Potency of Oral Rehydration Solution in Inducing Fluid Absorption is Related to Glucose Concentration

Abstract

Oral rehydration solutions (ORSs) is the key treatment of acute diarrhea in children, as it restores the electrolyte balance by stimulating the intestinal sodium/glucose transporter SGLT1 to induce fluid absorption. The World Health Organization (WHO) and The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) proposed ORSs with different chemical compositions. The main agent of childhood acute gastroenteritis is rotavirus (RV). We evaluate the effects of ORS with different concentration of glucose and sodium on RV induced secretion. Ussing chambers technique was used for electophysiology experiments to evaluate ion fluid flux. ESPGHAN ORS (sodium 60 mmol/L and glucose 111 mmol/L) induced a more potent proabsorptive effect in Caco-2 cells than WHO ORS, and this effect depended on the sodium/glucose ratio. Titration experiments showed that RV-induced fluid secretion can be reverted to a proabsorptive direction when sodium and glucose concentration fall in specific ranges, specifically 45–60 mEq/L and 80–110 mM respectively. The results were confirmed by testing commercial ORSs. These findings indicated that ORS proabsorptive potency depends on sodium and glucose concentrations. Optimal ORS composition should be tailored to reduce RV-induced ion secretion by also considering palatability. These in vitro data should be confirmed by clinical trials.

SARS-CoV-2 causes secretory diarrhea with an enterotoxin-like mechanism, which is reduced by diosmectite

“…This absence of effect was maintained over 72 h following exposure ( Figure 6 ). The lack of apparent effect of hiSARS-CoV-2 or spike protein on epithelial integrity (as judged by TEER measurements) was consistent with that seen for NSP4 in the model of rotavirus-associated secretory diarrhea, but contrasted with that for living rotavirus in the same model, which showed a progressive TEER decrease from 24 h after incubation; these findings are consistent with previously published data [ 15 , 17 ].

Figure 6 Transepithelial electrical resistance in Caco-2 cells following addition of hiSARS-CoV-2 or spike protein (A) and rotavirus or NSP4 (B) .

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“…Potency of the electrical effect was similar to that observed for rotavirus-NSP4 in the same experimental model, although comparisons were based on extrapolations from log-books of previous experiments rather than on parallel experiments of specific viral preparations. Data from the rotavirus experiments are consistent with previously published results [ 15 , 17 , 22 ].…”

“…These effects were identifiable in vitro by electrical parameters in polarized intestinal cells, with the initial electrogenic chloride secretion being characterized by an increase in the intensity of the short-circuit current ( Isc ), and cytotoxic damage being detectable by transepithelial electrical resistance (TEER) in Ussing chambers [ 15 ]. This in vitro model has been used to investigate the pathophysiology of diarrhea associated with a number of enteric pathogens and also the mechanisms of action of a number of antidiarrheal agents (e.g., modified oral rehydration solutions [ 17 ], probiotics [ 15 ], and dioctahedral smectite [diosmectite] [ 18 ]).…”

Unique Regulation of Intestinal Villus Epithelial Cl−/HCO3− Exchange by Cyclooxygenase Pathway Metabolites of Arachidonic Acid in a Mouse Model of Spontaneous Ileitis

“…In this regard, Na + /glucose cotransport mediated by BBM SGLT1 not only represents the unequivocal pathway for the absorption of the major nutrient glucose, but also plays a critical role in maintaining overall fluid and electrolyte homeostasis [29]. Indeed, Na + -glucose co-transport is the basis of Oral Rehydration Solution (ORS), used to treat dehydration due to diarrhea [30][31][32]. It seems quite logical to speculate that in IBD Na + /glucose cotransport and/or other Na + /nutrient symport mechanisms could have greater relevance to account for impaired NaCl absorption, which is further supported by the fact that the absorption of both electrolytes and nutrients (such as glucose) is substantially inhibited in this chronic inflammatory disease [33].…”

Lacticaseibacillus rhamnosus GG Counteracts Rotavirus-Induced Ion Secretion and Enterocyte Damage by Inhibiting Oxidative Stress and Apoptosis Through Specific Effects of Living and Postbiotic Preparations

“…The proabsorptive effect is indicated as negative value of Δ Isc whereas the positive values indicate an active ion secretion. The maximal increase of Isc (Δ Isc ) is considered the peak effect ( Buccigrossi et al., 2020 ). Caco-2 cell monolayers were stimulated with LGG or mLGG 1 hour before RV infection and for the duration of the experiment.…”