Mechanisms of Parenteral Nutrition-Associated Liver and Gut Injury

被引：105

作者：

Madnawat, Himani ^{[1
]}

Welu, Adam L. ^{[1
]}

Gilbert, Ester J. ^{[1
]}

Taylor, Derian B. ^{[1
]}

Jain, Sonali ^{[1
]}

Manithody, Chandrashekhara ^{[1
]}

Blomenkamp, Keith ^{[1
]}

Jain, Ajay K. ^{[1
]}

机构：

[1] St Louis Univ, Sch Med, Dept Pediat, Cardinal Glennon Childrens Med Ctr, St Louis, MO 63104 USA

来源：

NUTRITION IN CLINICAL PRACTICE | 2020年 / 35卷 / 01期

基金：

美国国家卫生研究院;

关键词：

liver diseases; microbiome; nutrition support; parenteral nutrition; sepsis; short bowel syndrome; FARNESOID-X-RECEPTOR; BILE-ACID SYNTHESIS; POLYUNSATURATED FATTY-ACIDS; ENTERAL NUTRITION; MUCOSAL ATROPHY; MOUSE MODEL; FISH-OIL; URSODEOXYCHOLIC ACID; INTESTINAL FAILURE; HEPATIC STEATOSIS;

D O I：

10.1002/ncp.10461

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 [营养与食品卫生学];

摘要：

Parenteral nutrition (PN) has revolutionized the care of patients with intestinal failure by providing nutrition intravenously. Worldwide, PN remains a standard tool of nutrition delivery in neonatal, pediatric, and adult patients. Though the benefits are evident, patients receiving PN can suffer serious cholestasis due to lack of enteral feeding and sometimes have fatal complications from liver injury and gut atrophy, including PN-associated liver disease or intestinal failure-associated liver disease. Recent studies into gut-systemic cross talk via the bile acid-regulated farnesoid X receptor (FXR)-fibroblast growth factor 19 (FGF19) axis, gut microbial control of the TGR5-glucagon-like peptide (GLP) axis, sepsis, and role of prematurity of hepatobiliary receptors are greatly broadening our understanding of PN-associated injury. It has also been shown that the composition of omega-6/omega-3 polyunsaturated fatty acids given parenterally as lipid emulsions can variably drive damage to hepatocytes and cell integrity. This manuscript reviews the mechanisms for the multifactorial pathogenesis of liver disease and gut injury with PN and discusses novel ameliorative strategies.

引用

页码：63 / 71

页数：9

共 102 条

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