Arginine appearance and nitric oxide synthesis in critically ill infants can be increased with a protein-energy–enriched enteral formula

Betue, Carlijn T.I. de; Joosten, Koen; Deutz, N.E.P.; Vreugdenhil, Anita; Waardenburg, Dick A. van

doi:10.3945/ajcn.112.042523

Cited by 33 publications

(28 citation statements)

References 40 publications

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“…Plasma AA concentrations were determined by using liquid chromatographymass spectrometry (QTrap 5500 MS; AB Sciex) using internal standard method (12). Preparations of muscle tissue samples obtained from the vastus lateralis muscles at 180 and 420 min were performed as previously described (18).…”

Section: E75 Anabolic Responses To Increasing Protein Intake In a Mealmentioning

confidence: 99%

The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults

Kim

Schutzler

Schrader

et al. 2016

American Journal of Physiology-Endocrinology and Metabolism

110

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We have determined whole body protein kinetics, i.e., protein synthesis (PS), breakdown (PB), and net balance (NB) in human subjects in the fasted state and following ingestion of ϳ40 g [moderate protein (MP)], which has been reported to maximize the protein synthetic response or ϳ70 g [higher protein (HP)] protein, more representative of the amount of protein in the dinner of an average American diet. Twenty-three healthy young adults who had performed prior resistance exercise (X-MP or X-HP) or time-matched resting (R-MP or R-HP) were studied during a primed continuous infusion of]phenylalanine and L-[ 2 H2]tyrosine. Subjects were randomly assigned into an exercise (X, n ϭ 12) or resting (R, n ϭ 11) group, and each group was studied at the two levels of dietary protein intake in random order. PS, PB, and NB were expressed as increases above the basal, fasting values (mg·kg lean body mass Ϫ1 ·min Ϫ1 ). Exercise did not significantly affect protein kinetics and blood chemistry. Feeding resulted in positive NB at both levels of protein intake: NB was greater in response to the meal containing HP vs. MP (P Ͻ 0.00001). The greater NB with HP was achieved primarily through a greater reduction in PB and to a lesser extent stimulation of protein synthesis (for all, P Ͻ 0.0001). HP resulted in greater plasma essential amino acid responses (P Ͻ 0.01) vs. MP, with no differences in insulin and glucose responses. In conclusion, whole body net protein balance improves with greater protein intake above that previously suggested to maximally stimulating muscle protein synthesis because of a simultaneous reduction in protein breakdown. essential amino acids; optimal protein intake; protein turnover; stable isotope tracers.THE PRINCIPAL NUTRITIONAL goal of a protein-rich meal is to induce an anabolic state in which protein synthesis exceeds breakdown. Several recent studies, including our own (25), indicate that the maximum acute stimulation of muscle protein synthesis (MPS) occurs with ingestion of ϳ 20 -35 g of high-quality protein (20,25,31) or more specifically 0.24 g·kg body wt Ϫ1 ·meal Ϫ1 in healthy young adults (19). The maximal dose in terms of stimulation of MPS is less than that typically consumed with the dinner meal in the average American diet, which generates a hypothesis that distributing the amount of protein intake throughout the day can more effectively stimulate anabolic response. However, the assertion that there is limited effectiveness of the conventional protein intake with dinner is based on incomplete assessment of the metabolic response of muscle protein. Importantly, the extent of muscle protein anabolism (the anabolic response) is not simply the response of MPS but rather the net balance between the response of protein synthesis and protein breakdown. We recently demonstrated the potential importance of suppression of protein breakdown in response to dietary intake of meals containing two levels of protein totaling either 0.8 or 1.5 g protein·kg Ϫ1 ·day Ϫ1 . We found that at both levels of dietary p...

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Section: E75 Anabolic Responses To Increasing Protein Intake In a Mealmentioning

confidence: 99%

The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults

Kim

Schutzler

Schrader

et al. 2016

American Journal of Physiology-Endocrinology and Metabolism

110

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“…Arginine, citrulline kinetics and NO synthesis in the current eight critically ill children, were in the range of infants fed with standard nutrition in our previous study (29), which is to date the only study on arginine kinetics in fed critically ill children. Plasma amino acid concentrations of arginine and citrulline were however higher in that population than in the current one.…”

Section: Discussionmentioning

confidence: 77%

24-Hour protein, arginine and citrulline metabolism in fed critically ill children – A stable isotope tracer study

et al. 2017

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Background & aims The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4–8h) time period and extrapolate results to 24-hour. However, 24-hour measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-hour appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children. Methods In eight critically ill children, admitted to the pediatric (n=4) or cardiovascular (n=4) intensive care unit, aged 0–10 years, receiving continuous (par)enteral nutrition with protein intake 1.0–3.7 g/kg/day, a 24-hour stable isotope tracer protocol was carried out. L-[ring-2H5]-phenylalanine, L-[3,3-2H2]-tyrosine, L-[5,5,5-2H3]-leucine, L-[guanido-15N2]-arginine and L-[5-13C-3,3,4,4-2H4]-citrulline were infused intravenously and L-[15N]-phenylalanine and L-[1-13C]leucine enterally. Arterial blood was sampled every hour. Results Coefficients of variation, representing intra-individual variability, of the amino acid appearances of phenylalanine, tyrosine, leucine, arginine and citrulline were high, on average 14–19% for intravenous tracers and 23–26% for enteral tracers. No evident circadian rhythm was present. The pattern and overall 24-hour level of whole body protein balance differed per individual. Conclusions In continuously fed stable critically ill children, the amino acid appearances of phenylalanine, tyrosine, leucine, arginine and citrulline show high variability. This should be kept in mind when performing stable isotope studies in this population. There was no apparent circadian rhythm.

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“…As previously reported, Gln and Pro are amino acids that are widely used in the production of Arg. Therefore, it is important that animals have significant levels of these two amino acids during the lactation period, since the milk is poor in Arg [2,25].…”

Section: Discussionmentioning

confidence: 99%

“…Supplementation with Arg has been widely used in domestic animals to increase its presence in the blood, since it is a precursor of antioxidative compounds and polyamines for different functions [2,12]. It has been shown that supplementation with Arg can stimulate angiogenesis in the mammary gland of different animal species.…”

Section: Introductionmentioning

confidence: 99%

Effects of L-Arginine Supplementation on Lactating Mares and the Development of Foals

Hunka

Silva

Kutschenko³

et al. 2016

Acta Scientiae. Vet.

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Background: Most animal species are able to produce Arginine (Arg) under normal conditions. However, in some situations, its degradation can be higher than its production. For example, during a period of lactation or disease, there is an increase in the consumption of Arg. In this case, endogenous production is not enough for the animal's demands. Indeed, Arg supplementation in animals has several benefits for the animal's body, such as the increase of angiogenesis, improvements in immunity and the reproductive system, as well as the stimulation of lactogenesis. During the early phase of growth, a deficiency of Arg could cause a reduction in the growth rate and metabolic activity of animals. Therefore, this amino acid is considered essential in some phases of the life of animals. However, very few studies of the supplementation of this amino acid in horses have been carried out. The aim of the present study was to characterize the effects of supplementing lactating mares and their foals with Arg. Materials, Methods & Results:Lactating mares (n = 10) were divided into two groups (control group: n = 3 / supplemented group: n = 7) and maintained exclusively under grazing. The supplemented group received 50 g of Arg during the lactation period. Samples of milk and blood from mares and blood from foals were collected at different phases of the lactation period. The following parameters were measured in milk: Glutamine (Gln); Glutamate (Glu); protein; fat; casein; lactose; urea and total solids. The following parameters were measured in blood: Gln; Glu; total plasmatic protein (TPP); albumin; urea; creatinine; uric acid; triglycerides; total cholesterol; calcium (C); phosphorous (P); magnesium (Mg) and ferrous (Fe). In addition, the biometric parameters of Wither Height (WH), Chest Perimeter (CP), Cannon Bone Circumference (CBC) and Fat Percentage (FP) of foals were obtained. A significant increase of Gln was observed in the milk in both groups (P < 0.05). The highest concentration of Gln was detected in the third month of the lactation period in the supplemented group (~ 2.26 mmol/mL), and the control group (~ 1.91 mmol/mL) during the same period. Gln did not alter in the blood (P > 0.05), although Glu was higher in the control group in the first month of the lactation period (~ 0.21 mmol/mL) (P < 0.05). An increase in uric acid (~ 0.19 mmol/L) in both groups on the day of birth (P < 0.05). In the supplemented group, increases in triglycerides (~ 0.60 mmol/L), Ca (~ 2.90 mmol/L) and Mg (~ 0.52 mmol/L) were observed in the first month of the lactation (P < 0.05). At birth, foals exhibited high levels of urea (~ 4.67 mmol/L) and uric acid (~ 0.21 mmol/L), and low levels of P (~ 2.02 mmol/L) (P < 0.05). The levels of Gln in the blood of foals remained between 0.50 and 0.70 mmol/mL throughout the lactation period (P > 0.05). Even when they were added (Gln + Glu), no differences were observed (P > 0.05). However, when the biometric parameters were analyzed, significant variations were detected in almost all charac...

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Arginine appearance and nitric oxide synthesis in critically ill infants can be increased with a protein-energy–enriched enteral formula

Cited by 33 publications

References 40 publications

The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults

The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults

24-Hour protein, arginine and citrulline metabolism in fed critically ill children – A stable isotope tracer study

Effects of L-Arginine Supplementation on Lactating Mares and the Development of Foals

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