Schröder J, Wardelmann E, Winkler W, Fändrich F, Schweizer E, Schroeder P
Department of General and Thoracic Surgery, University of Kiel, Germany.
JPEN J Parenter Enteral Nutr. 1995 Nov-Dec;19(6):502-6. doi: 10.1177/0148607195019006502.
Total parenteral nutrition (TPN) is associated with intestinal atrophy and dysfunction possibly attributed to the absence of the nonessential amino acid glutamine from commercially available TPN solutions because of the instability of the monoamino acid during heat sterilization and storage. The use of stable dipeptides may overcome this problem. In this study we tested the hypothesis that glutamine dipeptide supplementation with alanyl-L-glutamine during TPN for 10 days would reverse small bowel atrophy and TPN-induced dysfunction in rats.
A conventional TPN solution (250 kcal/kg bw) was compared with an isocaloric and isonitrogenous TPN supplemented with alanyl-L-glutamine dipeptide. A food-fed control group was included (n = 6 each group). Jejunum mucosal architecture, absorption of water and glucose, and disaccharidase activity of maltase and alkaline phosphatase were evaluated.
TPN-induced villous atrophy, significantly reduced absorption rate, and decreased activity of villous enzymes, compared with the TPN group, could be reversed by supplementation of glutamine dipeptide alanyl-L-glutamine to parenteral nutrition solutions with no difference to the control group.
Glutamine dipeptide-enriched parenteral nutrition preserves mucosal structure and reversed atrophy-associated dysfunction.
全胃肠外营养(TPN)与肠道萎缩和功能障碍有关,这可能归因于市售TPN溶液中缺乏非必需氨基酸谷氨酰胺,因为该单氨基酸在热灭菌和储存过程中不稳定。使用稳定的二肽可能会克服这个问题。在本研究中,我们检验了以下假设:在TPN期间补充谷氨酰胺二肽丙氨酰-L-谷氨酰胺10天可逆转大鼠小肠萎缩和TPN诱导的功能障碍。
将常规TPN溶液(250 kcal/kg体重)与补充丙氨酰-L-谷氨酰胺二肽的等热量、等氮TPN进行比较。纳入一个经口进食的对照组(每组n = 6)。评估空肠黏膜结构、水和葡萄糖的吸收以及麦芽糖酶和碱性磷酸酶的双糖酶活性。
与TPN组相比,TPN诱导的绒毛萎缩、吸收率显著降低以及绒毛酶活性降低,可通过在肠外营养溶液中补充谷氨酰胺二肽丙氨酰-L-谷氨酰胺来逆转,且与对照组无差异。
富含谷氨酰胺二肽的肠外营养可维持黏膜结构并逆转与萎缩相关的功能障碍。