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Increased Expression of Intestinal P-Selectin and Pulmonary E-Selectin During Intravenous Total Parenteral Nutrition
Kazuhiko Fukatsu, MD;
Andrew H. Lundberg, MD;
M. Keith Hanna, MD;
Yong Wu, MD;
Henry G. Wilcox, PhD;
D. Neil Granger, PhD;
A. Osama Gaber, MD;
Kenneth A. Kudsk, MD
Arch Surg. 2000;135:1177-1182.
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 up-regulated 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.
From the Departments of Surgery (Drs Fukatsu, Lundberg, Hanna, Wu, Gaber, and Kudsk) and Pharmacology (Dr Wilcox), University of Tennessee, Memphis; and Department of Physiology and Biophysics, Louisiana State University Medical Center, Shreveport (Dr Granger).
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ABSTRACT
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