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Glutamine Dipeptide—Supplemented Parenteral Nutrition Reverses Gut Atrophy, Disaccharidase Enzyme Activity, and Absorption in Rats

Department of General and Thoracic Surgery, University of Kiel

E. Wardelmann, MD

Department of Pathology, University of Bonn

W. Winkler, MD

Department of General and Thoracic Surgery, University of Kiel

F. Fandrich

Department of General and Thoracic Surgery, University of Kiel

E. Schweizer, MD

Department of General and Thoracic Surgery, University of Kiel

P. Schroeder, MD, PHD

Department of General Surgery, Krankenanstalten Gilead, Bielefeld, Germany

Background: 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. Methods: 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. Results: 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. Conclusions: Glutamine dipeptide-enriched parenteral nutrition preserves mucosal structure and reversed atrophy-associated dysfunction. (Journal of Parenteral and Enteral Nutrition 19:502-506, 1995)

Journal of Parenteral and Enteral Nutrition, Vol. 19, No. 6, 502-506 (1995)
DOI: 10.1177/0148607195019006502


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