Table 1.

Alterations in mucosal immunity associated with parenteral nutrition

Distribution of T&B cells

Lower mucosal addressin cellular adhesion molecule-1 expression on Peyer’s patch venules

Reduces entry of T&B cells into mucosal immune system for priming

Lower chemokines levels in Peyer’s patches and lamina propria and lung

Lesser stimulus for cell migration our of vascular tree and into tissue

T&B cell phenotypes in Peyer’s patches and lamina propria LUNG

CD4+ cells reduced by 50–60%

CD8+ cells unchanged

Lower levels of Th-2 type cytokines: IL-4 and IL-10

Peyer’s patches: IL-4 stimulates MadCAM-1 expression via NFkB

Lamina propria: IL-4 and IL-10 stimulate IgA production by B cells

Reduced levels of polymeric immunoglobulin receptor (pIgR) on the mucosal cells

pIgR transports IgA from lamina propria to lumen converting it to secretory IgA