Glucose polymer in the fluid therapy of acute diarrhoea: studies in a model of rotavirus infection in neonatal rats.
1. Unlike standard glucose-electrolyte oral rehydration solutions, solutions containing polymeric glucose as substrate can significantly reduce stool output, duration of diarrhoea and total oral rehydration solution requirements. However, neither the underlying mechanisms nor the optimal size and concentration of glucose polymer has been defined. 2. We have used a model of rotavirus diarrhoea in neonatal rats to compare the effects on water and solute absorption of varying the concentration of a glucose polymer (mean chain length five glucose residues) in experimental oral rehydration solutions. Three polymer (P) solutions were compared with solutions of identical electrolyte content (mmol/l: sodium, 60; potassium, 20; chloride, 60; citrate, 10) containing equivalent amounts of free glucose (G) as substrate by perfusion of the entire small intestine in situ. The polymer (9, 18, 36 mmol/l; 159, 168, 186 mosmol/kg, respectively) and the monomer (45, 90, 180 mmol/l; 195, 240 320 mosmol/kg) solutions were perfused in normal and rotavirus-infected neonatal rats. 3. In normal intestine polymer solutions promoted greater water absorption [P9, mean 291.4 (SEM 16.4); P18, 331.9 (13.1); P36, 284.3 (11.8) microliters min-1 g-1] than their equivalent monomer solutions [G45, 220.8 (8.4); G90, 240 (21); G180,79.4 (14.5) microliters min-1 g-1; P < 0.02]. In rotavirus-infected intestine, water absorption from all solutions declined, but the fall was much less pronounced from the polymer solutions [P9, 232.8 (6); P18, 277.2 (20.5); P36, 166 (18.2) microliters min-1 G-1] than from their monomeric counterparts [G45, 116.7 (25.5); G90, 68.7 (12.4); G180, 21 (11.6) microliters min-1 g-1; P < 0.005].(ABSTRACT TRUNCATED AT 250 WORDS)
Thillainayagam
A V
AV
Department of Gastroenterology, St Bartholomew's Hospital, London, U.K.
Dias
J A
JA
Salim
A F
AF
Mourad
F H
FH
Clark
M L
ML
Farthing
M J
MJ
D000208:Acute Disease; D000818:Animals; D000831:Animals, Newborn; D001692:Biological Transport; D002712:Chlorides / Q000378:metabolism; D003967:Diarrhea / Q000378:metabolism / Q000628:therapy*; D004195:Disease Models, Animal; D005440:Fluid Therapy; D005947:Glucose / Q000378:metabolism / Q000627:therapeutic use*; D007408:Intestinal Absorption / Q000502:physiology; D011108:Polymers / Q000627:therapeutic use; D011188:Potassium / Q000378:metabolism; D051381:Rats; D012400:Rotavirus Infections / Q000378:metabolism / Q000628:therapy*; D012964:Sodium / Q000378:metabolism; D014867:Water / Q000378:metabolism
D002712:Chlorides; D011108:Polymers; D014867:Water; D012964:Sodium; D005947:Glucose; D011188:Potassium