Yamada Waka, Kaji Tatsuru, Onishi Shun, Nakame Kazuhiko, Yamada Koji, Kawano Takafumi, Mukai Motoi, Souda Masakazu, Yoshioka Takako, Tanimoto Akihide, Ieiri Satoshi
Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University.
Department of Pathology and Oncology, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University.
J Pediatr Surg. 2016 Dec;51(12):2039-2043. doi: 10.1016/j.jpedsurg.2016.09.035. Epub 2016 Sep 17.
BACKGROUND/PURPOSE: Total parenteral nutrition (TPN) has been reported to be associated with mucosal atrophy of the small intestine. Ghrelin has hormonal, orexigenic, and metabolic activities. We investigated whether ghrelin improved intestinal mucosal atrophy using a TPN-supported rat model.
Rats underwent jugular vein catheterization and were divided into four groups: TPN alone (TPN), TPN plus low-dose ghrelin (TPNLG), TPN plus high-dose ghrelin (TPNHG), and oral feeding with normal chow (OF). Ghrelin was administered continuously at dosages of 10 or 50 μg/kg/day. On day 6 rats were euthanized, and the small intestine was harvested and divided into the jejunum and ileum. Then the villus height (VH) and crypt depth (CD) were evaluated.
The jejunal and ileal VH and CD in the TPN group were significantly decreased compared with those in the OF group. TPNHG improved only VH of the jejunum. TPNLG improved VH and CD of the jejunum and CD of the ileum. The improvement of TPNLG was significantly stronger than that in CD of the jejunum and ileum.
TPN was more strongly associated with mucosal atrophy in the jejunum than in the ileum. Low-dose intravenous administration of ghrelin improved TPN-associated intestinal mucosal atrophy more effectively than high-dose administration.
背景/目的：据报道，全胃肠外营养（TPN）与小肠黏膜萎缩有关。胃饥饿素具有激素、促食欲和代谢活性。我们使用TPN支持的大鼠模型研究了胃饥饿素是否能改善肠道黏膜萎缩。
大鼠行颈静脉插管，分为四组：单纯TPN组（TPN）、TPN加低剂量胃饥饿素组（TPNLG）、TPN加高剂量胃饥饿素组（TPNHG）和正常饲料经口喂养组（OF）。胃饥饿素以10或50μg/kg/天的剂量持续给药。第6天处死大鼠，取小肠并分为空肠和回肠。然后评估绒毛高度（VH）和隐窝深度（CD）。
与OF组相比，TPN组空肠和回肠的VH和CD显著降低。TPNHG仅改善了空肠的VH。TPNLG改善了空肠的VH和CD以及回肠的CD。TPNLG的改善作用在空肠和回肠的CD方面明显更强。
TPN与空肠黏膜萎缩的相关性比回肠更强。低剂量静脉注射胃饥饿素比高剂量更有效地改善了TPN相关的肠道黏膜萎缩。
