A Digestive Cartridge Reduces Parenteral Nutrition Dependence and Increases Bowel Growth in a Piglet Short Bowel Model.
A Digestive Cartridge Reduces Parenteral Nutrition Dependence and Increases Bowel Growth in a Piglet Short Bowel Model.
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DOI：
10.1097/sla.0000000000005839
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发表时间：
2023-10-01
影响因子：
9
通讯作者：
中科院分区：
文献类型：
--
作者：
在猪短肠综合征伴肠衰竭（bs - if）模型中，确定在肠内营养（EN）中使用固定化脂肪酶（ILC）水解脂肪是否能降低肠外营养（PN）依赖性。SBS-IF发生在肠道丧失导致吸收不良和PN依赖之后。有限的治疗方案可用于实现肠内自主。选取11头接受75%空肠回肠切除术的约克郡仔猪，随机分为对照组（n=6）和治疗组（n=5）。如果满足预先定义的临床标准，则术后开始PN并随着EN进展而减少。研究动物14天，评估PN/EN热量的变化。在研究结束时（第15天）评估肠道适应、吸收和营养状况。采用基线调整协方差分析进行组间比较。在为期14天的实验中，ILC动物的PN卡路里减少了19% (P<0.0001)，平均EN提前（66%对47%的总卡路里，P<0.0001）。治疗组动物的肠长增加（19.5比0.7%，P=0.03），隐窝细胞增殖比对照组高1.9倍（P=0.02）。到第15天，ILC治疗导致血浆中GLP-2 （P=0.02）、EPA （P<0.0001）、DHA （P=0.004）、维生素A （P=0.02）、LDL （P=0.02）和HDL （P=0.04）浓度升高。两组之间的肝酶和总胆红素没有差异。在猪SBS-IF模型中，ILC与肠内喂养联合使用减少了肠内营养依赖，改善了营养吸收，并促进了肠道生长。这些结果支持ILC在临床SBS-IF中的潜在作用。先天性或获得性肠丢失可导致肠衰竭，其特征是肠外营养依赖和限制生命的并发症。在短肠综合征伴肠衰竭的动物模型中，当与肠内喂养一起使用时，固定化脂肪酶盒减少了肠外营养依赖，改善了营养吸收，并促进了肠道生长。
To determine whether use of an immobilized lipase cartridge (ILC) to hydrolyze fats in enteral nutrition (EN) reduces parenteral nutrition (PN) dependence in a porcine model of short bowel syndrome with intestinal failure (SBS-IF). SBS-IF occurs following intestinal loss resulting in malabsorption and PN dependence. Limited therapeutic options are available for achieving enteral autonomy. Eleven Yorkshire piglets underwent 75% jejunoileal resection and were randomized into control (n=6) and treatment (n=5) groups. PN was initiated postoperatively and reduced as EN advanced, if pre-defined clinical criteria were fulfilled. Animals were studied for 14 days, and changes in PN/EN calories were assessed. Intestinal adaptation, absorption, and nutrition were evaluated at the end of the study (day 15). Comparisons between groups was performed using analysis of covariance adjusted for baseline. ILC animals demonstrated 19% greater reduction in PN calories (P<0.0001) and higher mean EN advancement (66% vs. 47% of total calories, P<0.0001) during the 14-day experiment. Treatment animals had increased intestinal length (19.5 vs. 0.7%, P=0.03) and 1.9-fold higher crypt cell proliferation (P=0.02) compared to controls. By day 15, ILC treatment resulted in higher plasma concentrations of GLP-2 (P=0.02), EPA (P<0.0001), DHA (P=0.004), Vitamin A (P=0.02), LDL (P=0.02), and HDL (P=0.04). There were no differences in liver enzymes or total bilirubin between the two groups. ILC use in conjunction with enteral feeding reduced PN dependence, improved nutrient absorption, and increased bowel growth in a porcine SBS-IF model. These results support a potential role for the ILC in clinical SBS-IF. Congenital or acquired intestinal loss can lead to intestinal failure, characterized by parenteral nutrition dependence and life-limiting complications. When used with enteral feeding, an immobilized lipase cartridge reduced parenteral nutrition dependence, improved nutrient absorption, and increased bowel growth in an animal model of short bowel syndrome with intestinal failure.
影响因子：
2.2
作者：
Tsikis, Savas Theodore;Fligor, Scott C.;Secor, Jordan D.;Yu, Lumeng J.;Pan, Amy;Loring, Greta;First, Eric;Nedder, Arthur P.;Grammer, Robin M.;Rudie, Coral;Gura, Kathleen M.;Puder, Mark
通讯作者：
Puder, Mark
影响因子：
3.6
作者：
Yang, Qing;Lan, Tian;Chen, Yuegang;Dawson, Paul A.
通讯作者：
Dawson, Paul A.
DOI：
10.1002/jpen.1167
发表时间：
2018-11
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
Villalona G;Price A;Blomenkamp K;Manithody C;Saxena S;Ratchford T;Westrich M;Kakarla V;Pochampally S;Phillips W;Heafner N;Korremla N;Greenspon J;Guzman MA;Kumar Jain A
通讯作者：
Kumar Jain A