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Alanine-Glutamine Dipeptide (AGD) Inhibits Expression of Inflammation-Related Genes in Hemorrhagic Shock

Rongjie Yang, MD^*, Xiaoyu Tan, MD, Ann M. Thomas, BS^*, Robert Steppacher, MD^*, Nilofer Qureshi, PhD, David C. Morrison, PhD^* and Charles W. Van Way, III, MD^*

From the ^* Department of Surgery and the Shock/Trauma Research Center, University of Missouri–Kansas City, Kansas City, Missouri

Correspondence: Charles W. Van Way III, MD, Professor and Chair of Surgery, Director of Shock/Trauma Research Center, University of Missouri–Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108. Electronic mail may be sent to charles.vanway{at}tmcmed.org.

Background: Inflammatory factors play an important role in the production of cellular damage after shock and reperfusion. Glutamine has been used to modulate the inflammatory response. Alanine-glutamine dipeptide (AGD) is a glutamine source. The hypothesis of the present study is that AGD given during resuscitation will suppress postshock expression of messenger ribonucleic acid (mRNA) for tumor necrosis factor (TNF-), interleukin-1 (IL-1β) and inducible nitric oxide synthase (iNOS). Methods: Male Sprague-Dawley rats (n = 74, 350 g ± 30 g) were randomly assigned to 5 groups. Under isoflurane anesthesia, the femoral artery and vein were cannulated. Hemorrhagic shock was induced by withdrawing blood through the arterial cannula until the mean arterial pressure (MAP) was 25–30 mm Hg and maintained at the level for 30 minutes with further withdrawals. Resuscitation was carried out by giving 21 mL/kg Ringer's lactate (LR) with or without the administration of AGD (936 mg/kg) and returning the shed blood. Controls were normal (anesthesia only), sham (surgical preparation), and shock (preparation and shock). Rats (n = 45, 9 per group) were killed 30 minutes after completion of resuscitation. Liver samples were collected, and total RNA was isolated for reverse transcription–polymerase chain reaction analysis of mRNA (TNF-, IL-1β, iNOS, and β-actin). Results: MAP recovered more quickly in the AGD group than in the LR group. Increased expression of liver mRNA for TNF-, IL-1β, and iNOS was seen after hemorrhagic shock and resuscitation. AGD treatment significantly reduced mRNA expression for all 3. Conclusions: AGD modified the expression of genes controlling cytokines and iNOS in the liver. This agent is a potential treatment for hemorrhagic shock.

Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 1, 32-36 (2007)
DOI: 10.1177/014860710703100132


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