Jian Zhang1,2,3, Wen-Qiao Yu4, Tao Wei1,2,3, Cheng Zhang1,2,3, Liang Wen1,2,3, Qi Chen1,2,3, Wei Chen1,2,3, Jun-Yu Qiu1,2,3, Yun Zhang1,2,3, Ting-Bo Liang1,2,3. 1. Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, Hangzhou, 310009, Zhejiang, China. 2. Zhejiang Provincial Key Laboratory of Pancreatic Disease, Hangzhou, 310009, Zhejiang, China. 3. Innovation Center for the Study of Pancreatic Diseases, Hangzhou, 310009, Zhejiang, China. 4. Department of Surgical Intensive Care Unit, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, China.
Abstract
SCOPE: Short-peptide-based enteral nutrition (SPEN) is absorbed more efficiently in patients with severe acute pancreatitis (SAP). More importantly, SPEN decreases SAP-induced enterogenous infection risk. This study aims to investigate whether SPEN alleviates intestinal bacterial translocation in mice with SAP, and the underlying mechanisms. METHODS AND RESULTS: The SAP model is established after pre-treatment with SPEN or intact-protein-based enteral nutrition. Although there is no improvement in pancreas injury, as evaluated through Hematoxylin-Eosin staining or serum amylase, SPEN obviously attenuates intestinal bacterial translocation after SAP. To unveil the mechanisms, it is found that the intestinal mechanical barrier destroyed by SAP is significantly relieved by SPEN, which presents with recovered ZO-1 expression, mucus layer, and goblet cell function. Additionally, SPEN alleviates local CCR6/CCL20 induced CD11c+ dendritic cell infiltration, systemic immunosuppression, and inhibits the secretion of luminal secretory immunoglobulin A. Possibly responsible for SAP-induced mucosal dysfunctions, destroyed intestinal mucosal microcirculation and local hypoxia are largely improved in SAP+SPEN group. CONCLUSION: SPEN can improve downregulated intestinal mucosal microcirculation secondary to SAP, which may be responsible for mucosal inflammation relief, maintenance of the mechanical barrier and mucosal immunity, the correction of systemic immunosuppression, and play a protective role in defending commensal bacterial translocation after SAP.
SCOPE: Short-peptide-based enteral nutrition (SPEN) is absorbed more efficiently in patients with severe acute pancreatitis (SAP). More importantly, SPEN decreases SAP-induced enterogenous infection risk. This study aims to investigate whether SPEN alleviates intestinal bacterial translocation in mice with SAP, and the underlying mechanisms. METHODS AND RESULTS: The SAP model is established after pre-treatment with SPEN or intact-protein-based enteral nutrition. Although there is no improvement in pancreas injury, as evaluated through Hematoxylin-Eosin staining or serum amylase, SPEN obviously attenuates intestinal bacterial translocation after SAP. To unveil the mechanisms, it is found that the intestinal mechanical barrier destroyed by SAP is significantly relieved by SPEN, which presents with recovered ZO-1 expression, mucus layer, and goblet cell function. Additionally, SPEN alleviates local CCR6/CCL20 induced CD11c+ dendritic cell infiltration, systemic immunosuppression, and inhibits the secretion of luminal secretory immunoglobulin A. Possibly responsible for SAP-induced mucosal dysfunctions, destroyed intestinal mucosal microcirculation and local hypoxia are largely improved in SAP+SPEN group. CONCLUSION: SPEN can improve downregulated intestinal mucosal microcirculation secondary to SAP, which may be responsible for mucosal inflammation relief, maintenance of the mechanical barrier and mucosal immunity, the correction of systemic immunosuppression, and play a protective role in defending commensal bacterial translocation after SAP.
Authors: Zsolt Balla; Eszter Sára Kormányos; Balázs Kui; Emese Réka Bálint; Gabriella Fűr; Erik Márk Orján; Béla Iványi; László Vécsei; Ferenc Fülöp; Gabriella Varga; András Harazin; Vilmos Tubak; Mária A Deli; Csaba Papp; Attila Gácser; Tamara Madácsy; Viktória Venglovecz; József Maléth; Péter Hegyi; Lóránd Kiss; Zoltán Rakonczay Journal: Front Immunol Date: 2021-10-21 Impact factor: 7.561