ABSTRACT
Intestinal tract is the central organ of the body's stress,and it has an important barrier function to prevent the harmful substances,such as bacteria and toxins,from the gut into the body.The main factors of intestinal barrier dysfunction are ischemia and hypoxia and endotoxin damage,and it is essential to explore the protective methods of the intestinal mucosa barrier in the early stage to prevent the organ metabolism disorder induced by intestinal derived endotoxin and bacterial translocation.Glutamine,which can effectively protect the integrity of the intestinal mucosa,maintain the normal intestinal permeability and improve the cell immunity,has been used to intensive adult patients and need further studies in the clinical application of newborns.
ABSTRACT
Objective:To evaluate visceral sensitivity,gut barrier function and autonomic nerve function (ANF) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D),and to explore their roles in IBS-D pathophysiology.Methods:A total of 46 IBS-D patients (IBS-D group) were selected from the Department of Gastroenterology of China-Japan Friendship Hospital from October 2015 to March 2016,and 20 healthy volunteer were served as a control group (HC group).Clinical and psychological symptoms were evaluated by questionnaire,and visceral sensitivity to rectal balloon distention,gut barrier function and autonomic nerve function (ANF) were examined.The difference in the abovementioned indexes were compared between the 2 groups,and the correlations in the parameters were analyzed in the IBS-D group.Results:The scores of IBS symptom severity scale (IBS-SSS),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and visceral sensitivity index (VSI) were significantly higher in the IBS-D group than those in the HC group (P＜0.01).In the visceral sensitivity test,maximum tolerable threshold in the IBS-D group was significantly decreased compared to that in the HC group (P＜0.01);there was no significant difference in first sensation threshold and defecating sensation threshold between the two groups (P＞0.05).As gut barrier function markers,the serum diamine oxidase (DAO) and d-lactate were significantly increased in the IBS-D group (P＜0.05).In ANF test,the total score and parasympathetic score as well as the proportion of abnormal scores in the IBS-D group were significantly higher than those in the HC group (P＜0.05).In IBS-D group,the HAMA,VSI and serum DAO were positively correlated with IBS-SSS (r=0.528,0.575,0.507;P＜0.01),while the 3 visceral sensitivity thresholds were negatively correlated with IBS-SSS (r=-0.636,-0.476,-0.697;P＜0.01);in addition to the IBS-SSS,the HAMA,HAMD,VSI and serum DAO were also significant negatively correlated with the visceral sensitivity thresholds (all P＜0.05);no significant correlations were found between the ANF and the other parameters.Conclusion:IBS-D patients show psychological symptoms,visceral hypersensitivity,impaired gut barrier function and abnormal ANF characterized by parasympathetic dysfunction;the former 3 factors are all associated with disease severity,and thus may play vital roles in IBS-D pathophysiology.
ABSTRACT
Objective:To investigate the effect of Nutrison MCT and Nutrison MF enteral nutrition on gut barrier function during the perioperative period in patient with malignant obstructive jaundice.Methods:82 cases of patients with malignant obstructive jaundice were randomized divided into Nutrison MCT group with 40 cases and Nutrison MF group with 42 cases.Enteral nutrition was given on admission.The level of urinary lactulose and mannitol(L/M) ratio,plasma endotoxin and diamine oxidase(DAO) activity on the 2nd day after admission,lday before surgery,5 days after full dose of enteral nutrition were collected.Results:Before surgery,no statistical significance difference of urinary L/M ratio,plasma endotoxin and DAO activity were found between the 2nd day after admission and 1day before surgery.After full dosing of enteral nutrition,urinary L/M ratio,plasma endotoxin and DAO activity were decreased,while Nutrison MCT group decreased more significantly than Nutrison MF group.Conclusion:Nutrison MCT can improve the gut barrier function of patients with malignant obstructive jaundice more earlier than Nutrison MF after surgery.
ABSTRACT
Neonatal necrotizing enterocolitis (NEC)is a major cause of morbidity and mortality in premature infants.The most important etiology in the pathogenesis of NEC is structural and immunological intestinal immaturity.Probiotic bacteria prevent or limits disease propagation in NEC.The unique characteristics of developing intestinal epithelia focusing on gut development and colonization as well as the inflammatory propensity of immature epithelia are highlighted in this paper.Additionally, potential mechanisms of beneficial probiotic interaction with immature intestinal epithelia including immunomodulation, upregulation of cytoprotective genes, prevention and regulation of apoptosis and maintenance of barrier function are reviewed.Probiotics may restore or supply essential bacterial strains needed for gut maturation and homeostasis.Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC.
ABSTRACT
Objective To study the influence of laparoscopic gastric surgery on the gut barrier function (GBF).Methods There were 64 gastric cancer patients undergoing respectively laparoscopic radical procedures (32 cases) and open gastric surgery (32 cases).Blood was drawn on day one before surgery,day 1,day 3 and day 7 after the surgery for the measurement of plasma D-lacate and plasma diamine oxidase activity by using ultraviolet spectrophotometry.Results There was no statistical difference among demographic,clinicopathological characterastics between the two groups (P ＞ 0.05).The difference on the operative time,blood loss and the time starting to take food after the surgery was significant between the two groups,P ＜ 0.05.The differences of plasma D-lacate level and the diamine oxidase (DAO) on perioperatively respective all time points were not significant between the two groups,P ＞ 0.05.Conclusion Laparoscopic radical gastrectomy is comparable to open procedures in causing damage to patient's gut barrier functions.
ABSTRACT
Objective To investigate the effects of enteral nutrition (EN) on the gut barrier function in patients with severe acute pancreatitis (SAP) and explore its clinical significance.Methods A total of 40 SAP patients from December 2009 to December 2011 was collected in this study.The 40 cases were divided into total parenteral nutrition (TPN) group (20 cases) and EN group (20 cases).The APACHE Ⅱ score and serum expression of endotoxin and intestinal fatty acid binding protein (IFABP) were compared between two groups.The serum expression of endotoxin and IFABP was determined by enzyme-linked immunosorbent assay method.Results The APACHE Ⅱ score and serum expression of endotoxin and IFABP were significantly decreased in EN group and TPN group after treatment of 1,7,14,21 d (P ＜0.05).The APACHE Ⅱ score was lower in EN group than that in TPN group after treatment of 7,14,21 d [(7.03 ±1.86) scores vs.(8.12 ±2.11) scores,(5.32 ± 1.14) scores vs.(6.87 ± 1.35) scores,(3.49 ±0.83) scores vs.(5.15 ± 1.02) scores,P ＜ 0.05].The serum expression of endotoxin was lower in EN group than that in TPN group after treatment of 7,14,21 d [(48.18 ± 15.48) EU/L vs.(60.12 ± 18.16) EU/L,(33.46 ± 12.04) EU/L vs.(51.32 ± 14.66) EU/L,(22.15 ± 7.81) EU/L vs.(35.62 ± 12.53) EU/L,P ＜ 0.05].The serum expression of IFABP was lower in EN group than that in TPN group after treatment of 7,14,21 d [(18.47 ± 3.55) ng/L vs.(22.57 ± 4.14) ng/L,(10.32 ± 2.68) ng/L vs.(18.11 ± 3.62) ng/L,(6.39 ± 2.26)ng/L vs.(12.16 ±3.06) ng/L,P ＜0.05].The APACHE Ⅱ score was positively correlated with serum expression of endotoxin (r =0.612,P ＜ 0.05) and IFABP (r =0.634,P ＜ 0.05).The serum expression of endotoxin was positively correlated with IFABP (r =0.627,P ＜ 0.05).Conclusions EN treatment shows more effective effect on improving the gut barrier function in SAP patients than TPN treatment.And it is worthy to be popularized in the clinical application.
ABSTRACT
Objective To evaluate the effect of enteral nutrition (EN) versus total parenteral nutrition(TPN) on gut barrier function in patients with severe acute pancreatitis (SAP). Methods Sixtythree patients with SAP enrolled from 4 hospitals were randomly assigned into EN group(29 cases) and TPN group(34 cases). EN group patients were fed via a spiral nasojejunal feeding tube placed routinely by endoscopy or fluoroscopy, and TPN group patients were nourished intravenously with TPN during the same period. The changes of serum endotoxin, diamine oxidase, and urinary excretion of lactulose and mannitol ratio (L/M) were observed. Results Plasma concentration of endotoxin were markedly decreased in EN group as compared with that in TPN group at the 7th,14th ,21th day of entry trial [(39. 30 ± 15. 82) EU/L vs (73.05 ±21.16) EU/L,(22.64 ±14.31) EU/L vs (49.34 ±24.54) EU/L,(14.81 ± 10.93)EU/L vs ( 30. 08 ± 14. 10 ) EU/L, P ＜ 0. 05]. Plasma concentration of diamine oxidase were markedly decreased in EN group as compared with that in TPN group at the 7th, 14th day of entry trial [(9. 97 ± 3. 84)U/Lvs (19.89±9.89)U/L,(5.42±1. 84) U/Lvs (8.79 ±4.08) U/L, both P ＜ 0. 05]. The urinary L/M decreased significantly in EN group than those in TPN group at the 7th, 14th,21th day of entry trial (0.28 ±0.25 vs 0. 65 ±0.45,0.21 ±0. 18 vs 0.54 ±0.41,0.08 ±0.04 vs 0.29 ±0.06, all P＜0.05).Conclusion EN has better effect on improving intestinal barrier function than TPN in treatment of patients with SAP.
ABSTRACT
The intestine is an organ involved with absorbing, processing, and transporting food into the body. However, if one were to assess the immunological portion of the intestine and compare it with better-known immunologically functioning organs such as the spleen, the intestine would be found to be the largest such organ and the extent of its immunologic function would be found to be equally proportionate. The mucosal surface of the intestine has the ability to respond to effector cells capable of protecting the host from potentially harmful organisms or local antigens. When there is increased intestinal permeability (Leaky gut syndrome), pathogenic bacteria and its products, toxins, antigens, chemicals and incompletely digested food penetrate the intestinal epithelium and are transported throughout the body. They activate the immune system and effect the pathophysiology of acute and chronic inflammatory disease and autoimmune disease. Therefore, by a better understanding of the importance of gut barrier function and the pathophysiology of gut related immunologic disease, we can make helpful suggestions for achieving optimal intestinal health.
Subject(s)
Autoimmune Diseases , Bacteria , Complement System Proteins , Immune System , Immune System Diseases , Intestinal Mucosa , Intestines , Permeability , SpleenABSTRACT
Objective: To observe the clinical effect of Tongfu granules(通腑颗粒) on the gastro- intestinal dysfunction in patients with multiple organ dysfunction syndrome(MODS).Methods: The trial was prospective,multi-centric and clinically controlled.One hundred and forty patients with MODS who had been selected were randomly divided into two groups: mosapride citrate group and Tongfu granules group.Respectively at 0 hour,the 48 th hour,the 7 th day or before death, the following scoring systems were calculated: the intestinal dysfunction score,acute physiology and chronic health evaluationⅡ((APACHEⅡ)) score and Marshall score.The duration of mechanical ventilation,hospitalization in intensive care unit(ICU) and the prognosis within 28 days were recorded.Results: After treatments,the intestinal dysfunction score,(APACHEⅡ) score and Marshall score of all patients decreased,at the same time,the therapeutic effects of Tongfu granules group were more significant than those in mosapride citrate group(P20 scores.The mortality was elevated with the increased number of dysfunction organs.Conclusion: Tongfu granules can ameliorate the severity of the disease situation andimprove the prognosis of patients with MODS.
ABSTRACT
12h interval from injury to operation had significantly higher concentration of plasma D-lactate and endotoxin at above metioned 4 time points. Plasma concentration of D-lactate and endotoxin in the last two groups declined to normal range at 72h after operation, while in the first two groups reduced to normal range before leaving hospital. Conclusion Acute intraperitoneal hemorrhage could damage gut barrier function, and injury degree was related with interval from injury to operation and blood loss amount.
ABSTRACT
The important function of the gastrointestinal tract in monitoring and sealing the host intestine from intruders is called the gut barrier.A variety of specific and nonspecific mechanisms are in operation to establish the host barrier,including luminal mechanism,secretion of the digestive enzymes,the epithelial cells together with tight junctions between them and the gut immune system.The pathogenesis of gut barrier dysfuntion is multifactorial.They can lead to the translocation of the intestinal bacteria.Sometimes,even the multiple organ dysfunction syndrome can happen.Nitric oxide,one of the smallest products of the cell,is known to have a very large role in diverse physiologic and pathological processes.Recent study shows its toxic metabolite,peroxynitrite(ONOO~(-)),play a major role in the intestinal mucosal injury.The purpose of this literature review is to provide a better understanding of the mechanism of the protection and injury to the gut barrier function about nitric oxide and peroxynitrite.
ABSTRACT
Objective To investigate the effect of enteral and parenteral nutrition on gut microecology in rats with abdominal infection. Methods Fourteen Sprague-Dawley (SD) model rats of abdominal infection, which had survived for more than 6 days were divided into two groups: PN group ( n =7) and PN+EN group ( n =7) via jejunostomy and jugular vein respectively for another 5 days. The nutrition support in the two groups was isonitrogen and isocaloric. At sacrifice on the sixth day, occludin and IgA level in plasma cells of intestine epithelium of the gut were measured by immunohistochemistry. Vena cava blood and homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine bacterial translocations, and portal vein blood was tested for endotoxin. Results The expression of occludin and IgA in the small and large intestine in PN+EN group were stronger than PN group ( P