title: Impairment of arginine metabolism in rats after massive intestinal resection: effect of parenteral nutrition supplemented with citrulline compared with arginine.
abstract: Arginine homoeostasis is impaired in short bowel syndrome, but its supplementation in short bowel syndrome patients remains controversial. Recently, we demonstrated the benefits of citrulline supplementation by the enteral route in resected rats. Since the first step in managing short bowel syndrome is to initiate total parenteral nutrition, we hypothesized that parenteral citrulline supplementation would be more appropriate in this situation than arginine supplementation. In the present study, 24 rats were assigned to four groups. The sham group underwent transection whereas the three other groups underwent resection (R) of 80% of the small intestine. All rats were then fed exclusively by total parenteral nutrition as follows: supplementation with citrulline (R+CIT), with arginine (R+ARG) or no supplementation (R). All of the rats received isocaloric and isonitrogenous nutrition for 4 days. Nitrogen balance was measured daily. Rats were then killed and the blood was collected and the intestinal mucosa and extensor digitorum longus muscle were removed for amino acid and protein analysis. Citrulline and arginine increased mucosal protein content in the ileum (compared with sham and R, P<0.05). However, only citrulline prevented extensor digitorum longus atrophy (R+CIT, 130+/-3 mg compared with R, 100+/-6 mg and R+ARG, 110+/-2 mg, P<0.05). In addition, arginine worsened nitrogen balance (R+ARG, 104+/-46 mg/72 h compared with R, 249+/-69 mg/72 h, P<0.05). Only citrulline was able to prevent muscle atrophy and it was achieved independently from any noticeable effect on the gut in particular because citrulline and arginine share the same effect on mucosal ileal protein content. These results suggest that citrulline should be considered as a potential supplement for total parenteral nutrition of short bowel syndrome patients.
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA 2498, Faculté de Pharmacie - Université Paris Descartes, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Osowska
authors.forename: Nathalie
authors.initials: N
authors.lastname: Neveux
authors.forename: Samir
authors.initials: S
authors.lastname: Nakib
authors.forename: Virginie
authors.initials: V
authors.lastname: Lasserre
authors.forename: Luc
authors.initials: L
authors.lastname: Cynober
authors.forename: Christophe
authors.initials: C
authors.lastname: Moinard
mesh_terms: D000818:Animals; D001120:Arginine / Q000378:metabolism / Q000627:therapeutic use*; D002956:Citrulline / Q000627:therapeutic use*; D007413:Intestinal Mucosa / Q000378:metabolism; D007421:Intestine, Small / Q000378:metabolism / Q000601:surgery; D008297:Male; D009133:Muscular Atrophy / Q000378:metabolism / Q000517:prevention & control; D009584:Nitrogen / Q000378:metabolism; D010288:Parenteral Nutrition / Q000379:methods*; D011073:Polyamines / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D012778:Short Bowel Syndrome / Q000378:metabolism / Q000628:therapy*; D015431:Weight Loss
chemical_list: D011073:Polyamines; D002956:Citrulline; D001120:Arginine; D009584:Nitrogen