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Children 2018, 5(10), 136; https://doi.org/10.3390/children5100136

Role of the Gut–Liver Axis in Driving Parenteral Nutrition-Associated Injury

1
Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA
2
Department of Surgery, Saint Louis University School of Medicine, 1 N. Grand Blvd., St. Louis, MO 63103, USA
*
Author to whom correspondence should be addressed.
Received: 7 August 2018 / Revised: 16 September 2018 / Accepted: 17 September 2018 / Published: 25 September 2018
(This article belongs to the Special Issue 5th Anniversary Issue)
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PDF [696 KB, uploaded 1 October 2018]
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Abstract

For decades, parenteral nutrition (PN) has been a successful method for intravenous delivery of nutrition and remains an essential therapy for individuals with intolerance of enteral feedings or impaired gut function. Although the benefits of PN are evident, its use does not come without a significant risk of complications. For instance, parenteral nutrition-associated liver disease (PNALD)—a well-described cholestatic liver injury—and atrophic changes in the gut have both been described in patients receiving PN. Although several mechanisms for these changes have been postulated, data have revealed that the introduction of enteral nutrition may mitigate this injury. This observation has led to the hypothesis that gut-derived signals, originating in response to the presence of luminal contents, may contribute to a decrease in damage to the liver and gut. This review seeks to present the current knowledge regarding the modulation of what is known as the “gut–liver axis” and the gut-derived signals which play a role in PN-associated injury. View Full-Text
Keywords: parenteral nutrition; total parenteral nutrition; fibroblast growth factor 19; farnesoid x receptor; glucagon like peptide; chenodeoxycholic acid; cholesterol 7 alpha-hydroxylase 1 parenteral nutrition; total parenteral nutrition; fibroblast growth factor 19; farnesoid x receptor; glucagon like peptide; chenodeoxycholic acid; cholesterol 7 alpha-hydroxylase 1
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Denton, C.; Price, A.; Friend, J.; Manithody, C.; Blomenkamp, K.; Westrich, M.; Kakarla, V.; Phillips, W.; Krebs, J.; Munoz Abraham, A.S.; Osei, H.; Jain, A.K. Role of the Gut–Liver Axis in Driving Parenteral Nutrition-Associated Injury. Children 2018, 5, 136.

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