Lo Hui-Chen, Wu Shih-Chi, Wang Yao-Horng, Lee Chien-Hsing
Department of Nutritional Science, Fu Jen Catholic University, #510 Jhongjheng Rd., Sinjhuang, Taipei, 242, Taiwan.
Pediatr Surg Int. 2010 Jun;26(6):625-32. doi: 10.1007/s00383-010-2582-9. Epub 2010 Feb 24.
Peritonitis is a life-threatening condition that may occur as a sequela of intra-abdominal infection. The management of peritonitis includes surgical intervention, antimicrobial therapy, and nutritional support. Arginine has been reported to have beneficial and adverse effects in subjects with inflammation, which might be related to the dose, time, and route of supplementation and the disease severity. So far, the optimal doses of parenteral arginine are not known. In this study, we investigated dose effects of parenterally supplemented arginine on anabolism and arginine-derived metabolites in sub-acute inflammation.
Male Wistar rats underwent modified cecal puncture procedure for induction of peritonitis were infused with total parenteral nutrition solutions for 7 days, which contained conventional, low, medium, and high doses of arginine, i.e., 1.61, 2.85, 4.08, and 6.54% of calories from arginine. Healthy, orally fed rats were included as references.
On day 7, peritonitic rats had significantly decreased body weight, declined serum albumin, and increased serum nitric oxide (NO) and tumor-necrosis factor-alpha compared to references (ANOVA, P < 0.05). There were no dose effects of parenteral arginine on body weight, nitrogen retention, and serum blood urea nitrogen and creatinine in peritonitic rats. In contrast, plasma arginine, proline, and ornithine, and urinary urea nitrogen were significantly increased, whereas serum NO and plasma glutamine were significantly decreased in dose-dependent manners with parenteral arginine. Pharmacological dose of parenteral arginine may increase the synthesis of ornithine, urea, and proline instead of citrulline and NO in peritonitic rats.
These results suggest that high dose of parenteral arginine may facilitate ureagenesis and proline conversion without causing augmentation of NO production in sub-acute inflammation. Therefore, pharmacological dose of parenteral arginine may not have benefits in anabolism but does not cause adverse effect in rats with sub-acute inflammation.
腹膜炎是一种可能作为腹腔内感染后遗症出现的危及生命的病症。腹膜炎的治疗包括手术干预、抗菌治疗和营养支持。据报道,精氨酸对炎症患者有有益和不良影响,这可能与补充的剂量、时间、途径以及疾病严重程度有关。到目前为止,肠外补充精氨酸的最佳剂量尚不清楚。在本研究中,我们研究了肠外补充精氨酸对亚急性炎症中合成代谢和精氨酸衍生代谢产物的剂量效应。
对接受改良盲肠穿刺术诱导腹膜炎的雄性Wistar大鼠输注全肠外营养溶液7天,这些溶液含有常规、低、中、高剂量的精氨酸,即来自精氨酸的热量分别为1.61%、2.85%、4.08%和6.54%。纳入健康的经口喂养大鼠作为对照。
与对照组相比,在第7天,腹膜炎大鼠体重显著下降,血清白蛋白降低,血清一氧化氮(NO)和肿瘤坏死因子-α升高(方差分析,P<0.05)。肠外精氨酸对腹膜炎大鼠的体重、氮潴留、血清血尿素氮和肌酐没有剂量效应。相反,随着肠外精氨酸剂量的增加,血浆精氨酸、脯氨酸和鸟氨酸以及尿尿素氮显著增加,而血清NO和血浆谷氨酰胺显著降低。药理剂量的肠外精氨酸可能会增加腹膜炎大鼠中鸟氨酸、尿素和脯氨酸的合成,而不是瓜氨酸和NO的合成。
这些结果表明,高剂量的肠外精氨酸可能促进尿素生成和脯氨酸转化,而不会在亚急性炎症中导致NO生成增加。因此,药理剂量的肠外精氨酸可能对合成代谢没有益处,但对亚急性炎症大鼠不会产生不良影响。