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Previous issue date: 1997 === Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) === A proliferacao de enterobacterias no intestino delgado (ID), especialmente anaerobias, promove reacoes enzimaticas que modificam a estrutura dos acidos biliares conjugados. Atraves de desconjugacao e 7α-desidroxilacao, formam-se acidos biliares capazes de provocar alteracoes funcionais e morfologicas na mucosa intestinal.Foram colhidas amostras de aspirado duodenal de 74 lactentes: 23 com diarreia aguda (Grupo I), 17 com diarreia persistente (Grupo II) e 34 com enteropatia ambiental assintomatica (Grupo III). As amostras foram submetidas a cultura e contagem de colonias de enterobacterias e cromatografia de camada delgada para acidos biliares. Nos 3 grupos a incidencia de proliferacao de enterobacterias no ID foi muito alta. Dos 74 lactentes estudados, 19 (25,7%) apresentavam acidos biliares desconjugados no intestino delgado: 4 (17,4%) no Grupo I, 5 (29,4%) no Grupo II e 10 (29,4%) no Grupo III, sem haver diferenca significante entre os 3 grupos. Os acidos biliares desconjugados encontrados foram: acido colico (14 casos); acido quenodeoxicolico (4 casos); acido deoxicolico (1 caso); acido litocolico (5 casos). Nao houve correlacao entre os isolamentos bacterianos no ID e presenca de acidos biliares desconjugados. Conclui-se que acidos biliares desconjugados e 7α-desidroxilados por enterobacterias frequentemente estao presentes no duodeno em grupos de lactentes com alta incidencia de proliferacao bacteriana no ID. Notavelmente, este fenomeno ocorreu mesmo em lactentes assintomaticos portadores de enteropatia ambiental, sendo este um dos provaveis mecanismos responsaveis pela desnutricao infantil nas comunidades carentes === Small-bowel (SB) bacterial overgrowth, mainly when anaerobes
are present, leads to enzymatic reactions that modify the structure of conjugated
primary bile acids. By deconjugation and 7-dehydroxylation, bile acids capable of
promoting functional and morphological derangements in the intestinal mucosa are
formed.
Samples of duodenal fluid were colected from 74 infants: 23
with acute diarrhea (group I), 17 with persistent diarrhea (group II), and 34 with
asymptomathic environmental enteropathy (group III). All samples were submited to
culture and colony counting for enterobacteriaceae, and bile acid thin-layer
chromatography.
The incidence of overgrowth of enterobacteriaceae in the SB
was very high in the 3 groups. Unconjugated bile acids were found in the SB in 19
(25,7%) of the 74 infants studied: 4 (17,4%) in group I, 5 (29,4%) in group II, and 10
(29,4%) in group III. The unconjugated bile acids found were: cholic acid (14 cases);
chenodeoxycholic acid (4 cases); deoxycholic acid (1 case); lithocholic acid (5
cases). There was no correlation between bacterial isolates in the SB and the
presence of unconjugated bile acids.
In conclusion, deconjugated and 7-dehydroxylated bile acids
are frequently present in duodenum of groups of infants with high incidence of SB
bacterial overgrowth. Interestingly, this situation was present even in asymptomathic
environmental enteropathic infants, and probably this is one of the mechanisms
responsible by the poor nutritional state of children living in developing countries. === BV UNIFESP: Teses e dissertações
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