营养支持对肠道菌群与肠黏膜免疫的影响

肠内营养(EN)有助于保持肠黏膜的屏障功能,维护肠黏膜的结构完整性,促进肠黏膜固有免疫和获得性免疫的产生,维持肠道菌群的平衡和多样性。肠外营养(PN)能预防胃肠道功能障碍患者进一步营养不良的发生,挽救危重症患者的生命,然而PN会增加危重症患者感染并发症的发生。全肠外营养(TPN)时肠黏膜免疫受损,肠道菌群(GM)紊乱,滋养性喂养能显著改善肠黏膜的免疫功能,促进肠道内稳态的恢复。GM紊乱加重肠黏膜的炎症反应,或将进一步加重肠黏膜免疫的损害。因此,全面理解营养支持、GM与肠黏膜免疫之间的相互关系具有重要意义。

Effect of nutritional support on gut microbiota and intestinal mucosal immunity

Enteral nutrition (EN) helps maintain gut barrier functions,including protecting mucosal structural integrity,promoting mucosal innate and acquired immunity,maintaining the balance and diversity of gut microbiota.Parenteral nutrition (PN) prevents progressive malnutrition and provides lifesaving therapy for many patients with gastrointestinal disorders.However,PN is associated with an increased incidence of infection in critically ill patients.Lack of EN during total parenteral nutrition (TPN) leads to disabled intestinal mucosal immunity with gut microbiota dysbiosis.Trophic feeding significantly restores intestinal mucosal immunity and promotes intestinal homeostasis.Dysbiosis aggregates inflammatory responses in intestinal mucosa during TPN,which could further impair intestinal mucosal immunity.Therefore,it's critical to clarify the interactions between nutritional support,gut microbiota and intestinal mucosal immunity.