{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:23:12Z","timestamp":1786335792627,"version":"build-2736575974"},"reference-count":74,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2018,9,25]],"date-time":"2018-09-25T00:00:00Z","timestamp":1537833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08DK098623"],"award-info":[{"award-number":["K08DK098623"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>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)\u2014a well-described cholestatic liver injury\u2014and 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 \u201cgut\u2013liver axis\u201d and the gut-derived signals which play a role in PN-associated injury.<\/jats:p>","DOI":"10.3390\/children5100136","type":"journal-article","created":{"date-parts":[[2018,9,25]],"date-time":"2018-09-25T11:12:26Z","timestamp":1537873946000},"page":"136","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Role of the Gut\u2013Liver Axis in Driving Parenteral Nutrition-Associated Injury"],"prefix":"10.3390","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-3413","authenticated-orcid":false,"given":"Christine","family":"Denton","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Friend","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrashekhara","family":"Manithody","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Blomenkamp","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Westrich","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vindhya","family":"Kakarla","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Krebs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando Salim","family":"Munoz Abraham","sequence":"additional","affiliation":[{"name":"Department of Surgery, Saint Louis University School of Medicine, 1 N. Grand Blvd., St. Louis, MO 63103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Osei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Saint Louis University School of Medicine, 1 N. Grand Blvd., St. Louis, MO 63103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9420-5722","authenticated-orcid":false,"given":"Ajay","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Saint Louis University School of Medicine, 1465 South Grand Blvd., St. Louis, MO 63104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.suc.2011.02.009","article-title":"Historical highlights of the development of total parenteral nutrition","volume":"91","author":"Dudrick","year":"2011","journal-title":"Surg. Clin. N. 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