Objective:
To determine the effect of the neuropeptide bombesin on total parenteral nutrition—induced impairment of upper respiratory tract immunity.
Design:
Randomized, controlled trial.
Participants:
Thirty-six adult male Institute for Cancer Research mice weighing 25 to 35 g.
Interventions:
Mice were inoculated intranasally with H1N1 virus. At 3 weeks, mice were randomized to receive chow plus intravenous saline (n=12), intravenous total parenteral nutrition (n= 12), or intravenous total parenteral nutrition plus bombesin (n=12) administered 3 times daily at 15 μg/kg. After 5 days, mice were rechallenged with intranasal virus and killed at 40 hours to determine viral shedding from the respiratory tract; normal convalescent mice do not shed virus because of intact IgA-mediated mechanisms.
Main Outcome Measures:
Viral shedding was determined by collection of nasal secretions. Samples were diluted and incubated with a suspension of Madin-Darby canine kidney cells. Viral growth was determined by hemagglutination.
Results:
Body weight was similar between the total parenteral nutrition and bombesin groups; however, both were significantly lower than that in the chow group (P<.05). After 6 days of feeding, no mice in the chow group shed virus, compared with 6 (50%) of the mice in the total parenteral nutrition group. Of the mice in the bombesin group, only I was positive for viral shedding. The total parenteral nutrition group showed increased viral shedding compared with both the chow group (P<.01) and the bombesin group (P<.05).
Conclusions:
Exogenous administration of bombesin reversed the total parenteral nutrition—associated impairment of upper respiratory tract immunity to an IgA-mediated infectious challenge. These observations support the concept of a common mucosal immune system, since neuropeptides are endogenous to the gastrointestinal and respiratory tracts. Hormonal modulation of immunity is a promising avenue of treatment for patients who require total parenteral nutrition.Arch Surg. 1997;132:89-93