title: Enteral feeding induces early intestinal adaptation in a parenterally fed neonatal piglet model of short bowel syndrome.
abstract: BACKGROUND
  Successful small intestinal (SI) adaptation following surgical resection is essential for optimizing newborn growth and development, but the potential for adaptation is unknown. The authors developed an SI resection model in neonatal piglets supported by intravenous and enteral nutrition.
  
  
  METHODS
  Piglets (n = 33, 12-13 days old) were randomized to 80% SI resection with parenteral nutrition feeding (R-PN), 80% SI resection with PN + enteral feeding (R-EN), or sham SI transection with PN + enteral feeding (sham-EN). In resected pigs, the distal 100 cm of ileum (residual SI) and 30 cm of proximal SI were left intact. All pigs received parenteral nutrition postsurgery. Enteral nutrition piglets received continuous gastric infusion of elemental diet from day 3 (40:60 parenteral nutrition:enteral nutrition). Piglets were killed 4, 6, or 10 days postsurgery.
  
  
  RESULTS
  By 10 days, R-EN piglets had longer residual SI than R-PN and sham-EN pigs (P < .05). At days 6 and 10, R-EN piglets had greater weight per length of intact SI (P < .05) and isolated mucosa (P < .05) compared to other groups. Greater gut weight in R-EN piglets was facilitated by a greater cellular proliferation index (P < .01) by 4 days compared to other groups and greater overall ornithine decarboxylase activity vs R-PN piglets (P < .05).
  
  
  CONCLUSIONS
  This new model demonstrated profound SI adaptation, initiated early postsurgery by polyamine synthesis and crypt cell proliferation and only in response to enteral feeding. These changes translated to greater gut mass and length within days, likely improving functional capacity long term.
authors.affiliation: Department of Biochemistry, Memorial University of Newfoundland, St John's, Newfoundland and Labrador, Canada.
authors.forename: M Elaine
authors.initials: ME
authors.lastname: Dodge
authors.forename: Robert F
authors.initials: RF
authors.lastname: Bertolo
authors.forename: Janet A
authors.initials: JA
authors.lastname: Brunton
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D000831:Animals, Newborn; D049109:Cell Proliferation; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D007082:Ileum; D007413:Intestinal Mucosa / Q000166:cytology / Q000254:growth & development*; D007421:Intestine, Small / Q000166:cytology / Q000254:growth & development* / Q000601:surgery; D009929:Organ Size; D009955:Ornithine Decarboxylase / Q000378:metabolism; D010288:Parenteral Nutrition; D011897:Random Allocation; D012778:Short Bowel Syndrome / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D013552:Swine
chemical_list: D009955:Ornithine Decarboxylase