School of Dietetics and Human Nutrition, McGill University, Quebec, Canada.
Pediatr Res. 2010 Mar;67(3):268-73. doi: 10.1203/PDR.0b013e3181cb8e49.
Malnutrition and cytokine-induced catabolism are pervasive in children with inflammatory bowel diseases (IBD), however, the benefits of aggressive nutrition support or of probiotics on nutrient and functional deficiencies and growth remain unclear. Piglets with dextran sulfate (DS)-induced colitis consuming a 50% macronutrient restricted diet (C-MR) were compared with those receiving probiotics (C-MRP) or adequate nutrition (C-WN) and with healthy well-nourished controls (REF). C-WN versus REF had reduced growth (-34% chest circumference and -22% snout-to-rump length gain) and a tendency toward lesser weight gain, but no differences in skeletal muscle protein fractional synthesis rates (FSR) or initiation of translation via the mTOR pathway were observed. Compared with C-WN, the C-MR and C-MRP piglets had lower weight gain, growth, and skeletal muscle FSR, and lower phosphorylated p70S6K1 with higher eIF4E4E-BP1, indicative of reduced initiation of protein translation. Finally, plasma leucine concentrations were positively correlated with weight and phosphorylated p70S6K1, whereas negatively correlated with eIF4E4E-BP1. In conclusion, reductions in weight gain, growth, protein turnover, skeletal muscle FSR, and initiation of protein translation with moderate macronutrient restriction in colitis are not ameliorated by probiotic supplementation. However, maintaining adequate nutrient intake during colitis preserves whole body protein metabolism, but growth remains compromised.
营养不良和细胞因子诱导的分解代谢在炎症性肠病(IBD)患儿中普遍存在,然而,积极的营养支持或益生菌对营养和功能缺陷以及生长的益处仍不清楚。接受葡聚糖硫酸钠(DS)诱导结肠炎的仔猪在摄入 50%宏量营养素限制饮食(C-MR)时,与接受益生菌(C-MRP)或充足营养(C-WN)的仔猪以及健康营养良好的对照组(REF)进行比较。与 REF 相比,C-WN 的生长速度较慢(胸围减少 34%,口鼻至臀部长度增加减少 22%),体重增加也有下降的趋势,但骨骼肌蛋白合成率(FSR)或通过 mTOR 途径启动翻译没有差异。与 C-WN 相比,C-MR 和 C-MRP 仔猪的体重增加、生长和骨骼肌 FSR 较低,磷酸化 p70S6K1 降低,而 eIF4E4E-BP1 升高,表明蛋白质翻译的起始减少。最后,血浆亮氨酸浓度与体重和磷酸化 p70S6K1 呈正相关,而与 eIF4E4E-BP1 呈负相关。总之,在结肠炎中,中等程度的宏量营养素限制会导致体重增加、生长、蛋白质周转、骨骼肌 FSR 和蛋白质翻译起始减少,而益生菌补充并不能改善这种情况。然而,在结肠炎期间保持充足的营养摄入可以维持全身蛋白质代谢,但生长仍然受到影响。