title: Effects of an alanyl-glutamine-based oral rehydration and nutrition therapy solution on electrolyte and water absorption in a rat model of secretory diarrhea induced by cholera toxin.
abstract: OBJECTIVE
  Recurring diarrhea and persistent diarrhea are commonly associated with malnutrition and long-term functional deficits. A beneficial approach would be to develop an alanyl-glutamine (AlaGln)-based oral rehydration and nutrition therapy (ORNT). We investigated the effect of an AlaGln-ORNT solution on electrolyte and water absorption in a rat model of secretory diarrhea induced by cholera toxin.
  
  
  METHODS
  Phenolsulfonphthalein (50 microg/mL) was used as a non-absorbable marker for calculation of net water and electrolyte transport. Solutions tested were Ringer's solution, a glutamine-based ORNT (Gln-ORNT) solution, and an AlaGln-ORNT solution. Cholera toxin (1 microg/mL) was injected into lumen of rat small intestinal segments and incubated for 18 h before the initiation of the perfusion.
  
  
  RESULTS
  Cholera toxin induced significant secretion of electrolyte and water in the control Ringer's solution. AlaGln-ORNT and Gln-ORNT solutions reduced the sodium secretory effect of cholera toxin by 128% and 36%, respectively. The net water secretion also was reduced by 95% and 60%, respectively, with the AlaGln-ORNT and Gln-ORTN solutions.
  
  
  CONCLUSIONS
  These results showed that AlaGln-ORNT solution can enhance water and electrolyte intestinal absorption even better than glutamine or glucose and thus provide a potential novel approach for ORNT to break the vicious cycle of diarrhea and malnutrition. Clinical trials are now needed in children and adults with diarrhea and malnutrition.
authors.affiliation: Institute of Biomedicine, Clinical Research Unit, Dept of Physiology and Pharmacology, Federal University of Ceará, Avenida José Bastos 3990, C.P. 3229, Porangabusso, Fortaleza, Ceará, Brazil CEP 60.436-160. alima@secrel.com.br
authors.forename: Aldo A M
authors.initials: AA
authors.lastname: Lima
authors.forename: Graça H P
authors.initials: GH
authors.lastname: Carvalho
authors.forename: Aline A
authors.initials: AA
authors.lastname: Figueiredo
authors.forename: Angela R
authors.initials: AR
authors.lastname: Gifoni
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Soares
authors.forename: Eduardo A T
authors.initials: EA
authors.lastname: Silva
authors.forename: Richard L
authors.initials: RL
authors.lastname: Guerrant
mesh_terms: D000818:Animals; D002772:Cholera Toxin; D003967:Diarrhea / Q000139:chemically induced / Q000378:metabolism / Q000628:therapy*; D004151:Dipeptides / Q000008:administration & dosage* / Q000627:therapeutic use; D004195:Disease Models, Animal; D004573:Electrolytes / Q000378:metabolism*; D005260:Female; D005440:Fluid Therapy / Q000379:methods; D005973:Glutamine; D007408:Intestinal Absorption / Q000187:drug effects*; D007700:Kinetics; D008297:Male; D011188:Potassium / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D015532:Rehydration Solutions / Q000008:administration & dosage* / Q000627:therapeutic use; D012964:Sodium / Q000378:metabolism; D014867:Water / Q000378:metabolism*
chemical_list: D004151:Dipeptides; D004573:Electrolytes; D015532:Rehydration Solutions; D014867:Water; D005973:Glutamine; D002772:Cholera Toxin; D012964:Sodium; D011188:Potassium; C054122:alanylglutamine