Does the route of feeding modify the inflammatory response?

Area of Science:

• Immunology
• Nutrition Science
• Gastroenterology

Background:

• Parenteral nutrition (PN) may increase endotoxin response compared to enteral feeding (EF).
• This is hypothesized to be due to gut barrier dysfunction during PN.
• This study investigated endotoxin response after PN versus EF.

Purpose of the Study:

• To compare endotoxin-induced immune and physiological responses in healthy volunteers receiving either enteral nutrition or parenteral nutrition.
• To evaluate the impact of feeding route on the human response to endotoxin.

Main Methods:

• Fifteen healthy volunteers underwent two separate study periods.
• Subjects received either 2 days of EF or 7 days of PN.
• Intravenous endotoxin was administered, and responses including temperature, symptoms, and blood markers (cytokines, hormones, cell counts) were measured.

Main Results:

• Parenteral nutrition resulted in diminished platelet counts and lower plasma interleukin-6 levels compared to enteral nutrition.
• The duration of symptoms was shorter in the PN group, though not statistically significant.
• Most other measured responses to endotoxin did not differ significantly between the two feeding groups.

Conclusions:

• Endotoxin responses in humans are largely similar between PN and EF.
• Platelet count and plasma interleukin-6 levels are reduced following PN compared to EF.
• The findings suggest subtle immune modulation by the route of nutrition delivery.