RT Journal
A1 Fukatsu K, Lundberg AH, Hanna M, et al
T1 ROute of nutrition influences intercellular adhesion molecule-1 expression and neutrophil accumulation in intestine
JF Archives of Surgery
JO Archives of Surgery
YR 1999
FD October 1
VO 134
IS 10
SP 1055
OP 1060
DO 10.1001/archsurg.134.10.1055
UL http://dx.doi.org/10.1001/archsurg.134.10.1055
AB Hypothesis 
    The levels of intestinal interleukin 10 and interleukin 4, inhibitors of intercellular adhesion molecule-1 (ICAM-1) expression, decline with total parenteral nutrition (TPN). These cytokine changes induced by lack of enteral nutrition may increase ICAM-1 expression, resulting in polymorphonuclear neutrophil accumulation in intestine.Design 
    Prospective randomized experimental trials.Setting 
    Laboratory.Materials 
    Male mice.Interventions 
    Sixty-three mice were randomized to chow, intravenous TPN, or intragastric TPN.Main Outcome Measures 
    Experiment 1: After diet manipulation, iodine 125–labeled anti–ICAM-1 antibody and iodine 131–labeled nonbinding antibody were injected to quantify ICAM-1 expression on endothelial cells in the lung, liver, kidney, and small intestine. Measurement of myeloperoxidase was used to quantify polymorphonuclear neutrophil accumulation in the organs. Experiment 2: Intestine was harvested for both ICAM-1 and myeloperoxidase levels after chow refeeding of mice in the intravenous TPN group.Results 
    In experiment 1, uninjured mice fed intravenous TPN showed significantly increased intestinal ICAM-1 expression and polymorphonuclear neutrophil accumulation with no significant changes in the lung, liver, or kidney. No changes occurred in mice fed chow or intragastric TPN. In experiment 2, reinstitution of enteral feeding returned intestinal ICAM-1 and myeloperoxidase levels to normal.Conclusion 
    Gut changes associated with lack of enteral feeding induce endothelial changes and an immunologic response, which may influence subsequent responses to injury.