title: Total parenteral nutrition adversely affects gut barrier function in neonatal piglets.
abstract: Sepsis is the most common morbidity in preterm infants, who often receive total parenteral nutrition (TPN). We hypothesized that gut barrier function is compromised in TPN-fed compared with enterally fed newborn piglets (ENT pigs). Colostrum-deprived newborn pigs were implanted with jugular venous and bladder catheters under general anesthesia. Pigs were either administered TPN (n = 15) or fed formula (ENT pigs, n = 15). After 6 days, pigs were gavaged a solution of mannitol, lactulose, and polyethylene glycol 4000 (PEG 4000) and urine was collected for 24 h. At 7 days, small bowel samples were assayed for myeloperoxidase activity, morphometry, and tight junction protein abundance. Intestinal contents and peripheral organ sites were cultured for bacteria. Urinary recovery (%dose) of mannitol (53 vs. 68) was lower, whereas that of lactulose (2.93 vs. 0.18) and PEG 4000 (12.78 vs. 0.96) were higher in TPN vs. ENT pigs, respectively (P < 0.05). Incidence of translocation was similar in TPN and ENT pigs. Myeloperoxidase activity was increased in TPN vs. ENT pigs in the jejunum (P < 0.001) and was weakly correlated with lactulose (R2 = 0.32) and PEG 4000 (R2 = 0.38) recovery. Goblet cell counts did not change, but intraepithelial lymphocyte numbers decreased with TPN. Only claudin-1 protein abundance was increased in the TPN group. We conclude that TPN is associated with impairment of neonatal gut barrier function as measured by permeability but not translocation.
authors.affiliation: Department of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Ketan
authors.initials: K
authors.lastname: Kansagra
authors.forename: Barbara
authors.initials: B
authors.lastname: Stoll
authors.forename: Cheryl
authors.initials: C
authors.lastname: Rognerud
authors.forename: Harri
authors.initials: H
authors.lastname: Niinikoski
authors.forename: Ching-Nan
authors.initials: CN
authors.lastname: Ou
authors.forename: Roger
authors.initials: R
authors.lastname: Harvey
authors.forename: Douglas
authors.initials: D
authors.lastname: Burrin
mesh_terms: D000818:Animals; D000831:Animals, Newborn / Q000254:growth & development / Q000378:metabolism* / Q000502:physiology; D018988:Bacterial Translocation; D002452:Cell Count; D062445:Claudin-1; D004231:Diuresis; D004751:Enteritis / Q000201:enzymology; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000382:microbiology / Q000473:pathology; D008565:Membrane Proteins / Q000378:metabolism; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D010539:Permeability; D009195:Peroxidase / Q000378:metabolism; D013552:Swine; D019108:Tight Junctions / Q000378:metabolism
chemical_list: D062445:Claudin-1; D008565:Membrane Proteins; D009195:Peroxidase