Serum Citrulline Is A Simple Quantitative Marker for Small Intestinal Enterocytes Mass and Absorption Function in Short Bowel Patients

Biomarkers for radiation-induced small bowel epithelial damage: An emerging role for plasma Citrulline

“…Finally, the assay is simple to apply and relatively cheap. Like surgery [65][66][67][68] , celiac and non-celiac disease [69] and acute cellular rejection following small bowel transplantation [70][71][72][73]75,152] , ionizing irradiation has been demonstrated to be an additional event associated with reduced small bowel epithelial cell mass that can be monitored by plasma citrulline [30,[76][77][78][79] . …”

“…Plasma citrulline has been identified as a biomarker for functional small bowel enterocyte mass under various clinical and experimental conditions. In addition to surgery [65][66][67][68] , celiac and non-celiac diseases [69] , viral enteritis [70] and acute cellular rejection following small bowel transplantation [70][71][72][73][74][75] , cytotoxic treatments was identified as another event associated with decreased plasma citrulline level due to epithelial cell loss [30,[76][77][78][79] . As a whole, plasma citrulline seems to be a quantitative parameter independent of the underlying cause for epithelial cell loss.…”

“…In this respect cumulative data indicate an important role for glucose metabolism [140,141,150] . A major determinant, however, under steady state conditions for the rate of citrulline released into the portal and subsequently the systemic circulation is the actual number of functional enterocytes [65][66][67][68][69]83,86,87,90,113,114,134,151] . This was further demonstrated by clinical data on small bowel transplantation [70][71][72][73][74][75]152] .…”

“…small intestinal enterocytes. Thus under steady state conditions, citrulline can be considered a marker for the functional epithelial cell mass of the small bowel, a concept amply demonstrated in experimental and clinical studies [65][66][67][68][69][70][71][72][73][74][75]80,83,[86][87][88]90,104,111,[113][114][115][116][132][133][134]152] . Of notice, the lower plasma citrulline level observed in short bowel patients was sustained up to one year after treatment [66] emphasizing its strict dependence on the epithelial cell mass.…”

Insuficiencia intestinal secundaria a síndrome de intestino corto: resultados de un programa multidisciplinario de rehabilitación intestinal

“…En la actualidad, la determinación de niveles plasmáticos de citrulina y la administración de un péptido análogo del glucagón (GLP-2), el primero para estimar la masa de enterocitos remanentes y el segundo para maximizar la capacidad absortiva, son elementos de apoyo en el tratamiento de pacientes con II [28][29][30] . Otro factor en la II es el rol de la inmunidad innata y su relación con determinadas patologías inflamatorias intestinales, su gravedad y alteración en los mecanismos de normal AI.…”