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lüll Intestinal epithelial cell apoptosis and loss of barrier function in the setting of altered microbiota with enteral nutrient deprivation Demehri FR; Barrett M; Ralls MW; Miyasaka EA; Feng Y; Teitelbaum DHFront Cell Infect Microbiol 2013[]; 3 (ä): 105Total parenteral nutrition (TPN), a commonly used treatment for patients who cannot receive enteral nutrition, is associated with significant septic complications due in part to a loss of epithelial barrier function (EBF). While the underlying mechanisms of TPN-related epithelial changes are poorly understood, a mouse model of TPN-dependence has helped identify several contributing factors. Enteral deprivation leads to a shift in intestinal microbiota to predominantly Gram-negative Proteobacteria. This is associated with an increase in expression of proinflammatory cytokines within the mucosa, including interferon-gamma and tumor necrosis factor-alpha. A concomitant loss of epithelial growth factors leads to a decrease in epithelial cell proliferation and increased apoptosis. The resulting loss of epithelial tight junction proteins contributes to EBF dysfunction. These mechanisms identify potential strategies of protecting against TPN-related complications, such as modification of luminal bacteria, blockade of proinflammatory cytokines, or growth factor replacement.|*Apoptosis[MESH]|*Biota[MESH]|Animals[MESH]|Cell Proliferation[MESH]|Cytokines/metabolism[MESH]|Epithelial Cells/*pathology[MESH]|Gastrointestinal Tract/*microbiology[MESH]|Humans[MESH]|Intercellular Signaling Peptides and Proteins/metabolism[MESH]|Intestinal Mucosa/*pathology[MESH]|Mice[MESH]|Parenteral Nutrition, Total/*adverse effects[MESH]|Tight Junction Proteins/metabolism[MESH] |