Effects of Short-Peptide-Based Enteral Nutrition on the Intestinal Microcirculation and Mucosal Barrier in Mice with Severe Acute Pancreatitis
Effects of Short-Peptide-Based Enteral Nutrition on the Intestinal Microcirculation and Mucosal Barrier in Mice with Severe Acute Pancreatitis
复制标题
短肽肠内营养对重症急性胰腺炎小鼠肠道微循环和粘膜屏障的影响
DOI：
10.1002/mnfr.201901191
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发表时间：
2020-01-29
影响因子：
5.2
通讯作者：
Liang，Ting-Bo
中科院分区：
文献类型：
--
作者：
Zhang，Jian;Yu，Wen-Qiao;Liang，Ting-Bo
Scope短肽肠内营养（SPEN）在重症急性胰腺炎（SAP）患者中吸收更有效。更重要的是，SPEN降低了SAP诱导的肠源性感染风险。本研究旨在探讨SPEN是否能减少SAP小鼠肠道细菌移位，并探讨其可能机制。方法和结果SAP模型经SPEN或完整蛋白肠内营养预处理后建立。虽然胰腺损伤没有改善，但通过苏木精-伊红染色或血清淀粉酶评价，SPEN明显减弱SAP后肠道细菌移位。为了揭示机制，发现由SAP破坏的肠机械屏障被SPEN显著缓解，其呈现恢复的ZO-1表达、粘液层和杯状细胞功能。此外，SPEN还能抑制局部CCR 6/CCL 20诱导的CD 11 c+树突状细胞浸润、全身免疫抑制，并抑制管腔分泌型免疫球蛋白A的分泌。结论SPEN可改善SAP引起的肠黏膜微循环障碍，可能与减轻SAP引起的肠黏膜炎症、维持机械屏障和黏膜免疫功能、纠正全身免疫抑制有关。对SAP后肠道细菌移位有保护作用。
ScopeShort‐peptide‐based enteral nutrition (SPEN) is absorbed more efficiently in patients with severe acute pancreatitis (SAP). More importantly, SPEN decreases SAP‐induced enterogenous infection risk. This study aims to investigate whether SPEN alleviates intestinal bacterial translocation in mice with SAP, and the underlying mechanisms.Methods and resultsThe SAP model is established after pre‐treatment with SPEN or intact‐protein‐based enteral nutrition. Although there is no improvement in pancreas injury, as evaluated through Hematoxylin‐Eosin staining or serum amylase, SPEN obviously attenuates intestinal bacterial translocation after SAP. To unveil the mechanisms, it is found that the intestinal mechanical barrier destroyed by SAP is significantly relieved by SPEN, which presents with recovered ZO‐1 expression, mucus layer, and goblet cell function. Additionally, SPEN alleviates local CCR6/CCL20 induced CD11c+dendritic cell infiltration, systemic immunosuppression, and inhibits the secretion of luminal secretory immunoglobulin A. Possibly responsible for SAP‐induced mucosal dysfunctions, destroyed intestinal mucosal microcirculation and local hypoxia are largely improved in SAP+SPEN group.ConclusionSPEN can improve downregulated intestinal mucosal microcirculation secondary to SAP, which may be responsible for mucosal inflammation relief, maintenance of the mechanical barrier and mucosal immunity, the correction of systemic immunosuppression, and play a protective role in defending commensal bacterial translocation after SAP.