Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients
Joint Authors
Wu, Xiuwen
Gu, Guosheng
Liu, Song
Zheng, Tao
Wang, Chenyang
Chen, Kai
Hu, Qiongyuan
Ren, Yanhan
Ren, Jianan
Ren, Huajian
Wang, Gefei
Hong, Zhiwu
Source
Oxidative Medicine and Cellular Longevity
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-11-21
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
The gut was suggested as the driver of critical illness and organ injury.
Recently, excessive formation of neutrophil extracellular traps (NETs) was associated with mucosal inflammation.
Direct investigation of intestinal mucosa is essential to illuminate the potential mechanism of gut barrier in critically ill patients.
We hypothesized that early enteral nutrition (EN) could decrease intestinal NETs and maintain the gut barrier.
Methods.
Intestinal biopsies were obtained using biopsy forceps from critically ill surgical patients complicated with enterocutaneous fistula.
Expressions of tight junction (TJ) proteins, mucosal inflammation, and apoptosis were evaluated.
Moreover, NET-associated proteins were evaluated in intestinal specimens of patients by Western blot and immunofluorescence analysis.
Results.
The intestinal barrier was significantly impaired in critically ill patients receiving early total parenteral nutrition (TPN), evidenced by intestinal villi atrophy, inflammatory infiltration, increased enterocyte apoptosis, and abnormal TJ expressions.
Early EN significantly alleviated these intestinal injuries.
In addition, we observed increased formation of the NET structure and elevated expressions of NET-associated proteins in intestines of critically ill surgical patients.
Early EN was associated with the diminished presence of NETs and reduced expression of NET-associated proteins.
Mechanically, analysis of the TLR4 pathway showed a significant increase in TLR4, NFκB, and MAPK signaling in patients receiving TPN when compared to those receiving early EN.
Conclusion.
The intestinal barrier is disrupted in the human gut during critical illness.
Our data suggests that an increased NET structure was showed in the gut of critically ill surgical patients, and early EN treatment was associated with the reduction of NET formation and the preservation of mucosal immunity.
American Psychological Association (APA)
Hu, Qiongyuan& Ren, Huajian& Hong, Zhiwu& Wang, Chenyang& Zheng, Tao& Ren, Yanhan…[et al.]. 2020. Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients. Oxidative Medicine and Cellular Longevity،Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1205709
Modern Language Association (MLA)
Hu, Qiongyuan…[et al.]. Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients. Oxidative Medicine and Cellular Longevity No. 2020 (2020), pp.1-8.
https://search.emarefa.net/detail/BIM-1205709
American Medical Association (AMA)
Hu, Qiongyuan& Ren, Huajian& Hong, Zhiwu& Wang, Chenyang& Zheng, Tao& Ren, Yanhan…[et al.]. Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients. Oxidative Medicine and Cellular Longevity. 2020. Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1205709
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1205709