Surgical Center, The University of Tokyo, Tokyo, Japan.
Sugiura Breast Gastroenterology Clinic, Tokorozawa, Japan.
J Surg Res. 2022 Dec;280:355-362. doi: 10.1016/j.jss.2022.07.004. Epub 2022 Aug 26.
Although parenteral nutrition (PN) is the only option for providing adequate nutrition to patients who cannot tolerate oral ingestion, it severely impairs intestinal barrier function in terms of morphology and immunity. While addition of either soybean oil (SO) or fish oil (FO) to PN partially reverses these defects, the effects of the oil composition (FO/SO ratio) on morphology and gut-associated lymphoid tissues (GALT) have yet to be elucidated. We focused on the effects of the FO/SO ratio in PN on the number of lymphocytes in Peyer's patches, immunoglobulin A levels, and intestinal structures.
Male ICR mice (n = 61) were randomized into five groups; oral nutrition (Chow, n = 14) and four groups receiving PN without oral nutrition. PN solutions contained fat emulsions with the following FO:SO ratios: 0:1 (SO, n = 12), 1:11.5 (11.5FSO, n = 17),1:2 (1:2FSO, n = 13) and 1:0 (FO, n = 5). All mice underwent jugular vein catheter insertion. The PN groups were given isocaloric and isonitrogenous nutritional support with 20% of total calories from fat emulsions with equivalent fat delivery in 11.9 g/kg/d. After 5 d of each feeding, Peyer's patches lymphocytes were isolated from the small intestine, counted and analyzed with flowcytometry for determination of their phenotypes (αβTCR+, γδTCR+, CD4+, CD8+ and B cells). Villus height and crypt depth of the jejunum and ileum were evaluated with hematoxylin-eosin staining. Immunoglobulin A levels in the intestinal washings were also determined.
Numbers of total lymphocytes and B lymphocytes in PP were increased in the 1:2 FSO-PN but neither in the 1:11.5 FSO nor the FO group, as compared to the SO group. There were no marked differences among the groups in numbers neither of total T cells nor in any of T cell phenotypes determined. The 1:2 FSO group showed significantly greater villus height and crypt depth than the SO group. IgA levels did not differ significantly among the four PN groups.
The PN with 1:2 FSO (FO:SO = 1:2) maintained lymphocyte numbers in PP and intestinal villus morphology at levels nearly the same as those obtained with chow feeding. An appropriate ratio of FO to SO in PN is expected to prevent immunological impairment and morphological atrophy of the gut associated with lack of oral nutrition.
尽管肠外营养（PN）是不能经口摄入的患者提供充足营养的唯一选择，但它会严重损害肠道屏障功能的形态和免疫。尽管在 PN 中添加大豆油（SO）或鱼油（FO）可以部分逆转这些缺陷，但油成分（FO/ SO 比例）对形态和肠道相关淋巴组织（GALT）的影响尚未阐明。我们专注于 FO/ SO 比值在 PN 中对派伊尔斑中淋巴细胞数量、免疫球蛋白 A 水平和肠道结构的影响。
雄性 ICR 小鼠（n = 61）随机分为五组；口服营养（Chow，n = 14）和四组不进行口服营养的 PN。PN 溶液含有脂肪乳剂，FO：SO 比例分别为 0:1（SO，n = 12）、1:11.5（11.5FSO，n = 17）、1:2（1:2FSO，n = 13）和 1:0（FO，n = 5）。所有小鼠均行颈静脉导管插入术。PN 组给予等热量和等氮量的营养支持，脂肪乳剂提供 20%的总热量，每天 11.9g/kg。在每种喂养后的第 5 天，从小肠中分离出派伊尔斑淋巴细胞，用流式细胞术计数并分析其表型（αβTCR+、γδTCR+、CD4+、CD8+和 B 细胞）。用苏木精-伊红染色评估空肠和回肠的绒毛高度和隐窝深度。还测定了肠灌洗液中免疫球蛋白 A 的水平。
与 SO 组相比，1:2 FSO-PN 组派伊尔斑中的总淋巴细胞和 B 淋巴细胞数量增加，但 1:11.5 FSO 组和 FO 组则不然。4 个 PN 组之间的总 T 细胞数量和任何 T 细胞表型均无明显差异。1:2 FSO 组的绒毛高度和隐窝深度明显大于 SO 组。4 个 PN 组的 IgA 水平无显著差异。
PN 中 1:2 FSO（FO：SO = 1:2）维持了派伊尔斑中的淋巴细胞数量和肠道绒毛形态，接近用饲料喂养获得的水平。PN 中 FO 与 SO 的适当比例有望防止与缺乏口服营养相关的免疫损伤和肠道形态萎缩。
