Parenteral versus enteral nutrition: effect on serum cytokines and the hepatic expression of mRNA of suppressor of cytokine signaling proteins, insulin-like growth factor-1 and the growth hormone receptor in rodent sepsis

Abstract

Introduction Early nutrition is recommended for patients with sepsis, but data are conflicting regarding the optimum route of delivery. Enteral nutrition (EN), compared with parenteral nutrition (PN), results in poorer achievement of nutritional goals but may be associated with fewer infections. Mechanisms underlying differential effects of the feeding route on patient outcomes are not understood, but probably involve the immune system and the anabolic response to nutrients. We studied the effect of nutrition and the route of delivery of nutrition on cytokine profiles, the growth hormone-insulin-like growth factor-1 (IGF-I) axis and a potential mechanism for immune and anabolic system interaction, the suppressors of cytokine signaling (SOCS), in rodents with and without sepsis.

Early nutritional support is associated with decreased length of hospitalization in dogs with septic peritonitis: A retrospective study of 45 cases (2000–2009)

“…When EN is not feasible due to poor tolerance related to clinical signs listed above, vasopressor‐dependent hypotension or lack of expertise for nasojejunal tube placement, parenteral nutrition (PN) is an alternative approach to ensure adequate nutritional intake. However, there are concerns for its effects on cytokine production, hormonal release, and immunosuppression . Therefore, the goal of this study is to investigate the effect of timing and route of nutritional support on length of hospitalization (LOH) in dogs that survived septic peritonitis.…”

“…However, there are concerns for its effects on cytokine production, hormonal release, and immunosuppression. 8,9 Therefore, the goal of this study is to investigate the effect of timing and route of nutritional support on length of hospitalization (LOH) in dogs that survived septic peritonitis. Markers of nutritional status, illness severity, and nutrition-related complications were also evaluated for their potential association with LOH.…”

Continuous Enteral and Parenteral Feeding Each Reduces Heart Rate Variability But Differentially Influences Monocyte Gene Expression in Humans

“…(4–7)Compared to enterally fed animals, those that received parenteral nutrition demonstrated increased gut bacterial translocation(8)and had increased mortality when challenged with bacterial lipopolysaccharide (endotoxin) or with intraabdominal infection. (9) Dysregulation of both innate and adaptive immune functions are believed to influence these adverse outcomes.…”

The Course Of IGF-1 Levels and Nutrient Intake in Extremely and Very Preterm Infants During Hospitalisation

“…Animal studies have shown that in a state of inflammation or poor nutrient intake, enteral feeding results in higher IGF-1 levels than parenteral feeding. This is thought to be due to a reduction in inflammatory cytokine levels after enteral feeding [9,10]. These findings suggest that the route of nutrient administration could mediate cytokine production and consequently influence IGF-1 levels.…”

“…Moreover, animal studies found that in a state of inflammation or nutrient deprivation, parenteral feeding was associated with lower IGF-1 levels compared to enteral feeding. This appears to be due to a decrease in pro-inflammatory cytokines after enteral feeding [9,10]. This leads us to believe that the neutralizing effect of anti-inflammatory cytokines, which are particularly abundant in colostrum and breast milk, is diminished and results in lower IGF-1 levels when parenteral nutrition is increased.…”