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Whole-Protein-Based Enteral Formula Stimulates Intestinal Ornithine Decarboxylase Activity More Than Single Amino Acids but Does Not Affect Mucosal Adenosine Triphosphate Content in Early Postsurgical Refeeding

Department of Surgery and Clinical Research Center, Faculty of Health Science, Linköping University, Sweden

Mikael Wirén, MD, PhD

Department of Surgery and Clinical Research Center, Faculty of Health Science, Linköping University, Sweden

Jörgen Larsson, MD, PhD

Department of Surgery, Karolinska Institute at Huddinge University Hospital, Stockholm, Sweden

Johan Permert, MD, PhD

Department of Surgery, Karolinska Institute at Huddinge University Hospital, Stockholm, Sweden

Background: To restore intestinal integrity after starvation and trauma, luminal nutrients are essential. Specific nutrients such as glutamine support mucosal proliferation and energy metabolism. The aim of this study was to compare effects of enteral formula vs specific amino acids on ornithine decarboxylase (ODC) activity and adenine nucleotide metabolism in jejunal mucosa. Methods: Male Wistar rats (240 to 280 g) were starved for 48 hours and subjected to intestinal transection, gastrotomy, and jejunal instillation of 5-mL nutrient solution. In the first experiment, standard enteral formula (EF) was compared with isonitrogenous formula supplemented with the glutamine precursor, -ketoglutarate (-KG) . In a second experiment, 2% glutamine was compared with isonitrogenous ornithine -KG, arginine -KG, glycine and diluted standard enteral formula (EF), or saline. The ODC activity, adenosine triphosphates (ATP), and RNA and protein in the jejunal mucosa were analyzed 2 hours after surgery. Results: The ODC peak in jejunal mucosa in animals treated with EF was higher than when supplemented with -KG (p < .05). Compared with specific amino compounds, EF resulted in a significantly higher ODC peak and no differences were seen between the different specific amino acids. Differences seen in ATP or energy charge between the groups were not significant. Conclusions: Immediate postoperative enteral feeding by standard EF results in rapid increase of ODC activity. This response was attenuated when the enteral nutrition was supplemented with -KG and was absent when isonitrogenous single amino acids were administered. We found no significant effects on ATP content in the small bowel mucosa by supplementing the diet with -KG. (Journal of Parenteral and Enteral Nutrition 23:207-212, 1999)

Journal of Parenteral and Enteral Nutrition, Vol. 23, No. 4, 207-212 (1999)
DOI: 10.1177/0148607199023004207


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