Effect of severe undernutrition and subsequent refeeding on gut mucosal protein fractional synthesis in human subjects

Winter, Trevor A.; O’Keefe, Stephen J.; Callanan, Marie; Marks, Tessa

doi:10.1016/j.nut.2006.10.005

Cited by 23 publications

(19 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Both ABA and LFA mice exhibited a decreased expression of these proteins while whole protein synthesis remained unaffected. This latter result is in accordance with previous data obtained in male ABA mice and in malnourished patients . By contrast, in rats, short‐term fasting was associated with a decreased protein synthesis rate in the stomach .…”

Section: Discussionsupporting

confidence: 93%

Delayed gastric emptying and altered antrum protein metabolism during activity‐based anorexia

Nobis

Morin

Achamrah

et al. 2018

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 93%

Delayed gastric emptying and altered antrum protein metabolism during activity‐based anorexia

Nobis

Morin

Achamrah

et al. 2018

Neurogastroenterology Motil

View full text Add to dashboard Cite

show abstract

“…If the caloric deficiency is severe and enough prolonged adults can lose up to half of their body weight, and body mass index decreases to 13 kg/m 2 or less. Severe undernutrition affects every body area: digestive system, cardiovascular and respiratory systems, reproductive system, nervous system, muscle, blood, metabolism and immune system [2,3,4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

Gentile

2012

Nutrients

View full text Add to dashboard Cite

Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water) and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium). In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1) to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2) to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI) of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001). Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.

show abstract

“…In some pathophysiologic conditions, protein turnover is altered and may contribute to intestinal or systemic diseases. Gut protein metabolism can be affected by nutritional state (3)(4)(5) or nutritional interventions (1,4,(6)(7)(8). Amino acids, as constituents of proteins and signaling molecules, have been extensively tested in vitro and in vivo, but results have appeared to be model and condition dependent (9).…”

Section: Introductionmentioning

confidence: 99%

“…The upper endoscopy (Olympus XQ20; Olympus) was performed 30 min after the enteral infusion was stopped. Sixteen mucosal biopsies were taken from the distal duodenum; 2 biopsies were fixed in formalin for histologic assessment; 14 biopsies were immediately frozen in liquid nitrogen and stored at 280 8 C for isotope analysis, proteolytic activity, protein expression, or messenger RNA analysis.…”

mentioning

confidence: 99%

Enteral delivery of proteins stimulates protein synthesis in human duodenal mucosa in the fed state through a mammalian target of rapamycin–independent pathway

Coëffier¹,

Claeyssens²,

Bôle‐Feysot³

et al. 2013

The American Journal of Clinical Nutrition

View full text Add to dashboard Cite

Background: Glutamine modulates duodenal protein metabolism in fasted healthy humans, but its effects in a fed state remain unknown. Objective: We aimed to assess the effects of either glutamine or an isonitrogenous protein mixture on duodenal protein metabolism in humans in the fed state. Design: Twenty-four healthy volunteers were randomly included in 2 groups. Each volunteer was studied on 2 occasions in a random order and received, during 5 h, either an enteral infusion of maltodextrins alone (0.25 g $ kg 21 $ h 21 ; both groups) that mimicked a carbohydrate fed state or maltodextrins with glutamine (group 1) or anSimultaneously, a continuous intravenous infusion of 13 C-leucine and 2 H 5 -phenylalanine (both 9 mmol $ kg 21 $ h 21 ) was performed.Endoscopic duodenal biopsies were taken. Leucine and phenylalanine enrichments were assessed by using gas chromatography-mass spectrometry in duodenal proteins and the intracellular free amino acids pool to calculate the mucosal fractional synthesis rate (FSR). Proteasome proteolytic activities and phosphokinase expression were assessed by using specific fluorogenic substrates and macroarrays, respectively. Results: The FSR and proteasome activity were not different after the glutamine supply compared with after maltodextrins alone. In contrast, the FSR increased (1.7-fold increase; P , 0.05) after protein-powder delivery without modification of total proteasome activity. The protein powder increased insulinemia, PI3 kinase, and erk phosphorylation but did not affect the mammalian target of rapamycin (mTOR) pathway and mitogen-activated protein kinase signal-integrating kinase 1 phosphorylation. A trend for an increase of eukaryotic translation initiation factor 4E phosphorylation was observed (P = 0.07). Conclusion: In the carbohydrate fed state, enteral proteins but not glutamine increased duodenal protein synthesis through an mTOR independent pathway in humans. This trial was registered at clinicaltrials.gov as NCT01254110. Am J Clin Nutr 2013;97:286-94.

show abstract

Effect of severe undernutrition and subsequent refeeding on gut mucosal protein fractional synthesis in human subjects

Cited by 23 publications

References 22 publications

Delayed gastric emptying and altered antrum protein metabolism during activity‐based anorexia

Delayed gastric emptying and altered antrum protein metabolism during activity‐based anorexia

Enteral Nutrition for Feeding Severely Underfed Patients with Anorexia Nervosa

Enteral delivery of proteins stimulates protein synthesis in human duodenal mucosa in the fed state through a mammalian target of rapamycin–independent pathway

Contact Info

Product

Resources

About