the malabsorption of nutrients and fluids that occurs after major intestinal resection, resulting from an adaptation process that begins immediately to increase the mucosal surface area and absorption. Certain nutrients and trophic factors are widely used to increase intestinal adaptation following massive intestinal resection. The efficacy and benefits of glutamine on the intestinal adaptation process is still controversial. This study was conducted to determine the effects of parenteral glutamine administration on intestinal adaptation in a rat model of SBS. Fourteen male Wistar rats were divided into two groups; all 14 underwent 75% small bowel resection. Within each group, rats were assigned to 14 days of treatment with subcutaneous glutamine (0.3 g/kg/day) or isotonic saline daily. Weight changes and histological intestinal adaptation parameters (mucosal thickness, villus height, and crypt depth) were measured. Non-mucosal intestinal changes were evaluated by intestinal fractioned collagen analysis. All rats initially lost weight and began to gain weight postoperatively; however, they did not reach their preoperative weights during the experiment and there was no significant difference between the groups. Histological adaptation parameters were significantly increased after 75% intestinal resection in both groups compared to paired native samples (P<0.01); although the percent of increase was slightly higher in Gln group, no significant difference was detected between the two groups. Fractioned-collagen amounts were found to be similar between groups. The results indicated that parenteral glutamine administration alone does not improve the intestinal adaptation process after massive intestinal resection in rats.

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“…Following massive SBR the intestine hypertrophies, and nutrient absorption becomes more efficient (Duran 2005). The intestine lengthens, and the diameter and villus height increase with a resultant increase in surface area (Duran 2005).…”

Section: Introductionmentioning

confidence: 99%

Short- and long-term effects of small bowel resection: a unique histological study in a piglet model of short bowel syndrome

Pereira‐Fantini

Thomas

Wilson

et al. 2011

Histochem Cell Biol

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If we are to develop successful interventions to improve clinical outcomes for short bowel syndrome patients we require (1) knowledge of changes within the epithelial population following small bowel resection (SBR) and (2) an idea of when these changes occur to inform on the timing of potential interventions aimed at enhancing the adaptive response. The aim of this study was to produce a temporal map of epithelial changes within the crypt and villus at early and late adaptation phases. Four-week-old piglets underwent a 75% SBR or sham operation and were studied at 2, 4 and 6 weeks post-operation to allow analysis of early and late adaptation responses. Piglets received polymeric infant formula (PIF). Immunohistochemistry with specific cell markers was used to quantitate intestinal cell types and the total cell numbers. Changes within the crypt were temporally dependent on an early significant increase in enterocytes and proliferative cells not sustained at 6 weeks. Goblet cell numbers were increased at all time points. Despite a significant increase in total villus cell numbers at 6 weeks there was no change in specific cell types. We observed two distinct phases of cellular change following SBR. An early increase in enterocytes and proliferative cells was not reflected in increased weight gain indicating the early increase represents immature enterocytes. Interventions aimed at increasing differentiation of the rapidly changing crypt population would allow for an earlier increase in absorption.

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The effects of long-term total parenteral nutrition on gut mucosal immunity in children with short bowel syndrome: a systematic review

Cited by 50 publications

References 154 publications

Artificial Nutrition and Intestinal Mucosal Barrier Functionality

Artificial Nutrition and Intestinal Mucosal Barrier Functionality

The effects of parenteral glutamine on intestinal adaptation in a rat model of short bowel syndrome

Short- and long-term effects of small bowel resection: a unique histological study in a piglet model of short bowel syndrome

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