Tags

Type your tag names separated by a space and hit enter

Intravenous glutamine supplementation enhances renal de novo arginine synthesis in humans: a stable isotope study.
Am J Clin Nutr 2014; 100(5):1385-91AJ

Abstract

BACKGROUND

Arginine plays a role in many different pathways in multiple cell types. Consequently, a shortage of arginine, caused by pathologic conditions such as cancer or injury, has the potential to disturb many cellular and organ functions. Glutamine is the ultimate source for de novo synthesis of arginine in humans via the intestinal-renal axis. Therefore, we hypothesized that parenteral glutamine supplementation may stimulate the interorgan pathway of arginine production.

OBJECTIVES

The objectives were to quantify arginine production from its precursor glutamine and to establish the contribution of the kidneys to de novo synthesis of arginine in patients receiving intravenous supplementation of glutamine dipeptide during major abdominal surgery.

DESIGN

Whole-body and renal metabolism of glutamine, citrulline, and arginine was assessed by stable isotope techniques in 7 patients receiving a perioperative supplement of intravenous alanyl-glutamine (0.5 g · kg(-1) · d(-1)).

RESULTS

Plasma glutamine, citrulline, and arginine concentrations increased significantly in patients receiving intravenous glutamine dipeptide. At whole-body level, 91% of total citrulline turnover was derived from glutamine, whereas 49% of whole-body citrulline turnover was used for de novo synthesis of arginine. The kidneys were responsible for 75% of whole-body arginine production from citrulline.

CONCLUSIONS

Glutamine and citrulline are important sources for de novo arginine synthesis. The kidneys are the main production site for endogenous arginine. After comparison of these results with previous similar studies, our data suggest that an intravenous glutamine supplement doubles renal arginine production from citrulline. This trial was registered at www.trialregister.nl as NTR2914.

Authors+Show Affiliations

From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).From the Departments of Surgery (NB, SJHB, JL, WW, and PAMvL), Internal Medicine (MARV), Intensive Care (AB), and Pediatrics (JBvG), VU University Medical Center, Amsterdam, Netherlands; the Department of Surgery, Medical Center Alkmaar, Trial Center Holland Health, Alkmaar, Netherlands (NB and APJH); the Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Amsterdam, Netherlands (JEO, HS, and JBvG); and the Department of Intensive Care, Medisch Spectrum Twente, Enschede, Netherlands (AB).

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25332337

Citation

Buijs, Nikki, et al. "Intravenous Glutamine Supplementation Enhances Renal De Novo Arginine Synthesis in Humans: a Stable Isotope Study." The American Journal of Clinical Nutrition, vol. 100, no. 5, 2014, pp. 1385-91.
Buijs N, Brinkmann SJ, Oosterink JE, et al. Intravenous glutamine supplementation enhances renal de novo arginine synthesis in humans: a stable isotope study. Am J Clin Nutr. 2014;100(5):1385-91.
Buijs, N., Brinkmann, S. J., Oosterink, J. E., Luttikhold, J., Schierbeek, H., Wisselink, W., ... Vermeulen, M. A. (2014). Intravenous glutamine supplementation enhances renal de novo arginine synthesis in humans: a stable isotope study. The American Journal of Clinical Nutrition, 100(5), pp. 1385-91. doi:10.3945/ajcn.113.081547.
Buijs N, et al. Intravenous Glutamine Supplementation Enhances Renal De Novo Arginine Synthesis in Humans: a Stable Isotope Study. Am J Clin Nutr. 2014;100(5):1385-91. PubMed PMID: 25332337.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravenous glutamine supplementation enhances renal de novo arginine synthesis in humans: a stable isotope study. AU - Buijs,Nikki, AU - Brinkmann,Saskia J H, AU - Oosterink,J Efraim, AU - Luttikhold,Joanna, AU - Schierbeek,Henk, AU - Wisselink,Willem, AU - Beishuizen,Albertus, AU - van Goudoever,Johannes B, AU - Houdijk,Alexander P J, AU - van Leeuwen,Paul A M, AU - Vermeulen,Mechteld A R, Y1 - 2014/10/01/ PY - 2014/10/22/entrez PY - 2014/10/22/pubmed PY - 2015/2/24/medline SP - 1385 EP - 91 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 100 IS - 5 N2 - BACKGROUND: Arginine plays a role in many different pathways in multiple cell types. Consequently, a shortage of arginine, caused by pathologic conditions such as cancer or injury, has the potential to disturb many cellular and organ functions. Glutamine is the ultimate source for de novo synthesis of arginine in humans via the intestinal-renal axis. Therefore, we hypothesized that parenteral glutamine supplementation may stimulate the interorgan pathway of arginine production. OBJECTIVES: The objectives were to quantify arginine production from its precursor glutamine and to establish the contribution of the kidneys to de novo synthesis of arginine in patients receiving intravenous supplementation of glutamine dipeptide during major abdominal surgery. DESIGN: Whole-body and renal metabolism of glutamine, citrulline, and arginine was assessed by stable isotope techniques in 7 patients receiving a perioperative supplement of intravenous alanyl-glutamine (0.5 g · kg(-1) · d(-1)). RESULTS: Plasma glutamine, citrulline, and arginine concentrations increased significantly in patients receiving intravenous glutamine dipeptide. At whole-body level, 91% of total citrulline turnover was derived from glutamine, whereas 49% of whole-body citrulline turnover was used for de novo synthesis of arginine. The kidneys were responsible for 75% of whole-body arginine production from citrulline. CONCLUSIONS: Glutamine and citrulline are important sources for de novo arginine synthesis. The kidneys are the main production site for endogenous arginine. After comparison of these results with previous similar studies, our data suggest that an intravenous glutamine supplement doubles renal arginine production from citrulline. This trial was registered at www.trialregister.nl as NTR2914. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/25332337/Intravenous_glutamine_supplementation_enhances_renal_de_novo_arginine_synthesis_in_humans:_a_stable_isotope_study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.113.081547 DB - PRIME DP - Unbound Medicine ER -