Kansagra Ketan, Stoll Barbara, Rognerud Cheryl, Niinikoski Harri, Ou Ching-Nan, Harvey Roger, Burrin Douglas
Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.
Am J Physiol Gastrointest Liver Physiol. 2003 Dec;285(6):G1162-70. doi: 10.1152/ajpgi.00243.2003. Epub 2003 Sep 11.
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 = 15) or fed formula (ENT pigs, n = 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 < 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 < 0.001) and was weakly correlated with lactulose (R2 = 0.32) and PEG 4000 (R2 = 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.
脓毒症是早产儿中最常见的发病情况，这些早产儿常接受全胃肠外营养（TPN）。我们假设，与经肠喂养的新生仔猪（ENT仔猪）相比，接受TPN喂养的仔猪肠道屏障功能受损。初乳缺乏的新生仔猪在全身麻醉下植入颈静脉和膀胱导管。仔猪要么接受TPN（n = 15），要么喂食配方奶（ENT仔猪，n = 15）。6天后，给仔猪灌胃甘露醇、乳果糖和聚乙二醇4000（PEG 4000）的混合溶液，并收集24小时尿液。在第7天，检测小肠样本的髓过氧化物酶活性、形态学和紧密连接蛋白丰度。对肠道内容物和外周器官部位进行细菌培养。与ENT仔猪相比，TPN仔猪的甘露醇尿回收率（%剂量）较低（53对68），而乳果糖（2.93对0.18）和PEG 4000（12.78对0.96）的尿回收率较高（P < 0.05）。TPN仔猪和ENT仔猪的细菌移位发生率相似。与ENT仔猪相比，TPN仔猪空肠中的髓过氧化物酶活性增加（P < 0.001），且与乳果糖（R2 = 0.32）和PEG 4000（R2 = 0.38）的回收率呈弱相关。杯状细胞计数没有变化，但TPN组的上皮内淋巴细胞数量减少。只有TPN组的claudin-1蛋白丰度增加。我们得出结论，以通透性而非细菌移位来衡量，TPN与新生儿肠道屏障功能受损有关。
