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[The defense against infection in the short bowel syndrome]
I Eizaguirre1, M J Barrena, P Aldazábal
1Servicio de Cirugía Pediátrica, Hospital Nuestra Señora de Aránzazu, San Sebastián.
Abstract:
The high risk of infection in the short-bowel syndrome (SBS) may be due to malnutrition, lost of lymphoid bowel structures or both. Total parenteral nutrition (TPN) may alleviate the malnutrition, but we do not know what will happen with immune response in SBS with good nutritional state. We have studied the cellular immunity (lymphocytic subsets T4 and T8 and T4/T8 ratio) and the humoral one (IgG, IgM, IgA and B lymphocytes) in blood, spleen and mesenteric lymph nodes, in 12 wistar rats with 80% bowel resection, 6 of them with oral feeding and 6 with TPN, and 6 control rats, during 7 days. The weight increased and the total protein, albumin and prealbumin levels were the same in all groups. There was not difference between the resected groups. No difference was observed in the rate of immunoglobulins and the resected groups showed significatively lower figures than the control group in T4, B lymphocytes and T4/T8 ratio in blood, T4 and T8 in mesenteric nodes and in T4 and T4/T8 ratio in the spleen. These results suggest that the resection of large amounts of bowel could produce a fall in the immune response even when adequate nutritional state is preserved.