Demehri Farokh R, Barrett Meredith, Teitelbaum Daniel H
Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan.
Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan
Nutr Clin Pract. 2015 Dec;30(6):798-806. doi: 10.1177/0884533615609904. Epub 2015 Sep 30.
Parenteral nutrition (PN) dependence, while life sustaining, carries a significant risk of septic complications associated with epithelial barrier dysfunction and translocation of gut-derived microbiota. Increasing evidence suggests that PN-associated changes in the intestinal microbiota play a central role in the breakdown of the intestinal epithelial barrier. This review outlines the clinical and experimental evidence of epithelial barrier dysfunction with PN, the role of gut inflammatory dysregulation in driving this process, and the role of the intestinal microbiome in modulating inflammation in the gut and systemically. The article summarizes the most current work of our laboratory and others and describes many of the laboratory findings behind our current understanding of the PN enteral environment. Understanding the interaction between nutrient delivery, the intestinal microbiome, and PN-associated complications may lead to the development of novel therapies to enhance safety and quality of life for patients requiring PN.
肠外营养（PN）依赖虽然维持生命，但存在与上皮屏障功能障碍和肠道来源微生物群易位相关的严重脓毒症并发症风险。越来越多的证据表明，PN相关的肠道微生物群变化在肠道上皮屏障破坏中起核心作用。本综述概述了PN导致上皮屏障功能障碍的临床和实验证据、肠道炎症失调在驱动这一过程中的作用以及肠道微生物群在调节肠道和全身炎症中的作用。本文总结了我们实验室和其他实验室的最新研究成果，并描述了目前我们对PN肠道环境理解背后的许多实验室发现。了解营养输送、肠道微生物群和PN相关并发症之间的相互作用，可能会催生新的治疗方法，以提高需要PN的患者的安全性和生活质量。
