Spaeth G, Gottwald T, Specian R D, Mainous M R, Berg R D, Deitch E A
Department of Surgery, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
Ann Surg. 1994 Dec;220(6):798-808. doi: 10.1097/00000658-199412000-00014.
The authors investigated the role of mucin and secretory immunoglobulin A (slgA) in a model of nutritionally induced bacterial translocation.
Parenteral and certain elemental diets have been shown to impair intestinal barrier function, whereas fiber has been shown to protect against nutritionally induced bacterial translocation. However, the factors responsible for these phenomenon have not been fully determined.
Intestinal mucin levels, mucosal protein content, slgA, intestinal morphology, and permeability to horseradish peroxidase, bacterial translocation, and intestinal bacterial population levels were measured in rats 7 days after receiving total parenteral nutrition (TPN) solution (28% glucose, 4.25% amino acids; 307 kcal/kg/day) enterally (ORAL-TPN) or parenterally (IV-TPN) with or without enteral bulk fiber supplementation. Chow-fed rats served as control subjects.
The incidence of bacterial translocation in the ORAL-TPN and IV-TPN groups was reduced significantly by the provision of fiber (p < 0.05). Mucosal protein, slgA, and insoluble mucin levels were decreased in the jejunum of the ORAL-TPN and IV-TPN groups, with mucosal protein levels being decreased to a greater extent than slgA or mucin. Although similar decreases in these parameters were observed in the fiber-fed groups, fiber appeared to improve intestinal barrier function as measured by horseradish peroxidase permeability.
The provision of bulk-forming fiber improves intestinal barrier function as measured by peroxidase permeability and bacterial translocation, but does not restore mucosal protein content, intestinal mucin, or slgA levels to normal.
作者在营养诱导细菌移位模型中研究了黏蛋白和分泌型免疫球蛋白A(sIgA)的作用。
肠外营养和某些要素膳已被证明会损害肠道屏障功能,而纤维已被证明可预防营养诱导的细菌移位。然而,导致这些现象的因素尚未完全确定。
在大鼠接受肠内(口服-全肠外营养)或肠外(静脉-全肠外营养)全肠外营养溶液(28%葡萄糖,4.25%氨基酸;307千卡/千克/天)7天后,测量其肠道黏蛋白水平、黏膜蛋白含量、sIgA、肠道形态、对辣根过氧化物酶的通透性、细菌移位及肠道细菌种群水平,其中部分大鼠补充或未补充肠内大体积纤维。以喂饲普通饲料的大鼠作为对照。
补充纤维后,口服-全肠外营养组和静脉-全肠外营养组的细菌移位发生率显著降低(p<0.05)。口服-全肠外营养组和静脉-全肠外营养组空肠黏膜蛋白、sIgA和不溶性黏蛋白水平降低,黏膜蛋白水平降低程度大于sIgA或黏蛋白。虽然在补充纤维的组中也观察到这些参数有类似降低,但从辣根过氧化物酶通透性测量来看,纤维似乎改善了肠道屏障功能。
从过氧化物酶通透性和细菌移位测量来看,补充大体积纤维可改善肠道屏障功能,但不能使黏膜蛋白含量、肠道黏蛋白或sIgA水平恢复正常。