scholarly journals Detectable serum flagellin and lipopolysaccharide and upregulated anti-flagellin and lipopolysaccharide immunoglobulins in human short bowel syndrome

2008 ◽  
Vol 294 (2) ◽  
pp. R402-R410 ◽  
Author(s):  
Thomas R. Ziegler ◽  
Menghua Luo ◽  
Concepción F. Estívariz ◽  
Daniel A. Moore ◽  
Shanthi V. Sitaraman ◽  
...  
Keyword(s):  
Immune Responses ◽  
Short Bowel Syndrome ◽  
Systemic Exposure ◽  
Barrier Dysfunction ◽  
Serum Samples ◽  
Short Bowel ◽  
Control Serum ◽  
Serial Serum ◽  
Modified Diet ◽  
Hormone Control

Gut barrier dysfunction may occur in short bowel syndrome (SBS). We hypothesized that systemic exposure to flagellin and lipopolysaccharide (LPS) in SBS might regulate specific immune responses. We analyzed serial serum samples obtained from parenteral nutrition (PN)-dependent patients with SBS versus non-SBS control serum. Serum from 23 adult SBS patients was obtained at baseline and 4, 8, 12, 16, 20, and 24 wk in a trial of modified diet with or without growth hormone. Control serum was obtained from 48 healthy adults and 37 adults requiring PN during critical illness. Serum flagellin was detected by an ELISA recognizing an array of gram-negative flagellins, and LPS was detected by limulus assay. Serum flagellin- and LPS-specific immunoglobulin levels (IgM, IgA, and IgG) were determined by ELISA. Serum flagellin and LPS were undetectable in control subjects. In contrast, serum flagellin, LPS, or both were detected in 14 SBS patients (61%) during one or more time points [flagellin alone, 5/23 (22%); LPS alone, 6/23 (26%); or flagellin + LPS, 3/23 (13%)]. Flagellin-specific serum IgM, IgA, and IgG levels were markedly increased in SBS patients compared with both control populations and remained elevated during the 6-mo study period. LPS-specific IgA was significantly higher in SBS patients compared with healthy controls; LPS-specific IgM, IgA, and IgG levels each decreased over time in association with PN weaning. We conclude that adults with PN-dependent SBS are systemically exposed to flagellin and LPS, presumably from the gut lumen. This likely regulates innate and adaptive immune responses to these specific bacterial products.

Growth Hormone, Glutamine, and a Modified Diet Enhance Nutrient Absorption in Patients With Severe Short Bowel Syndrome

1995 ◽  
Vol 19 (4) ◽  
pp. 296-302 ◽  
Author(s):  
Theresa A. Byrne ◽  
Thomas B. Morrissey ◽  
Thomas V. Nattakom ◽  
Thomas R. Ziegler ◽  
Douglas W. Wilmore
Keyword(s):  
Growth Hormone ◽  
Short Bowel Syndrome ◽  
Nutrient Absorption ◽  
Short Bowel ◽  
Severe Short Bowel Syndrome ◽  
Modified Diet

scholarly journals A New Treatment for Patients with Short-Bowel Syndrome Growth Hormone, Glutamine, and a Modified Diet

1995 ◽  
Vol 222 (3) ◽  
pp. 243-255 ◽  
Author(s):  
Theresa A. Byrne ◽  
Rebecca L. Persinger ◽  
Lorrie S. Young ◽  
Thomas R. Ziegler ◽  
Douglas W. Wilmore
Keyword(s):  
Growth Hormone ◽  
Short Bowel Syndrome ◽  
Short Bowel ◽  
New Treatment ◽  
Modified Diet

scholarly journals Serum IL-18 Is Increased at Early Postburn Period in Moderately Burned Patients

2006 ◽  
Vol 2006 ◽  
pp. 1-4 ◽  
Author(s):  
Y. Kenan Coban ◽  
Murat Aral
Keyword(s):  
Body Mass Index ◽  
Inflammatory Response ◽  
Immune Responses ◽  
Burn Injury ◽  
Serum Levels ◽  
The Other ◽  
Serum Samples ◽  
Serial Serum ◽  
Highly Correlated ◽  
Th1 Immune Responses

A severe systemic inflammatory response is usually seen after burn injury. IL-18enhances the Th1 immune responses in bacterial andviral infections. In order to evaluate the IL-18serum levels as well as IL-6and TNF-αat the48th hour postburn, serial serum samples of8burned patients were analyzed.8moderately burned patients were included into the study. Serum samples were taken at admission at the48th hour of postburn. IL-6, IL-18, and TNF-αserum levels were analyzed. Total mean burned surface area (TBSA) was24.6±5.7%and mean BMI (body mass index) was24.5±3.4. The patients' age ranged from17to38(mean26.3±7.4) years. An increase in sera IL-6, IL-18, and TNF-αwas detected at the48th hour postburn (P<.0001). All patients survived. A marked increase in serum levels of IL-18as well as the other cytokines evaluated was observed in the moderately burned patients. These three parameters were highly correlated with each other (r>0.9andP<.001). This is the first study that shows an increase in serum IL-18levels at the early postburn period.

scholarly journals Dietary glutamine and oral antibiotics each improve indexes of gut barrier function in rat short bowel syndrome

2009 ◽  
Vol 296 (2) ◽  
pp. G348-G355 ◽  
Author(s):  
Junqiang Tian ◽  
Li Hao ◽  
Prakash Chandra ◽  
Dean P. Jones ◽  
Ifor R. Willams ◽  
...  
Keyword(s):  
Small Bowel ◽  
Short Bowel Syndrome ◽  
Bacterial Translocation ◽  
Barrier Function ◽  
Oral Antibiotics ◽  
Barrier Dysfunction ◽  
Gut Barrier ◽  
Gram Negative ◽  
Short Bowel ◽  
Gut Barrier Function

Short bowel syndrome (SBS) is associated with gut barrier dysfunction. We examined effects of dietary glutamine (GLN) or oral antibiotics (ABX) on indexes of gut barrier function in a rat model of SBS. Adult rats underwent a 60% distal small bowel + proximal colonic resection (RX) or bowel transection (TX; control). Rats were pair fed diets with or without l-GLN for 20 days after operation. Oral ABX (neomycin, metronidazole, and polymyxin B) were given in some RX rats fed control diet. Stool secretory immunoglobulin A (sIgA) was measured serially. On day 21, mesenteric lymph nodes (MLN) were cultured for gram-negative bacteria. IgA-positive plasma cells in jejunum, stool levels of flagellin- and lipopolysaccharide (LPS)-specific sIgA, and serum total, anti-flagellin- and anti-LPS IgG levels were determined. RX caused gram-negative bacterial translocation to MLN, increased serum total and anti-LPS IgG and increased stool total sIgA. After RX, dietary GLN tended to blunt bacterial translocation to MLN (−29%, P = NS) and significantly decreased anti-LPS IgG levels in serum, increased both stool and jejunal mucosal sIgA and increased stool anti-LPS-specific IgA. Oral ABX eliminated RX-induced bacterial translocation, significantly decreased total and anti-LPS IgG levels in serum, significantly decreased stool total IgA and increased stool LPS-specific IgA. Partial small bowel-colonic resection in rats is associated with gram-negative bacterial translocation from the gut and a concomitant adaptive immune response to LPS. These indexes of gut barrier dysfunction are ameliorated or blunted by administration of dietary GLN or oral ABX, respectively. Dietary GLN upregulates small bowel sIgA in this model.

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