Effects of Intragastric L-Arginine Administration on Proximal Stomach Tone Under Basal Conditions and After an Intragastric Diet

Abstract

Nitric oxide (NO) plays an important role as a nonadrenergic, noncholinergic inhibitory neurotransmitter in the GI tract. Our study aims were to investigate the effect of a single intragastric L-arginine (L-Arg) administration, as a source of NO, on proximal stomach tone in basal and postintragastric administration of a polymeric diet in humans and to evaluate concomitantly the effect on antral area as an indirect assessment of gastric emptying. Eight healthy volunteers were studied in a randomized double-blind crossover study after, respectively, 15 g L-Arg, 30 g L-Arg, or placebo administered in the stomach through a gastric tube. The drug administration was followed by a polymeric diet infusion (500 ml/500 kcal) at a rate of 250 ml/hr. Gastric tone variations were recorded with an electronic barostat, gastric emptying was concomitantly estimated by repeated ultrasound measurements of antral area, and symptoms were recorded throughout the experiment.L-Arg administration was associated with significantly higher increases in barostat bag volumes at both dosages, 30 g (117+/-16 ml) and 15 g (67+/-15 ml), compared to placebo (46+/-11 ml; P < 0.05). In response to the polymeric diet the 30-g L-Arg challenge was associated with a smaller increase in intrabag volume, whereas postinfusion final volumes did not differ in the three treatment conditions. Antral areas were not different at any time of measurement among the three challenges. Bloating and diarrhea were observed after 30-g L-Arg administration in five subjects of eight. Short-term L-Arg administration was able to induce proximal stomach relaxation that allowed a secondary response to enteral feeding only at the 15-g dosage. This 15-g dosage was as well tolerated as the placebo and was associated with no significant changes in gastric emptying patterns.

L-Arginine L-Glutamate Enhances Gastric Motor Function in Rats and Dogs and Improves Delayed Gastric Emptying in Dogs

“…L-Arginine is an important precursor for the inhibitory neurotransmitter NO, which controls GI motility and blood circulation by relaxing smooth muscle (Sanders and Ward, 1992). NO mediates the reflexive relaxation of the stomach to accommodate food or fluid (Desai et al, 1991), and its precursor, L-arginine, also causes gastric relaxation in humans at relatively high doses (Savoye et al, 2006). In this study, we confirmed that the effect of ArgGlu on gastric relaxation is attributed to L-arginine (Fig.…”

Safety assessment of L-Arg oral intake in healthy subjects: a systematic review of randomized control trials

“…4 ). The study by Vignini et al ( 2010 ) was excluded because it did not report the amount of one-time L-Arg dose; thus, 23 studies were a target for the meta-analysis within Categories B and C. RD regarding the occurrence of gastrointestinal symptoms reported by Savoye et al ( 2006 ) was 0.63 (95% CI: 0.27–0.98), which was significant ( P = 0.0005). However, upon integrating all of the targeted studies, RD was 0.01 (95% CI: − 0.02–0.04), indicating no significant increase in gastrointestinal symptoms in association with L-Arg ( P = 0.34).…”

“…In Category C, the highest dose and the longest duration of administration were 30,000 mg/day (Savoye et al 2006 ) and 45 days (Pahlavani et al 2014 ), respectively. The highest one-time dose was 30,000 mg (Savoye et al 2006 ).…”

“…However, we did not use the data from Vignini et al in the meta-analysis and w-CPRM because there was no report the amounts of the one-time dose applied. In addition, Savoye et al ( 2006 ) administered L-Arg in the stomach through a gastric tube, but this is considered equivalent to oral intake. In this work, we also included studies in which L-Arg intervention involved L-Arg as a hydrochloride, not only L-Arg alone.…”