Intestinal Adaptation Is Stimulated by Partial Enteral Nutrition Supplemented With the Prebiotic Short-Chain Fructooligosaccharide in a Neonatal Intestinal Failure Piglet Model
Intestinal Adaptation Is Stimulated by Partial Enteral Nutrition Supplemented With the Prebiotic Short-Chain Fructooligosaccharide in a Neonatal Intestinal Failure Piglet Model
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DOI：
10.1177/0148607112444131
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发表时间：
2012-09-01
影响因子：
3.4
通讯作者：
Tappenden, Kelly A.
中科院分区：
文献类型：
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作者：
Barnes, Jennifer L.;Hartmann, Bolette;Tappenden, Kelly A.
背景资料：丁酸盐已被证明在小肠切除术后添加到肠外营养（PN）中时可刺激肠道适应，但目前的PN制剂中不可用。作者假设，益生菌前给药可能是一种临床上可行的丁酸盐给药方法，并刺激肠道适应。方法和材料：新生仔猪（48小时龄，n = 87）接受颈静脉导管置入和80%空回肠切除术，并随机分配至以下治疗组之一：控制（20%标准肠内营养/80%标准PN），对照加益生元（10 g/L短链低聚果糖[scFOS]）、对照加益生菌（1 × 10（9）CFU鼠李糖乳杆菌GG [LGG]）、或对照加合生素（scFOS + LGG）。动物接受输注24小时、3天或7天，并评估肠道适应的标志物。结果如下：与所有其他治疗相比，益生元治疗增加了回肠粘膜重量（P = 0.017），与对照组相比，增加了回肠蛋白质（P = 0.049），无论是哪一天。益生元和合生素组的回肠绒毛长度增加（P = 0.011），无论是哪一天，特别是由于上皮细胞增殖的增加（P = 0.003）。在7天益生元组中，空肠中的肽转运上调（P = .026），而空肠和结肠中的谷氨酰胺转运增加（分别为P = .001和.003）。结论：益生元和/或合生素补充导致整个残留肠道的结构和功能增强。协同益生元和益生菌组合的鉴定可以增强单独使用益生元治疗获得的有希望的结果。(JPEN肠外肠内营养杂志2012;36：524-537）
Background: Butyrate has been shown to stimulate intestinal adaptation when added to parenteral nutrition (PN) following small bowel resection but is not available in current PN formulations. The authors hypothesized that pre- and probiotic administration may be a clinically feasible method to administer butyrate and stimulate intestinal adaptation. Methods and Materials: Neonatal piglets (48 hours old, n = 87) underwent placement of a jugular catheter and an 80% jejunoileal resection and were randomized to one of the following treatment groups: control (20% standard enteral nutrition/80% standard PN), control plus prebiotic (10 g/L short-chain fructooligosaccharides [scFOS]), control plus probiotic (1 x 10(9) CFU Lactobacillus rhamnosus GG [LGG]), or control plus synbiotic (scFOS + LGG). Animals received infusions for 24 hours, 3 days, or 7 days, and markers of intestinal adaptation were assessed. Results: Prebiotic treatment increased ileal mucosa weight compared with all other treatments (P = .017) and ileal protein compared with control (P = .049), regardless of day. Ileal villus length increased in the prebiotic and synbiotic group (P = .011), regardless of day, specifically due to an increase in epithelial proliferation (P = .003). In the 7-day prebiotic group, peptide transport was upregulated in the jejunum (P = .026), whereas glutamine transport was increased in both the jejunum and colon (P = .001 and .003, respectively). Conclusions: Prebiotic and/or synbiotic supplementation resulted in enhanced structure and function throughout the residual intestine. Identification of a synergistic prebiotic and probiotic combination may enhance the promising results obtained with prebiotic treatment alone. (JPEN J Parenter Enteral Nutr. 2012;36:524-537)