Small intestinal mucosa changes, including epithelial cell proliferative activity, of children receiving total parenteral nutrition (TPN).
We examined the small intestinal histology disaccharidase activities as well as the incorporation of [3H]thymidine into DNA of biopsies maintained in organ culture from seven children (ages 9 months to 5 years) receiving total parenteral nutrition (TPN). Three children suffered from inflammatory bowel disease and received TPN for one month (short term). Four required long-term TPN (> 9 months) for short-bowel syndrome. DNA was extracted from the samples following serial precipitation with perchloric acid. Results were compared to those from 22 age-matched children investigated for abdominal pain or chronic diarrhea. Short-term TPN resulted in slightly lower lactase, sucrase, and palatinase activities that were not statistically different from controls. Long-term TPN resulted in focal mild villus atrophy and a decrease in disaccharidase activity in two patients. Biopsies from long-term TPN patients incorporated less thymidine compared to those of controls (P < 0.001) when data was expressed per total biopsy (3.6 +/- 1.1 vs. 8.4 +/- 1.1 fmol) or per milligram of tissue (1.0 +/- 0.12 vs 2.7 +/- 0.7 fmol). The above data are in general agreement with the hypoplastic effect of TPN in animals. However, in children, much longer periods of TPN are required to realize the changes.
Rossi
T M
TM
Department of Pediatrics, Children's Hospital of Buffalo, New York 14222.
Lee
P C
PC
Young
C
C
Tjota
A
A
D000293:Adolescent; D016022:Case-Control Studies; D002455:Cell Division; D002648:Child; D002675:Child, Preschool; D004247:DNA / Q000378:metabolism; D004186:Disaccharidases / Q000378:metabolism; D004848:Epithelium / Q000473:pathology; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000201:enzymology / Q000473:pathology*; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D010289:Parenteral Nutrition, Total; D012778:Short Bowel Syndrome / Q000201:enzymology / Q000473:pathology*; D013936:Thymidine
D004247:DNA; D004186:Disaccharidases; D013936:Thymidine