In vitro uptake of amino acids in the jejunal mucosa of patients with cholera.

In vitro uptake of 14C-labelled amino acids was studied in jejunal mucosa biopsy specimens from 64 adults admitted for treatment of cholera (proven by stool culture) within 48 hours of onset of watery diarrhoea to determine the state of amino acid carriers in the jejunal mucosa during actively purging disease. Continued absorption of amino acids by the NBB carrier (for neutral amino acids), the Y+ system (for dibasic amino acids), and the PHE carrier were operative even during the actively purging stage of watery diarrhoea due to cholera. The IMINO carrier for absorption of N-substituted amino acids was found to be inoperative during cholera but the imino acids could be absorbed by the PHE carrier. This study demonstrates continued intestinal absorption of amino acids during cholera, provides scientific basis for use of amino acids in "improved" oral rehydration solutions utilising amino acid transport systems which are linked to the absorption of sodium (and water) so that reduction in diarrhoeal stools can be achieved, and emphasises the importance of maintaining feeding during acute diarrhoea to prevent the development of malnutrition.