Decreased plasma isoleucine concentrations after upper gastrointestinal haemorrhage in humans.

Dejong, C.H.C.; Meijerink, W. J. H. J.; Berlo, C.L.H. van; Deutz, N.E.P.; Soeters, Peter B.

doi:10.1136/gut.39.1.13

Cited by 20 publications

(8 citation statements)

References 17 publications

(5 reference statements)

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“…The arterial concentrations we measured in this study were comparable to those we previously published for a group of pre-operative elective surgical patients (Dejong et al 1996). In each blood vessel, glutamine was the most concentrated amino acid, with means ranging from 393.3 ± 5.3 µmol/L in the superior mesenteric vein to 518.1 ± 20.0 µmol/L in the radial artery.…”

Section: Resultssupporting

confidence: 89%

Human splanchnic amino-acid metabolism

et al. 2016

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Plasma levels of several amino acids are correlated with metabolic dysregulation in obesity and type 2 diabetes. To increase our understanding of human amino-acid metabolism, we aimed to determine splanchnic interorgan amino-acid handling. Twenty patients planned to undergo a pylorus preserving pancreatico-duodenectomy were included in this study. Blood was sampled from the portal vein, hepatic vein, superior mesenteric vein, inferior mesenteric vein, splenic vein, renal vein, and the radial artery during surgery. The difference between arterial and venous concentrations of 21 amino acids was determined using liquid chromatography as a measure of amino-acid metabolism across a given organ. Whereas glutamine was significantly taken up by the small intestine (121.0 ± 23.8 µmol/L; P < 0.0001), citrulline was released (−36.1 ± 4.6 µmol/L; P < 0.0001). This, however, was not seen for the colon. Interestingly, the liver showed a small, but a significant uptake of citrulline from the circulation (4.8 ± 1.6 µmol/L; P = 0.0138) next to many other amino acids. The kidneys showed a marked release of serine and alanine into the circulation (−58.0 ± 4.4 µmol/L and −61.8 ± 5.2 µmol/L, P < 0.0001), and a smaller, but statistically significant release of tyrosine (−12.0 ± 1.3 µmol/L, P < 0.0001). The spleen only released taurine (−9.6 ± 3.3 µmol/L; P = 0.0078). Simultaneous blood sampling in different veins provides unique qualitative and quantitative information on integrative amino-acid physiology, and reveals that the well-known intestinal glutamine–citrulline pathway appears to be functional in the small intestine but not in the colon.

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Section: Resultssupporting

confidence: 89%

Human splanchnic amino-acid metabolism

et al. 2016

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“…This amino acid pattern resembled the changes observed in patients admitted with an acute upper GI bleed 21 and experimental animals receiving intragastric erythrocytes. 8,9,22 The common finding of severe hypoisoleucinemia can be explained by the fact that hemoglobin does not contain isoleucine and by BCAA- Fig.…”

Section: Discussionmentioning

confidence: 66%

Isoleucine infusion during “simulated” upper gastrointestinal bleeding improves liver and muscle protein synthesis in cirrhotic patients

et al. 2007

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Upper gastrointestinal (GI) bleeding in cirrhotic patients has a high incidence of mortality and morbidity. Postbleeding catabolism has been hypothesized to be partly due to the low biological value of hemoglobin, which lacks the essential amino acid isoleucine. The aims were to study the metabolic consequences of a "simulated" upper GI bleed in patients with cirrhosis of the liver and the effects of intravenous infusion of isoleucine. Portal drained viscera, liver, muscle, and kidney protein kinetics were quantified using a multicatheterization technique during routine portography. Sixteen overnight-fasted, metabolically stable patients who received an intragastric infusion of an amino acid solution mimicking hemoglobin every 4 hours were randomized to saline or isoleucine infusion and received a mixture of stable isotopes (L-[ring-2 H 5 ]phenylalanine, L-[ring-2 H 4 ]tyrosine, and L-[ring-2 H 2 ]tyrosine) to determine organ protein kinetics. This simulated bleed resulted in hypoisoleucinemia that was attenuated by isoleucine infusion. Isoleucine infusion during the bleed resulted in a positive net balance of phenylalanine across liver and muscle, whereas renal and portal drained viscera protein kinetics were unaffected. In the control group, no significant effect was shown. Conclusion: The present study investigated hepatic and portal drained viscera protein metabolism selectively in humans. The data show that hepatic and muscle protein synthesis is stimulated by improving the amino acid composition of the upper GI bleed by simultaneous intravenous isoleucine administration. (HEPATOLOGY 2007;45:560-568.)

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“…In a series of studies, isoleucine concentrations were shown to decrease markedly after an actual or a simulated upper GI bleed, whereas the concentration of most other amino acids increased [7][8][9][10][11]. Post-bleeding hypoisoleucinemia has been shown to occur in experimental animals [8,10], in healthy volunteers [8], and in patients with impaired and normal liver function [9,11].…”

Section: Introductionmentioning

confidence: 97%

“…Post-bleeding hypoisoleucinemia has been shown to occur in experimental animals [8,10], in healthy volunteers [8], and in patients with impaired and normal liver function [9,11]. We hypothesized that decreased plasma and tissue isoleucine concentrations could impair protein synthesis [5], and therefore influence the function of rapidly dividing cells (e.g.…”

Section: Introductionmentioning

confidence: 99%