Malnutrition predisposes to endotoxin-induced edema and impaired inflammatory response in parenterally fed piglets
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Malnutrition predisposes to endotoxin-induced edema and impaired inflammatory response in parenterally fed piglets. / Bæk, Ole; Fabiansen, Christian; Friis, Henrik; Ritz, Christian; Koch, Jørgen; Willesen, Jakob L; Heegaard, Peter M H; Lykkesfeldt, Jens; Briend, André; Golden, Michael H; Sangild, Per Torp; Thymann, Thomas.
In: Journal of Parenteral and Enteral Nutrition, Vol. 44, No. 4, 2020, p. 668-676.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Malnutrition predisposes to endotoxin-induced edema and impaired inflammatory response in parenterally fed piglets
AU - Bæk, Ole
AU - Fabiansen, Christian
AU - Friis, Henrik
AU - Ritz, Christian
AU - Koch, Jørgen
AU - Willesen, Jakob L
AU - Heegaard, Peter M H
AU - Lykkesfeldt, Jens
AU - Briend, André
AU - Golden, Michael H
AU - Sangild, Per Torp
AU - Thymann, Thomas
N1 - CURIS 2019 NEXS 298 © 2019 American Society for Parenteral and Enteral Nutrition.
PY - 2020
Y1 - 2020
N2 - Background: Poor nutrition status is common among hospitalized children and children in low-income countries and may be associated with increased susceptibility to edema and infections. We hypothesized that poor nutrition status, established with a suboptimal composition of parenteral nutrition (PN), predisposes to endotoxemia-induced edema, oxidative stress, and dysregulated immune responses.Methods: Using a 2 × 2 factorial design, 3-day-old piglets (n = 40) were given either optimal or suboptimal composition of PN for 7 days and then infused with either saline or lipopolysaccharide (LPS) for 9 hours to induce an acute-phase reaction. Abdominal tissue edema and blood markers of immunity, inflammation, and oxidative stress were assessed.Results: Piglets receiving suboptimal nutrition showed signs of malnutrition with restricted growth, signs of inflammation (elevated C-reactive protein [CRP], interleukin-6, and serum amyloid A levels), oxidative stress (lower erythrocyte glutathione/hemoglobin and α-tocopherol/cholesterol ratios), and liver dysfunction (increased liver weight and blood bilirubin levels). Perirenal edema was more excessive in malnourished LPS-infused animals, relative to healthy LPS-infused control animals (P < .01). Malnutrition reduced the inflammatory response to LPS (lower CRP, tumor necrosis factor-α, haptoglobin, and neutrophil to lymphocyte ratio) but did not influence LPS-induced oxidative stress markers.Conclusions: We conclude that endotoxemia and malnutrition in combination lead to acute-phase hyporesponsiveness and perirenal edema in piglets. This finding may have implications for pediatric patients that suffer from malnutrition, as their response to bacterial infections may differ substantially from patients of normal nutrition status.
AB - Background: Poor nutrition status is common among hospitalized children and children in low-income countries and may be associated with increased susceptibility to edema and infections. We hypothesized that poor nutrition status, established with a suboptimal composition of parenteral nutrition (PN), predisposes to endotoxemia-induced edema, oxidative stress, and dysregulated immune responses.Methods: Using a 2 × 2 factorial design, 3-day-old piglets (n = 40) were given either optimal or suboptimal composition of PN for 7 days and then infused with either saline or lipopolysaccharide (LPS) for 9 hours to induce an acute-phase reaction. Abdominal tissue edema and blood markers of immunity, inflammation, and oxidative stress were assessed.Results: Piglets receiving suboptimal nutrition showed signs of malnutrition with restricted growth, signs of inflammation (elevated C-reactive protein [CRP], interleukin-6, and serum amyloid A levels), oxidative stress (lower erythrocyte glutathione/hemoglobin and α-tocopherol/cholesterol ratios), and liver dysfunction (increased liver weight and blood bilirubin levels). Perirenal edema was more excessive in malnourished LPS-infused animals, relative to healthy LPS-infused control animals (P < .01). Malnutrition reduced the inflammatory response to LPS (lower CRP, tumor necrosis factor-α, haptoglobin, and neutrophil to lymphocyte ratio) but did not influence LPS-induced oxidative stress markers.Conclusions: We conclude that endotoxemia and malnutrition in combination lead to acute-phase hyporesponsiveness and perirenal edema in piglets. This finding may have implications for pediatric patients that suffer from malnutrition, as their response to bacterial infections may differ substantially from patients of normal nutrition status.
KW - Faculty of Science
KW - Edema
KW - Inflammation
KW - Kwashiorkor
KW - Lipopolysaccharide
KW - Malnutrition
KW - Oxidative stress
KW - Piglets
U2 - 10.1002/jpen.1705
DO - 10.1002/jpen.1705
M3 - Journal article
C2 - 31512266
VL - 44
SP - 668
EP - 676
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
SN - 0148-6071
IS - 4
ER -
ID: 227473484