Novel Substrates to Maintain Gut Integrity

Gardiner, Keith; Kirk, Stephen; Rowlands, B. J.

doi:10.1079/nrr19950006

Cited by 40 publications

(20 citation statements)

References 181 publications

(213 reference statements)

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“…Other authors have also demonstrated that total parenteral nutritional support was associated with many infectious complications such as catheter sepsis 3 and sepsis of intestinal origin due to dysfunction of the intestinal mucosa barrier 4 . Explanations for this observation include the fact that total parenteral nutrition does not nourish the enterocyte; in addition, nutrients are largely absent in the intestinal lumen, particularly glutamine, which plays an important role in mucosal trophism 18 . A previous prospective randomized study that evaluated the impact of early total parenteral nutrition in acute pancreatitis showed that the group that received early parenteral nutrition had significantly longer hospitalizations and a greater incidence of catheter sepsis, compared with a control group that received only analgesia and fluid resuscitation 19 .…”

Section: Discussionmentioning

confidence: 99%

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis

et al. 2010

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Purpose:To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. Methods: The study was comprised of 31 patients, divided into a parenteral group (n=16) and an enteral group (n=15), who met severity criteria for abdominal tomography (Balthazar classes C, D, and E). The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. Results: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10). Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006). There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. Conclusion: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support. Key words: Nutritional Support. Parenteral Nutrition. Enteral Nutrition. Pancreatitis. RESUMO Objetivo:Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. Métodos: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16), no período de 1995 a 1998 e grupo enteral (n=15), no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E). Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. Resultados: A maioria dos pacientes era Balthazar E, principalmente no grupo enteral, porém sem significado estatístico (p=0,21). Também não houve diferença estatística nos dois grupos em relação ao tempo médio de uso de suporte nutricional, somatostatina e antibiótico. O imipenem foi a droga de escolha para profilaxia da infecção pancreática nos dois grupos. Houve mais complicações gerais no grupo parenteral, sem significado estatístico (p=0,10). As complicações infecciosas do tipo sépsis do cateter e infecção do tecido pancreático foram mais frequentes no grupo parenteral, com significância estatística (p=0,06). Não houve diferença na média de internação nos dois grupos. Houve três óbitos no grupo parenteral e nenhum no enteral. Conclusão: O suporte nutricional enteral está associado à menor taxa de complicações sépticas do que o parenteral. Descritores: Apoio Nutricional. Nutrição Parenteral. Nutrição Enteral. Pancreatite.

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Section: Discussionmentioning

confidence: 99%

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis

et al. 2010

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“…Glutamine is a major fuel and important nitrogen source for enterocytes and plays a key role in maintaining mucosal cell integrity and gut barrier function (van Acker et al, 1999;Rhoads, 1999;Buchman, 1996;Hall et al, 1996;Gardiner et al, 1995;Lacey & Wilmore, 1990;Miller, 1999).…”

Section: Introductionmentioning

confidence: 99%

Oral glutamine in paediatric oncology patients: a dose finding study

et al. 2003

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Objective: The purpose of this study was to determine the most appropriate dose of oral glutamine to use in a further clinical study in paediatric oncology patients. Design: This was a phase I, pharmokinetic study. Setting: The study was carried out at The Yorkshire Regional Centre for Paediatric Oncology and Haematology, St James's University Hospital, Leeds, UK. Subjects: Thirteen patients undergoing treatment for paediatric malignancy participated in this study. All 13 completed the study. Interventions: The most appropriate dose was determined by patient acceptability and by plasma glutamine and ammonia levels measured at timed intervals after ingestion of a single glutamine dose. Results: Doses of 0.35, 0.5 and 0.65 g=kg were well tolerated with no untoward plasma glutamine and ammonia levels. One patient was recruited to a higher dose of 0.75 g=kg, but the plasma glutamine and ammonia levels peaked at 2601 and 155 mmol=l, respectively. The ammonia level was greater than the acceptable upper limit. It was difficult to disperse the glutamine adequately at this dose, resulting in the suspension being found to be unpalatable and therefore no further patients were recruited at this dose. Conclusion: It was concluded that 0.65 g=kg is a safe dose of glutamine to use in a clinical study in paediatric oncology patients. Sponsorship: Scientific Hospital Supplies UK Ltd provided the L-glutamine and financial help for the biochemical analysis.

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“…In this context, the advances in human medical biotechnology form an important basis for the research and development in animal biotechnology. In the application of biotechnology for the nutrition of farm animals, some nutrients, called nucleotides, improve feed characteristics through the gut and immune systems development and function in young animals (Gardiner et al 1995); they represent an active and fertile area of research.…”

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confidence: 99%

Nucleotides in broiler chicken diet: effect on breast muscles quality

Chiofalo¹,

Presti²,

Savoini³

et al. 2011

Czech J. Food Sci.

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Chiofalo B., Lo Presti V., Savoini G., D'Alessandro E., Chiofalo V., Liotta L. (2011): Nucleotides in broiler chicken diet: effect on breast muscles quality. Czech J. Food Sci., 29: 308-317.The study evaluated the effects of nucleotide dietary supplementation on the physical and nutritional characteristics of the Pectoralis major muscle of male broiler chickens (n = 60 000), divided into two homogeneous groups: Control (C) and Nucleotides (N). The animals of the two groups, from the birth (24 h of age) to the slaughtering age (52 days), received the same diet, supplemented (N) or not (C) with 0.1% of a Nucleotide pool. At the slaughtering, on a sample of 130 animals per group, randomly selected, the physical and nutritional characteristics of Pectoralis major muscle were determined. The meat of the N group showed significantly higher redness and Hue values, lower shear force values, higher lipid and ash percentages and iron content. Moreover, nucleotides significantly increased monounsaturated acids and linolenic acid and decreased eicosapentanoic and docosahexanoic acids. The unsaturation degree was higher in the Nucleotides group and Atherogenic index was positively influenced by the nucleotide supplementation. Nucleotide dietary supplementation improved the physical and nutritional characteristics of the Pectoralis major muscle of broiler chickens.

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Novel Substrates to Maintain Gut Integrity

Cited by 40 publications

References 181 publications

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis

Parenteral nutrition versus enteral nutrition in severe acute pancreatitis

Oral glutamine in paediatric oncology patients: a dose finding study

Nucleotides in broiler chicken diet: effect on breast muscles quality

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