Clinical Trials Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2019; 25(22): 2799-2808
Published online Jun 14, 2019. doi: 10.3748/wjg.v25.i22.2799
Effects of early enteral nutrition on Th17/Treg cells and IL-23/IL-17 in septic patients
Jia-Kui Sun, Wen-Hao Zhang, Wen-Xiu Chen, Xiang Wang, Xin-Wei Mu
Jia-Kui Sun, Wen-Hao Zhang, Wen-Xiu Chen, Xiang Wang, Xin-Wei Mu, Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
Author contributions: Sun JK, Wang X, and Mu XW designed the research; Sun JK, Zhang WH, and Chen WX performed the research; Sun JK and Zhang WH analyzed the data; and Sun JK wrote the paper.
Supported by: the National Natural Science Foundation of China, No. 81701881; and the Nanjing Medical Science and Technology Development Foundation, No. YKK15098 and No. YKK17102.
Institutional review board statement: The study was reviewed and approved by the Institutional Ethics Committee of Nanjing First Hospital (Approval Number: KY20170921-02).
Clinical trial registration statement: This study is registered at https://www.clinicaltrials.gov. The registration identification number is NCT03385850.
Informed consent statement: All involved persons (legally authorized representative) gave their written informed consent prior to study inclusion.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiang Wang, MD, Doctor, Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing 210006, Jiangsu Province, China. njdrwx2016@163.com
Telephone: +86-25-52271234 Fax: +86-25-52271326
Received: March 14, 2019
Peer-review started: March 14, 2019
First decision: March 27, 2019
Revised: April 4, 2019
Accepted: April 29, 2019
Article in press: April 29, 2019
Published online: June 14, 2019
Processing time: 93 Days and 18.5 Hours
Core Tip

Core tip: The aim of this prospective clinical trial was to investigate the effects of early enteral nutrition (EEN) on Th17/Treg cell ratios and the IL-23/IL-17 axis in septic patients. Patients were randomly divided into an EEN or delayed enteral nutrition (DEN) group. As a result, the Th17 cell percentages, Th17/Treg cell ratios, IL-17, IL-23, and IL-6 levels of the EEN group were lower than those of the DEN group on the 7th day after admission. In other words, EEN could regulate the imbalance of Th17/Treg cell ratios and suppress the IL-23/IL-17 axis during sepsis. Moreover, EEN could reduce the clinical severity but did not reduce the 28-d mortality of sepsis.