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Total parenteral nutrition adversely affects gut barrier function in neonatal piglets
Ketan Kansagra1, Barbara Stoll, Cheryl Rognerud
1Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.
American Journal of Physiology. Gastrointestinal and Liver Physiology
|September 13, 2003
Summary
Total parenteral nutrition (TPN) impairs neonatal gut barrier function in piglets, increasing intestinal permeability. However, TPN did not affect bacterial translocation, suggesting a specific impact on barrier integrity rather than systemic infection risk.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Nutritional science
Background:
- Sepsis is a common complication in preterm infants, often managed with total parenteral nutrition (TPN).
- The impact of TPN on neonatal gut barrier function requires further investigation.
Purpose of the Study:
- To investigate the hypothesis that gut barrier function is compromised in TPN-fed compared to enterally fed newborn piglets.
- To assess intestinal permeability, inflammatory markers, and structural changes in the neonatal gut under TPN versus enteral feeding.
Main Methods:
- Newborn piglets were divided into two groups: one receiving TPN and the other enteral formula feeding (ENT pigs).
- Intestinal permeability was assessed using urinary recovery of orally administered mannitol, lactulose, and polyethylene glycol 4000 (PEG 4000).
- Small bowel samples were analyzed for myeloperoxidase activity, morphometry, and tight junction protein expression; bacterial translocation was also evaluated.
Main Results:
- TPN-fed piglets exhibited significantly higher intestinal permeability, indicated by increased lactulose and PEG 4000 recovery, and decreased mannitol recovery compared to ENT pigs.
- Myeloperoxidase activity in the jejunum was elevated in TPN-fed piglets, correlating with increased permeability markers.
- While goblet cell counts remained unchanged, intraepithelial lymphocyte numbers decreased in TPN-fed piglets; claudin-1 protein abundance was notably increased.
Conclusions:
- Total parenteral nutrition is associated with impaired neonatal gut barrier function, specifically an increase in intestinal permeability.
- Despite increased permeability, TPN did not lead to a higher incidence of bacterial translocation in this neonatal piglet model.
- These findings highlight a specific disruption of gut barrier integrity by TPN in neonates, distinct from systemic bacterial dissemination.