Medical Safety Management Center, Dokkyo Medical University Hospital, Shimotsuga, Tochigi, Japan.
The Research Institute for Time Studies, Yamaguchi University, Yamaguchi, Yamaguchi, Japan.
Genes Cells. 2022 Oct;27(10):613-620. doi: 10.1111/gtc.12976. Epub 2022 Aug 3.
When patients cannot eat on their own, total parenteral nutrition (TPN) is a clinically beneficial method of maintaining nutrition. However, many animal studies have demonstrated that circadian rhythms are strongly affected by feeding time, raising the concern that continuous TPN around the clock may have an unexpected negative impact on the circadian clock of patients. To investigate this concern, we compared clock gene expression of aged subjects with or without TPN using hair follicle cells and found that while none of the non-TPN subjects showed any obvious defects in circadian rhythms of peripheral clock gene expression, a portion of aged subjects receiving continuous TPN showed abnormal circadian rhythms in peripheral clocks. Continuous TPN around the clock may therefore potentially perturb peripheral circadian rhythms, giving rise to the proposal that TPN needs to be administered with consideration to time factors.
当患者无法自主进食时，全胃肠外营养（TPN）是一种维持营养的临床有益方法。然而，许多动物研究表明，昼夜节律受喂养时间的强烈影响，这让人担心 24 小时不间断的 TPN 可能会对患者的生物钟产生意想不到的负面影响。为了研究这一担忧，我们使用毛囊细胞比较了有或没有 TPN 的老年患者的时钟基因表达情况，结果发现，虽然没有一个非 TPN 患者的外周时钟基因表达的昼夜节律出现明显缺陷，但一部分接受持续 TPN 的老年患者的外周时钟出现了异常的昼夜节律。因此，24 小时不间断的 TPN 可能会潜在地扰乱外周昼夜节律，这就提出了 TPN 需要考虑时间因素进行给药的建议。
