Alanyl-glutamine-supplemented total parenteral nutrition improves survival and protein metabolism in rat protracted bacterial peritonitis model.
BACKGROUND
The effects of glutamine-enriched total parenteral nutrition (TPN) solution on survival, and protein turnover in the whole body and in individual organs were investigated in a rat protracted peritonitis model.


METHODS
Twenty-three rats underwent venous catheter insertion. Osmotic pumps were implanted in the peritoneal cavity to allow continuous delivery of Escherichia coli (4 x 10(8) CFU/d). The conventional TPN group received a conventional amino acid solution. The Ala-Gln TPN group received an alanyl-glutamine-enriched TPN solution. The two TPN solutions were isocaloric and isonitrogenous.


RESULTS
Over the 5 days of TPN treatment, the survival rate of the Ala-Gln group was significantly higher than that of the conventional group. The Ala-Gln group tended to have increased whole-body protein turnover compared with the conventional group. Fractional protein synthetic rates (FSR) in the liver and gastrocnemius muscle of the Ala-Gln group were significantly higher than those of the conventional group. The serum glutamine concentration correlated positively with the FSR of both liver and muscle. The Ala-Gln group showed significantly greater mucosal height and mitoses per crypt, in the small intestine, than did the conventional group.


CONCLUSIONS
Our results suggested that, in comparison with standard glutamine-free TPN, Ala-Gln-supplemented TPN increases protein synthesis in the liver and skeletal muscle, protects the morphology of the intestinal mucosa, and improves survival in protracted bacterial peritonitis. Ala-Gln supplementation may be useful in septic patients.
Naka
S
S
Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Saito
H
H
Hashiguchi
Y
Y
Lin
M T
MT
Furukawa
S
S
Inaba
T
T
Fukushima
R
R
Wada
N
N
Muto
T
T
D000409:Alanine / Q000008:administration & dosage*; D000596:Amino Acids / Q000097:blood; D000818:Animals; D004927:Escherichia coli Infections / Q000378:metabolism / Q000628:therapy; D005973:Glutamine / Q000008:administration & dosage*; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D010289:Parenteral Nutrition, Total; D010538:Peritonitis / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D014176:Protein Biosynthesis; D011506:Proteins / Q000378:metabolism*; D051381:Rats; D017208:Rats, Wistar; D015996:Survival Rate
D000596:Amino Acids; D011506:Proteins; D005973:Glutamine; D000409:Alanine