Gastrointestinal immune and microbiome changes during parenteral nutrition.
Gastrointestinal immune and microbiome changes during parenteral nutrition.
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DOI：
10.1152/ajpgi.00321.2016
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发表时间：
2017-02
期刊：
影响因子：
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通讯作者：
J. Pierre
中科院分区：
文献类型：
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作者：
J. Pierre
肠外营养（PN）是一种救生疗法，为无法或不应通过胃肠道（GI）进食的患者提供静脉营养支持。不幸的是，与肠内营养相比，PN也存在与感染和代谢并发症相关的某些风险。在这篇综述中，提供了PN和GI免疫和微生物组变化的概述。PN影响肠道相关淋巴组织功能，特别是适应性免疫细胞，改变肠道上皮和化学分泌物，并显著改变肠道微生物组。总的来说，这些变化在功能上导致对感染性和伤害性挑战的易感性增加。由于大量患者仍然需要PN，因此通过在PN期间刺激GI免疫功能来改善结局的研究仍然值得关注。本综述最后描述了在PN期间使用肠神经系统神经肽或微生物衍生产品的最新进展，这可能通过维持免疫力和生理学来改善GI参数。
Parenteral nutrition (PN) is a lifesaving therapy that provides intravenous nutrition support to patients who cannot, or should not, feed via the gastrointestinal (GI) tract. Unfortunately, PN also carries certain risks related to infection and metabolic complications compared with enteral nutrition. In this review, an overview of PN and GI immune and microbiome changes is provided. PN impacts the gut-associated lymphoid tissue functions, especially adaptive immune cells, changes the intestinal epithelium and chemical secretions, and significantly alters the intestinal microbiome. Collectively, these changes functionally result in increased susceptibility to infectious and injurious challenge. Since PN remains necessary in large numbers of patients, the search to improve outcomes by stimulating GI immune function during PN remains of interest. This review closes by describing recent advances in using enteric nervous system neuropeptides or microbially derived products during PN, which may improve GI parameters by maintaining immunity and physiology.