Increased expression of intestinal P-selectin and pulmonary E-selectin during intravenous total parenteral nutrition

Hypothesis: Intravenous total parenteral nutrition (TPN) induces intestinal polymorphonuclear neutrophil recruitment with increased intestinal intercellular adhesion molecule-1 expression. While intercellular adhesion molecule-1 causes firm adhesion of leukocytes to the endothelial cells, P- and E-selectin mediate leukocyte recruitment via rolling. Therefore, manipulation of nutrition may also affect P- and E-selectin expression in organs. Design: Prospective randomized experimental trials. Setting: Laboratory. Materials: Male mice. Interventions: Fifty-three mice were randomized to chow, intravenous TPN, or intragastric TPN. Main Outcome Measures: After 5 days of diet, mice were administered iodine 125-labeled anti-P-selectin antibody (or iodine 125-labeled anti-E-selectin antibody) and iodine 131-labeled nonbinding antibody to quantify P-selectin (or E-selectin) expression in organs(lung, liver, kidney, small intestine, colon, stomach, pancreas, mesentery, heart, and skeletal muscle). Results: P-selectin in small intestine, colon, stomach, and pancreas in the intravenous TPN group increased significantly as compared with the chow and the intragastric TPN groups. E-selectin expression was upregulated after intravenous TPN in the lung but not in other sites. Conclusions: In a time frame (5 days) when intercellular adhesion molecule-1 expression and neutrophil recruitment are increased, intestinal expression of P-selectin remains up-regulated. Early lung inflammatory changes are reflected by increases in E-selectin. This change may reflect early pulmonary dysfunction with intravenous TPN, but its significance requires further study.