title: Effect of enteral nutrition and ecoimmunonutrition on bacterial translocation and cytokine production in patients with severe acute pancreatitis.
abstract: BACKGROUND
  Severe acute pancreatitis (SAP) with severe complications such as multiple organ failure, necrosis, abscess, and formation of pancreatic pseudocysts often gives rise to a high mortality despite intensive treatment. Parenteral nutrition (PN), elemental enteral nutrition, and ecoimmunonutrition (EIN) hastened the recovery of SAP patients, stimulated gastrointestinal motility, and alleviated the degree of systemic inflammatory response syndrome. This study aimed to examine the effects of enteral nutrition (EN) and EIN on bacterial translocation and cytokine production in patients with SAP.
  
  
  METHODS
  One hundred eighty-three SAP patients were randomly divided into three groups receiving PN, EN, or EN + EIN. Acute Physiology and Chronic Health Evaluation II scores, complications (systemic inflammatory response syndrome, multiorgan failure, and infections), intestinal bacterial strains of stool, and plasma concentrations of endotoxin, tumor necrosis factor α (TNF-α), and interleukin (IL) 6 and IL-10 were evaluated.
  
  
  RESULTS
  The percentage of pancreatic sepsis, multiple organ dysfunction syndrome, and mortality was significantly lower in the EN group and was further lower in the EN + EIN group than that in the PN group. The plasma concentrations of TNF-α and IL-6 and APACHE II scores were significantly decreased in the EN group and were further lowered in the EN + EIN group than those in the PN group. The plasma concentration of IL-10 was higher in the EN group and was further increased in the EN + EIN group than that in the PN group.
  
  
  CONCLUSIONS
  EN plays effective roles in the treatment of SAP by decreasing the expression of endotoxin, TNF-α, and IL-6 and the bacterial translocation, enhancing the expression of IL-10, and the combination of EIN with EN results in more therapeutic benefits than EN alone.
authors.affiliation: Department of Digestive Internal Medicine, Pingxiang Hospital, Southern Medical University, Pingxiang, Jiangxi, People's Republic of China.
authors.forename: Guiliang
authors.initials: G
authors.lastname: Wang
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wen
authors.forename: Linfang
authors.initials: L
authors.lastname: Xu
authors.forename: Shufeng
authors.initials: S
authors.lastname: Zhou
authors.forename: Min
authors.initials: M
authors.lastname: Gong
authors.forename: Ping
authors.initials: P
authors.lastname: Wen
authors.forename: Xianzhong
authors.initials: X
authors.lastname: Xiao
mesh_terms: D000208:Acute Disease; D000328:Adult; D018988:Bacterial Translocation / Q000502:physiology*; D016207:Cytokines / Q000097:blood*; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D015994:Incidence; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology; D010195:Pancreatitis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010288:Parenteral Nutrition; D019936:Probiotics / Q000008:administration & dosage*; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000209:etiology
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D016753:Interleukin-10
keywords: Bacterial translocation; Cytokines; Ecoimmunonutrition; Enteral nutrition; Severe acute pancreatitis