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Total parenteral nutrition, bacterial translocation, and host immune function
J Shou1, J Lappin, E A Minnard
1Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia.
American Journal of Surgery
|January 1, 1994
Summary
Total parenteral nutrition (TPN) impairs immune cell function and increases bacterial translocation. However, even a small amount of oral feeding can reverse these negative effects, improving immune response and gut barrier integrity.
Area of Science:
- Immunology
- Nutrition Science
- Gastroenterology
Background:
- Total parenteral nutrition (TPN) is linked to higher infectious complication rates than enteral nutrition.
- Understanding TPN's impact on immune function is crucial for patient care.
Purpose of the Study:
- To investigate how TPN affects immune cell function and bacterial translocation.
- To determine if partial oral feeding can mitigate TPN-induced immune deficits.
Main Methods:
- Male Wistar rats were fed either a regular diet (RD) or TPN for 7 days.
- Immune cell function (splenocyte mitogenesis, macrophage phagocytosis) and bacterial translocation (via mesenteric lymph nodes) were assessed.
- A second study introduced varying amounts of oral chow with parenteral nutrition (PN).
Main Results:
- TPN significantly reduced splenocyte and macrophage function and increased bacterial translocation compared to RD.
- Partial oral feeding (10% chow) began to reverse impaired phagocytosis.
- 20% oral chow restored immune function and significantly reduced bacterial translocation.
Conclusions:
- TPN administration compromises immune cell function and intestinal barrier integrity.
- Introducing even small amounts of oral nutrition can restore immune function and reduce bacterial translocation, highlighting the importance of gut feeding.