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T Lymphocyte Numbers in Human Gut Associated Lymphoid Tissue Are Reduced Without Enteral Nutrition
Koichi Okamoto, MD*,
Kazuhiko Fukatsu, MD ,
Chikara Ueno, MD*,
Eiji Shinto, MD ,
Yojiro Hashiguchi, MD*,
Hidetoshi Nagayoshi, MD*,
Hoshio Hiraide, MD and
Hidetaka Mochizuki, MD*
From the * Department of Surgery I and
Department of Pathology II, National Defense
Medical College, Saitama, Japan; and the
Division of Basic Traumatology, National
Defense Medical College Research Institute, Saitama, Japan
Correspondence: Kazuhiko Fukatsu, MD, Division of Basic Traumatology, National
Defense Medical College Research Institute, 3–2 Namiki, Tokorozawa,
Saitama, Japan. Electronic mail may be sent to
fukatsu{at}res.ndmc.ac.jp.
Background: Clinically, in the absence of enteral nutrition, the
morbidity of infectious complication is high. Although experiments using mice
have shown alterations in gut-associated lymphoid tissue (GALT) to be an
important mechanism underlying impaired host defense, there are no clinical
studies on the effects of nutritional routes on GALT. Methods: A
total of 27 colon cancer cases who underwent right colectomy or hemicolectomy
were reviewed. Six patients did not receive enteral nutrition for 4 to 28 days
before surgery because of bowel obstruction (parenteral nutrition [PN] group).
Twenty-one patients were enterally fed before surgery (enteral nutrition [EN]
group). The terminal ileum from resected specimens was examined
microscopically. T-cell numbers in intraepithelial spaces (IE) and the lamina
propria (LP) were determined immunohistochemically in blinded fashion.
Results: There were no significant differences in baseline
characteristics between the 2 groups. T-cell number in the LP was
significantly lower in the PN group than in the EN group, with no difference
in IE cell numbers. Conclusions: Lack of enteral delivery of
nutrients reduces GALT cell number in patients with colon cancer, as is the
case in mice.
Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 1,
56-58 (2005)
DOI: 10.1177/014860710502900156
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