Kudsk Kenneth A, Gomez F Enrique, Kang Woodae, Ueno Chikara
Veterans Administration Surgical Services, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
JPEN J Parenter Enteral Nutr. 2007 Nov-Dec;31(6):477-81. doi: 10.1177/0148607107031006477.
Compared with chow or a complex enteral diet (CED), IV administration of a parenteral nutrition solution (IV-PN) impairs intestinal and respiratory mucosal immunity, resulting in cellular and immunoglobulin A (IgA) defects in the intestine and impaired respiratory antiviral and antibacterial defenses. PN given intragastrically (IG-PN) impairs intestinal immunity similar to IV-PN but preserves antiviral defences and partially preserves antibacterial defenses. Lymphotoxin beta receptor (LTbetaR) is a molecule essential for development and organization of lymphoid tissue. It controls many molecules important in mucosal immune integrity. This study examines effects of route (IV or enteral) and type (PN, CED, or chow) on murine intestine and lung LTbetaR expression.
Forty-three mice randomly received IV-PN (n = 12), IG-PN (n = 11), IV saline + chow (chow; n = 11), or a CED (n = 9). After 5 days of feeding, intestinal and lung samples were obtained and processed for levels of LTbetaR by Western blot.
IV-PN significantly reduced intestinal and lung LTbetaR compared with CED and chow. IG-PN reduced LTbetaR levels only in the intestine but preserved lung levels.
Route and type of nutrition differentially influence molecular events in the intestinal and respiratory mucosal immune systems. Enteral feeding with any diet (complex or chemically defined) maintains lung LTbetaR expression, whereas intestinal LTbetaR levels are maintained only with CEDs (chow and CED). We hypothesize that LTbetaR is responsible for the observed preservation of respiratory tract immunity with administration of a noncomplex, chemically defined enteral diet, whereas intestinal immunity is compromised with this diet.
与普通饲料或复杂肠内饮食(CED)相比,静脉注射肠外营养溶液(IV-PN)会损害肠道和呼吸道黏膜免疫,导致肠道细胞和免疫球蛋白A(IgA)缺陷,以及呼吸道抗病毒和抗菌防御功能受损。胃内给予肠外营养(IG-PN)对肠道免疫的损害与IV-PN相似,但能维持抗病毒防御功能,并部分维持抗菌防御功能。淋巴毒素β受体(LTbetaR)是淋巴组织发育和组织形成所必需的分子。它控制着许多对黏膜免疫完整性至关重要的分子。本研究探讨了营养途径(静脉或肠内)和类型(PN、CED或普通饲料)对小鼠肠道和肺LTbetaR表达的影响。
43只小鼠随机接受IV-PN(n = 12)、IG-PN(n = 11)、静脉注射生理盐水+普通饲料(普通饲料;n = 11)或CED(n = 9)。喂养5天后,获取肠道和肺样本,通过蛋白质印迹法检测LTbetaR水平。
与CED和普通饲料相比,IV-PN显著降低了肠道和肺的LTbetaR水平。IG-PN仅降低了肠道中的LTbetaR水平,但维持了肺中的水平。
营养途径和类型对肠道和呼吸道黏膜免疫系统中的分子事件有不同影响。任何饮食(复杂或化学定义明确的)进行肠内喂养均可维持肺LTbetaR表达,而只有CED(普通饲料和CED)能维持肠道LTbetaR水平。我们推测,LTbetaR是观察到的给予非复杂、化学定义明确的肠内饮食时呼吸道免疫得以维持的原因,而这种饮食会损害肠道免疫。