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脓毒症大鼠小肠上皮细胞谷氨酰胺消耗增加。

Increased glutamine consumption in small intestine epithelial cells during sepsis in rats.

作者信息

Noguchi Y, James J H, Fischer J E, Hasselgren P O

机构信息

Department of Surgery, University of Cincinnati, Ohio 45267-0558, USA.

出版信息

Am J Surg. 1997 Mar;173(3):199-205. doi: 10.1016/s0002-9610(96)00012-8.

Abstract

BACKGROUND

Previous reports have emphasized increased intestinal glutamine consumption during sepsis. This may be of clinical significance as glutamine is a (and perhaps the) physiologic fuel for the intestine. A problem remains, however, as glutaminase, the major enzyme for the degradation of glutamine, is decreased rather than increased in sepsis. This implies an alteration in the metabolic fate of glutamine in sepsis, which may be of clinical significance.

METHODS

We determined the effect of sepsis on glutamine metabolism in mucosa of small intestine. Sepsis was induced in rats by cecal ligation and puncture. Control rats were sham-operated. After 16 hours, glutamine consumption was measured in isolated enterocytes, and glutaminase, glutamine synthetase, and glutamine transaminase activities and DNA synthesis were determined in mucosa.

RESULTS

Glutamine consumption was increased during sepsis in enterocytes from the tips of the villi and was unchanged in enterocytes from the midportions of the villi and the crypts. As previously shown, mucosal glutaminase activity was reduced. However, glutamine synthetase and glutamine transaminase activities were stimulated in septic rats, suggesting an increase in metabolism of glutamine via alternate pathways. DNA synthesis was increased during sepsis, especially in crypt cells.

CONCLUSIONS

Increased or unchanged glutamine consumption in enterocytes from septic rats, despite reduced glutaminase activity, appears to reflect increased activity of other enzyme systems and/or increased utilization of the amino acid for DNA and protein synthesis. Since other aspects of glutamine metabolism may also be deranged in sepsis, a continual enteral supply of glutamine to the intestinal lumen during sepsis may be clinically useful.

摘要

背景

既往报道强调脓毒症期间肠道谷氨酰胺消耗增加。这可能具有临床意义,因为谷氨酰胺是肠道的(或许是唯一的)生理燃料。然而,问题依然存在,因为谷氨酰胺降解的主要酶——谷氨酰胺酶,在脓毒症时是降低而非升高的。这意味着脓毒症时谷氨酰胺的代谢命运发生了改变,这可能具有临床意义。

方法

我们测定了脓毒症对小肠黏膜谷氨酰胺代谢的影响。通过盲肠结扎和穿刺诱导大鼠发生脓毒症。对照大鼠行假手术。16小时后,测定分离的肠细胞中的谷氨酰胺消耗,并测定黏膜中的谷氨酰胺酶、谷氨酰胺合成酶、谷氨酰胺转氨酶活性及DNA合成。

结果

脓毒症期间,绒毛顶端肠细胞的谷氨酰胺消耗增加,而绒毛中部和隐窝的肠细胞的谷氨酰胺消耗未改变。如先前所示,黏膜谷氨酰胺酶活性降低。然而,脓毒症大鼠的谷氨酰胺合成酶和谷氨酰胺转氨酶活性受到刺激,提示通过替代途径的谷氨酰胺代谢增加。脓毒症期间DNA合成增加,尤其是在隐窝细胞中。

结论

尽管谷氨酰胺酶活性降低,但脓毒症大鼠肠细胞中谷氨酰胺消耗增加或未改变,这似乎反映了其他酶系统活性增加和/或该氨基酸用于DNA和蛋白质合成的利用率增加。由于脓毒症时谷氨酰胺代谢的其他方面也可能紊乱,脓毒症期间持续向肠腔内补充谷氨酰胺可能具有临床实用性。

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