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Journal of Parenteral and Enteral Nutrition
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Review: Intestinal Amino Acid Absorption During Sepsis

Keith Gardiner, FRCS

Department of Surgery, Sinai Hospital of Baltimore and the Johns Hopkins Medical Institutions, Baltimore

Adrian Barbul, MD, FACS

Department of Surgery, Sinai Hospital of Baltimore and the Johns Hopkins Medical Institutions, Baltimore

Sepsis has been shown to cause a decrease in mesenteric blood flow in association with ultrastructural changes in the small intestine and impaired immune, barrier, and metabolic functions of the gut. These impairments in the structure and function of the gastrointestinal tract may have a detrimental effect on the morbidity and mortality of sepsis. Two recent studies have shown that the ability of the small intestine to absorb amino acids is also impaired during sepsis, but the systemic and cellular mechanisms of this impairment are not known. Release of cytokines induced by systemic bacteria or endotoxin may lead to a reduction in the synthesis of transporter proteins by the enterocyte at a time when there is reduced availability of both luminal (because of anorexia) and circulating (because of reduced mesenteric blood flow) substrates. Future research needs to investigate the systemic and local mediation of the sepsis-induced reduction in intestinal amino acid absorption and the possibility of correcting the defect by the administration of enteral nutrients, hormones, or drugs. (Journal of Parenteral and Enteral Nutrition 17:277-283, 1993)

Journal of Parenteral and Enteral Nutrition, Vol. 17, No. 3, 277-283 (1993)
DOI: 10.1177/0148607193017003277
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