Maeshima Yoshinori, Fukatsu Kazuhiko, Moriya Tomoyuki, Ikezawa Fumie, Ueno Chikara, Saitoh Daizoh, Mochizuki Hidetaka
Department of Surgery, National Defense Medical College, Saitama, Japan.
JPEN J Parenter Enteral Nutr. 2007 Sep-Oct;31(5):416-22. doi: 10.1177/0148607107031005416.
Lack of enteral nutrition reduces gut-associated lymphoid tissue (GALT) mass and function, a mechanism underlying the increased morbidity of infectious complications in severely injured or critically ill patients. Strategies to restore parenteral nutrition (PN)-induced changes of GALT mass and function have been pursued. However, the influences of adding fish oil to PN on gut immunity remain to be clarified.
Male Institute of Cancer Research (ICR) mice (n = 50) were randomized to 4 groups: ad libitum chow (chow), fat free PN (fat (-)-PN), PN + fish oil (FO-PN), and PN + safflower oil (SO-PN). The PN groups were given isocaloric and isonitrogenous PN solutions. The FO- and SO-PN groups received 20% of total calories from fat emulsions. After 5 days of feeding, lymphocytes from Peyer's patches (PPs), the intraepithelial space (IE), and the lamina propria (LP) of the entire small intestine were isolated. GALT lymphocyte numbers and phenotypes (CD4+, CD8+, alphabetaTCR+, gammadeltaTCR+, B220+ cells) were determined. Immunoglobulin A (IgA) levels of small intestinal washings were also measured by enzyme-linked immunosorbent assay. Another set of mice (n = 24) was used to determine plasma fatty acid compositions after feeding.
Lymphocyte numbers from PPs and the LP and intestinal IgA levels were significantly lower in the PN groups than in the chow group, with no significant differences between any 2 PN groups. The FO- and SO-PN groups showed moderate recovery of IE cell numbers compared with the fat (-)-PN group. Omega-3 and omega-6 fatty acid levels were increased with fish and safflower oil additions, respectively, compared with the fat (-)-PN group.
Adding fish oil to PN does not exacerbate PN-induced GALT changes but rather partially reverses these changes, with increased plasma omega-3 fatty acid levels.
肠内营养缺乏会降低肠道相关淋巴组织（GALT）的质量和功能，这是严重受伤或重症患者感染并发症发病率增加的潜在机制。人们一直在寻求恢复肠外营养（PN）引起的GALT质量和功能变化的策略。然而，在PN中添加鱼油对肠道免疫的影响仍有待阐明。
将雄性癌症研究所（ICR）小鼠（n = 50）随机分为4组：自由摄食普通饲料（普通饲料组）、无脂PN（脂肪（-）-PN组）、PN + 鱼油（FO-PN组）和PN + 红花油（SO-PN组）。PN组给予等热量和等氮量的PN溶液。FO-PN组和SO-PN组从脂肪乳剂中获取20%的总热量。喂养5天后，分离整个小肠派尔集合淋巴结（PPs）、上皮内间隙（IE）和固有层（LP）的淋巴细胞。测定GALT淋巴细胞数量和表型（CD4 +、CD8 +、αβTCR +、γδTCR +、B220 + 细胞）。还通过酶联免疫吸附测定法测量小肠灌洗液中的免疫球蛋白A（IgA）水平。另一组小鼠（n = 24）用于测定喂养后的血浆脂肪酸组成。
PN组PPs和LP的淋巴细胞数量以及肠道IgA水平显著低于普通饲料组，任何两个PN组之间无显著差异。与脂肪（-）-PN组相比，FO-PN组和SO-PN组的IE细胞数量有中度恢复。与脂肪（-）-PN组相比，添加鱼油和红花油后，ω-3和ω-6脂肪酸水平分别升高。
在PN中添加鱼油不会加剧PN引起的GALT变化，反而部分逆转这些变化，同时血浆ω-3脂肪酸水平升高。
