2023 IARS Mentored Research Award

Mara SerbanescuMara Serbanescu, MD
Duke University School of Medicine
Durham, NC

Dr. Serbanescu’s Research

Role of Nutrition on Gut Microbes & Translocation after Trauma Laparotomy

The gut microbiota modulate various host responses, and may influence host immune and inflammatory responses after major abdominal trauma. However, the significance of gut microbial composition and bacterial translocation in early trauma remains unclear, as does the potential therapeutic benefit of parenteral nutrition on these dynamics when enteral feeding is prohibited. This study hypothesizes that following emergent trauma laparotomy, reduced intestinal barrier integrity and pathologic changes in the gut microbiota contribute to translocation of gut microbes to the circulation, and that barrier defenses may be fortified by early parenteral nutrition compared to no nutrition alone. This research will build on previous work in a mouse model using 16S rRNA sequencing and immunophenotyping to identify how changes in gut microbiota influence the novel bloodstream microbiome and systemic immune responses.

Leveraging a recently DOD-funded RCT focused on nutritional interventions in patients admitted following trauma laparotomy, 16S rRNA sequencing of paired rectal swab and blood samples, and biomarkers of intestinal permeability and inflammation will be used to delineate the relationship between gut and blood microbial profiles and barrier integrity, and identify how these are influenced by parenteral nutrition. Aim 1 examines the relationship of gut and blood microbial signatures on intestinal permeability upon admission; Aim 2 assesses differences in these relationships at 5 days after parenteral nutrition is initiated versus delayed nutrition. Aim 3 establishes if early parenteral nutrition affects longitudinal relationships between gut/blood microbial signatures and inflammatory cytokines and infection at 14 days.

Understanding the role of dysbiosis and microbial signatures in this homogenous population is significant, and the influence of modern nutritional interventions, may both alter current practices, and lead to new therapeutic targets.