In Search of a Super Solution: Controlled Trial of Glycine‐Glucose Oral Rehydration Solution in Infantile Diarrhoea

Patra, F. C.; Mahalanabis, Dilip; Jalan, K. N.; A, Sen; Banerjee, Parthajit

doi:10.1111/j.1651-2227.1984.tb09891.x

Cited by 63 publications

(24 citation statements)

References 9 publications

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“…Our data support the clinical evaluation of an appropriate amino acid in an oral rehydration solution to improve Na and water absorption. Several clinical trials have shown that modestly hypertonic oral treatment solutions containing amino acid may reduce stool output as well as oral fluid requirements in patients with acute diarrhea (4,5,33). However, based on our limited experiments, the addition of dipeptides to an oral treatment solution would not be expected to confer an absorptive advantage over amino acids.…”

Section: Discussionmentioning

confidence: 71%

“…Hellier et al (3) demonstrated that certain amino acids promote small intestinal absorption in man (3). Furthermore, preliminary studies have shown a beneficial effect of an amino acid-containing oral rehydration solution in treating diarrhea (4,5). Our current in vitro data provide a theoretical basis for the clinical testing of oral rehydration solutions supplemented with neutral amino acid.…”

mentioning

confidence: 94%

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Alanine Enhances Jejunal Sodium Absorption in the Presence of Glucose Studies in Piglet Viral Diarrhea

1986

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ABSTRACT. We measured the response of jejunal sodium (Na) absorption to neutral amino acid (L-alanine) and to dipeptides (L-alanyl-L-alanine, glycylsarcosine) in normal piglets and in piglets with acute viral diarrhea after experimental infection with transmissible gastroenteritis (TGE) virus. In the TGE jejunum villi were blunted, crypts were deepened, and the epithelium was composed of relatively undifferentiated cells with reduced disaccharidase, decreased sodium-potassium-stimulated ATPase, and elevated thymidine kinase activities. The response of Na absorption to a maximal concentration of L-alanine (20 mM) or D-glucose (30 mM) was significantly blunted in TGE jejunum in Ussing chambers. However, the addition of L-alanine together with D-glucose caused a significantly greater increment of Na absorption than either L-alanine or D-glucose alone in control and TGE tissue. The effect of Na absorption of the dipeptide L-alanyl-L-alanine (10 mM), which was rapidly hydrolyzed by control and TGE mucosa, was similar to that of L-alanine (20 mM), while glycylsarcosine, a poorly hydrolyzed dipeptide, did not change net Na absorption in the jejunum. Our data support the concept of separate carrier systems for neutral amino acid and hexose in the crypt-type intestinal epithelium characterizing viral enteritis. We speculate that a sodiumcotransporting amino acid, if added to oral glucose-electrolyte solutions, could benefit oral rehydration therapy in acute viral diarrhea; neither of the dipeptides tested here can be expected to enhance absorption to any greater extent than its constituent amino acids. (Pediatr Res 20: 879-883,1986) Abbreviations Isc, short-circuit current Na, sodium JE:, Na flux from mucosa to serosa Jr;, Na flux from serosa to mucosa JPJ, net Na flux AJZ, increment in net Na flux Na+-K+-ATPase, sodium-potassium-stimulated adenosinetriphosphatase ORT, oral rehydration therapy TGE, transmissible gastroenteritis WHO, World Health Organization Received January 23, 1986; accepted April 30, 1986. Supported by a grant from the Medical Research Council of Canada. J.M.R. was a recipient of a research fellowship from the Canadian Cystic Fibrosis Foundation.All correspondence and requests for reprints should be addressed to J. Richard Hamilton, M.D., Division of Gastroenterology, The Hospital for Sick Children, 555 University Avenue. Toronto, Ontario, Canada M5G 1x8.ORT has greatly improved the outlook for millions of babies aMicted each year with acute enteritis. The current WHO/ UNICEF formulation for oral rehydration has been very effective in restoring the water and electrolyte status of patients with diarrhea, but it does not diminish stool losses (l,2). To accelerate clinical recovery and promote general acceptance of ORT, a solution that actually reduces diarrheal volume would be very desirable.One theoretical approach to improving standard ORT is to incorporate additional nonionic solute in its formulation to promote water and salt absorption in the diseased intestine. To evaluate the pathophysiologica...

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Section: Discussionmentioning

confidence: 71%

mentioning

confidence: 94%

Alanine Enhances Jejunal Sodium Absorption in the Presence of Glucose Studies in Piglet Viral Diarrhea

1986

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“…The World Health Organization has supported and distributed a standardized formulation (WHO-ORS) containing 90 mM of sodium and 111 mM of glucose, plus potassium and a buffer (citrate or bicar bonate). There have been attempts to improve this for mulation and develop "super" ORS which would over come the limitations of the standard formula [2]. Additions of amino acids such as glycine, alanine and glutamine [3][4][5] have had mixed success, without achieving the ultimate goal of decreasing purging rate.…”

Section: Introductionmentioning

confidence: 99%

Oral rehydration solutions (ORS): enhancement by a soluble fiber.

Sia²,

Harper³

et al. 1994

Journal of the American College of Nutrition

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“…one utilizing adulcs (30) and one utilizing children ( 31 ), demonstrated that, when glycine was added to a glu cose-O RS, both the duration of diarrhea and the stool output were considerably red uced, in comparison with the use of an ORS without glycine. In contrast, Santosham and co-worke rs ( 32) evaluated the safety and efficacy of a glycine-ORS.…”

Section: Ors Organic Substrate Compositionmentioning

confidence: 99%

Oral Rehydration Therapy: WHO at 40, ORT at 30

LaPook

Fedorak

1989

Canadian Journal of Gastroenterology

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Oral rehydration therapy may prove to be mankind's most significant therapeutic advance this centu ry. Diarrheal d isease remains the number o ne killer of children in the world and is a major cause of illness within Canada and o ther developed countries. Since its discovery 30 years ago, o ral rehydration therapy, comprising glucose, salt and water, has been a simple and low cost treatment for people with life threatening diarrheal disease. Recent developments in solutions for o ra l rehydration therapy have led to the recognition chat the existing World Health Organization glucose based o ral replacement salt could be improved. ln commercially available rehydration solutions, the sodium concentration has been lowered to reduce hypernatremia in noncholera induced diarrhea. Citrate has replaced bicarbonate as the base in oral replacement solutions to pro long shelf life. O rganic substrates to replace glucose and enhance intestinal fluid and electrolyte absorption without osmotic penalty are being examined. However, their acceptance and proper u tilization in developing countries remains to be determined. Can J Gastroe nterol 1989;3( 1):7-14 Key Words: Absorption, Diarrhea , Glucose cotransport, Intestine, Oral rehydration salt, Oral rehydration therapy, Sodium, World Health Organization La therapie de rehydratation par voie orale RESUME: La rchyd raration par voie orale pourrait bien s'averer le progres therapeutique le plus significatif pour l'humanite. Dans le monde, les maladies accompagnees de diarrhees son t toujours la cause premiere de mortalite infantile et un factcur important d'affections au Canada ct dans Jes au tres pays deve loppes. Dcpuis sa decouvcrte il ya 30 ans de cela, la therapie de rehydratation o rale a base de glucose, de sel et d'eau , est demeuree un traitement simple ct peu onereux pour ceux done la vie est menacee par les diarrhces graves. Des progres recents dans le domaine des solutions destinees ace mode de traitement ont permis de reconnaitre que les sels de remplacemenr a base de glucose, administres oralement, pouvaient etre ameliores. Dans la composition des solutions disponibles sur le marche, la concen tration de sodium a ere diminuce pour reduire l'hypernarremie propre aux diarrhees noncholeriques provoquees. La duree de vie des produits a ere prolongee grace a !'utilisation du citrate plutot que du bicarbonate. Sont presentement a l'ecude les substrats organiques destines a rem placer le glucose, a promouvoir !es secretions intestinales et l'absorption des electrolytes sans encouri r d'inconvenien t osmotique. Leur adoption par les pays en voie de developpement et leur uti lisation correcte restent cependant a determiner.

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In Search of a Super Solution: Controlled Trial of Glycine‐Glucose Oral Rehydration Solution in Infantile Diarrhoea

Cited by 63 publications

References 9 publications

Alanine Enhances Jejunal Sodium Absorption in the Presence of Glucose Studies in Piglet Viral Diarrhea

Alanine Enhances Jejunal Sodium Absorption in the Presence of Glucose Studies in Piglet Viral Diarrhea

Oral rehydration solutions (ORS): enhancement by a soluble fiber.

Oral Rehydration Therapy: WHO at 40, ORT at 30

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