Abstract
Total parenteral nutrition (TPN) and elemental diet (ED) produce intestinal atrophy and increase bacterial translocation (BT) to mesenteric lymph nodes. The increased rate of BT may be due to alterations in mucosal structure, enzyme activity, or mucin content. Fiber improves intestinal structure and function in rats and may reduce the rate of BT. This study determined whether the addition of fiber to TPN or ED would maintain intestinal integrity and decrease BT to the mesenteric lymph nodes. Fifty-six adult male Sprague-Dawley rats underwent placement of jugular catheters and were assigned to one of five dietary groups: TPN, TPN+oral oat fiber (TPNF) 2 g/day, ED, ED+oral oat fiber (EDF) 2 g/day, or AIN-76 (control); they were pair-fed for 7 days. On day 8 the mesenteric lymph nodes were removed for bacterial cultures; and jejunal mucosal weight, DNA, protein, alkaline phosphatase, maltase, and jejunal mucin content were measured. Enteral nutrition significantly decreased BT when compared to parenteral feeding, and fiber significantly decreased BT when administered to rats receiving TPN or ED. Improvements in intestinal mucosal structure were not consistently associated with decreased rates of BT. Additionally, BT occurred independently of jejunal mucin concentration. Mechanisms other than maintenance of mucosal structure or mucin content are important in the mediation of fiber-induced decreased BT in rats receiving TPN or ED.
Résumé
La nutrition parentérale totale (NPT) et la nutrition entérale élémentaire (NE) sont responsables d'atrophie intestinale et une augmentation de la translocation bactérienne (TB) vers les ganglions mésentériques (GM). L'augmentation de la TB pourrait être la conséquence d'altérations de la structure muqueuse, de l'activité enzymatique, ou d'une modification du contenu en mucine. L'ingestion de fibres améliore la structure et la fonction intestinales chez le rat et pourrait réduire la TB. Cette étude avait comme but de déterminer si l'introduction des fibres au cours de la NPT ou de la NE pourrait maintenir l'intégrité intestinale et diminuer la TB vers les GM. Cinquant-six rats Sprague-Dawley adultes ont eu un cathéter jugulaire et ont été assignés à un de cinq groupes: NPT, NPT+2g/jour de fibres (avoine) (NPTF), NE, NE+2g/jour de fibre (avoine) (NEF) ou AIN-76 (contrôles) et ont été alimentés par paires pendant sept jours. Au jour 8, les GM ont été enlevés pour culture bactérienne et on a mesuré le poids de la muqueuse jéjunale, de l'ADN, de la protéine, des phosphatases alcalines, de la maltase, et du contenu en mucine. La nutrition entérale a diminué de façon significative la TB lorsque des fibres ont été inclues dans l'alimentation que ce soit par NPTF ou par NEF. L'amélioration de la structure de la muqueuse intestinale ne s'est pas produite de façon constante. De plus, la TB s'est produite de façon indépendante de la concentration jéjunale en mucine. D'autres mécanismes pour maintenir la structure de la muqueuse ou le contenu en mucine sont importants dans la médiation d'une diminution par des fibres de la TB chez le rat recevant une NPT ou une NE.
Resumen
La nutrición parenteral total (TPN) y la dieta elemental (ED) producen atrofia intestinal e incrementan la translocación bacteriana (BT) a los ganglios linfáticos mesentéricos. La aumentada tasa de BT puede deberse a alteraciones en la estructura de la mucosa, a actividad enzimática o a contenido de mucina. La fibra administrada por vía oral mejora la estructura y la función intestinales en las ratas y puede reducir la BT. El presente estudio tuvo como propósito determinar si la adición de fibra oral a los regímenes de TPN o ED podría mantener la integridad intestinal y disminuir la BT a los ganglios linfáticos. Sesenta y una ratas macho Sprague-Dawley fueron sometidos a la colocación de catéteres yugulares y asignados a 1 de 5 grupos dietarios: TPN, TPN+2g/día fibra de avena oral (TPNF), ED, Ed+2g/dia fibra de avena oral (EDF), o AIN-76 (control) durante 7 dias. En el día 8 se resecaron ganglios linfático mesentéricos para cultivos bacterianos, también se determinaron el peso de la mucosa duodenal y las concentraciones yeyunales de DNA, proteína, fosfatasa alcalina, maltasa y mucina. La nutrición enteral disminuyó significativamente la BT en comparación con la alimentación parenteral, y la fibra oral disminuyó significativamente la BT cuando fue administrada a las ratas en TPN o ED. La mejoría en la estructura de la mucosa intestinal no apareció consistentemente asociada con disminución de la BT. Además, la BT ocurrió en forma independiente de la concentración de mucina yeyunal. Otros mecanismos diferentes del mantenimiento de la estructura de la muscosa o del contenido de mucina tienen importancia en cuanto a la mediación de la disminución de la BT por la fibra en ratas que reciben TPN o DE.
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Frankel, W., Zhang, W., Singh, A. et al. Fiber: Effect on bacterial translocation and intestinal mucin content. World J. Surg. 19, 144–148 (1995). https://doi.org/10.1007/BF00317001
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DOI: https://doi.org/10.1007/BF00317001