Glutamine and Whey Protein Improve Intestinal Permeability and Morphology in Patients with Crohn’s Disease: A Randomized Controlled Trial

Benjamin, Jaya; Makharia, Govind; Ahuja, Vineet; Rajan, K. D. Anand; Kalaivani, Mani; Gupta, Siddhartha Datta; Joshi, Yogendra

doi:10.1007/s10620-011-1947-9

Cited by 64 publications

(42 citation statements)

References 63 publications

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“…The geometry of the microstructures (stamp #1) shown in Fig. 3B was designed to simulate the anatomical shape of the in vivo human duodenal epithelium (villus height = 437±98 μm, villus width = 149±41 μm, crypt depth = 193±37 μm, mucosal thickness = 642±128 μm, and crypt to villus ratio= 2.26±0.57, n=10 [63]). On PDMS stamp (#1), the villus height = 477 μm, villus width = 170 μm, crypt depth = 132 μm, crypt width = 60 μm, total height of crypt/villus = 609 μm, and crypt to villus ratio = 2.…”

Section: Resultsmentioning

confidence: 99%

A microengineered collagen scaffold for generating a polarized crypt-villus architecture of human small intestinal epithelium

et al. 2017

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The human small intestinal epithelium possesses a distinct crypt-villus architecture and tissue polarity in which proliferative cells reside inside crypts while differentiated cells are localized to the villi. Indirect evidence has shown that the processes of differentiation and migration are driven in part by biochemical gradients of factors that specify the polarity of these cellular compartments; however, direct evidence for gradient-driven patterning of this in vivo architecture has been hampered by limitations of the in vitro systems available. Enteroid cultures are a powerful in vitro system; nevertheless, these spheroidal structures fail to replicate the architecture and lineage compartmentalization found in vivo, and are not easily subjected to gradients of growth factors. In the current work, we report the development of a micropatterned collagen scaffold with suitable extracellular matrix and stiffness to generate an in vitro self-renewing human small intestinal epithelium that replicates key features of the in vivo small intestine: a crypt-villus architecture with appropriate cell-lineage compartmentalization and an open and accessible luminal surface. Chemical gradients applied to the crypt-villus axis promoted the creation of a stem/progenitor-cell zone and supported cell migration along the crypt-villus axis. This new approach combining microengineered scaffolds, biophysical cues and chemical gradients to control the intestinal epithelium ex vivo can serve as a physiologically relevant mimic of the human small intestinal epithelium, and is broadly applicable to model other tissues that rely on gradients for physiological function.

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Section: Resultsmentioning

confidence: 99%

A microengineered collagen scaffold for generating a polarized crypt-villus architecture of human small intestinal epithelium

et al. 2017

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“…The authors determined how much glutamine is required to observe improved clinical outcomes: 21 g glutamine/day for 28 days for Crohn’s disease, and 42 g/day for 21 days for short bowel syndrome. In a randomized controlled trial, Benjamin et al reported that glutamine supplementation (0.5 g/kg BW; 2 months) in patients with Crohn’s disease in remission phase reduced the intestinal permeability and morphology [118]. …”

Section: Clinical Implications For Intestinal Diseasesmentioning

confidence: 99%

“…Short-term glutamine administration during a flare-up phase could give a greater impact on outcomes than other phases. Additionally, a relatively small sample size showed greater efficacy of glutamine supplementation in critically ill patients [137,138,139] and in IBD patients [117,118]. Therefore, a well-controlled clinical trial with a sufficiently sized population would be required to determine the efficacy of glutamine supplementation in intestinal diseases.…”

Section: Clinical Implications For Intestinal Diseasesmentioning

confidence: 99%

The Roles of Glutamine in the Intestine and Its Implication in Intestinal Diseases

Kim

2017

IJMS

230

153

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Glutamine, the most abundant free amino acid in the human body, is a major substrate utilized by intestinal cells. The roles of glutamine in intestinal physiology and management of multiple intestinal diseases have been reported. In gut physiology, glutamine promotes enterocyte proliferation, regulates tight junction proteins, suppresses pro-inflammatory signaling pathways, and protects cells against apoptosis and cellular stresses during normal and pathologic conditions. As glutamine stores are depleted during severe metabolic stress including trauma, sepsis, and inflammatory bowel diseases, glutamine supplementation has been examined in patients to improve their clinical outcomes. In this review, we discuss the physiological roles of glutamine for intestinal health and its underlying mechanisms. In addition, we discuss the current evidence for the efficacy of glutamine supplementation in intestinal diseases.

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“…Glutamine and whey protein improved intestinal permeability and morphology in patients with CD in remission. 78 A randomized controlled trial of curcumin capsules (3g/day) and mesalamine was superior over mesalamine alone in inducing remmision (54% vs. 0%, p-0.01). 79–85 Clinical response (reduction of ≥3 points in SCCAI) and endoscopic remission was seen 65.3% and 38% of the curcumin group respectively vs. 12.5% and 0 % in the placebo group (P < .001).…”

Section: Dietmentioning

confidence: 98%

Modifiable Environmental Factors in Inflammatory Bowel Disease

Burke

Boumitri

Ananthakrishnan

2017

Curr Gastroenterol Rep

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Inflammatory bowel diseases (Crohn’s disease, ulcerative colitis) are believed to arise as a result of a dysregulated immune response to commensal gut microbial flora in a genetically susceptible host. Several environmental factors may influence predisposition to disease or its natural history by modification of both the host immune response and intestinal microbial composition. Proposed environmental influences include tobacco use, diet, antibiotics, vitamin D deficiency, stress, appendectomy, and use of oral contraceptive use. Emerging epidemiologic evidence has confirmed the association of many of these factors with incident disease using prospective data. In addition, laboratory data has supported their mechanistic plausibility and relevance to intestinal inflammation. However, fewer studies have examined their impact on natural history. This article will focus on translating such evidence into clinical practice by a focus on interventional studies that have modified such environmental influences to improve disease outcomes.

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Glutamine and Whey Protein Improve Intestinal Permeability and Morphology in Patients with Crohn’s Disease: A Randomized Controlled Trial

Abstract: Intestinal permeability and morphology improved significantly in both glutamine and ACG.

Cited by 64 publications

References 63 publications

A microengineered collagen scaffold for generating a polarized crypt-villus architecture of human small intestinal epithelium

A microengineered collagen scaffold for generating a polarized crypt-villus architecture of human small intestinal epithelium

The Roles of Glutamine in the Intestine and Its Implication in Intestinal Diseases

Modifiable Environmental Factors in Inflammatory Bowel Disease

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