Combined Enteral and Parenteral Glutamine Supplementation in Endotoxemic Swine: Effects on Portal and Systemic Circulation Levels.

Abstract

OBJECTIVE:

To measure plasma glutamine (GLN) levels in systemic and portal circulation after combined enteral and parenteral administration in early endotoxemic swine. We hypothesized that this combination will be more efficient than intravenous administration alone in restoring plasma levels during the course of endotoxemia.

MATERIALS AND METHODS:

Endotoxemia was induced with Escherichia coli O111:B4 lipopolysaccharide (LPS) (250 μg/kg body weight) in 16 anes-thetized, fasted swine and maintained by constant infusion (2 μg/kg/h) over 180 min. Another 16 swine served as controls. After infusion with LPS or placebo, GLN was administered intravenously, enterally or in combination (0.5 g/kg i.v. plus 0.5 g/kg enterally) over 30 min. At 0, 15, 30, 45, 60, 120 and 180 min, blood was drawn from the systemic and portal circulation for colorimetric assessment of GLN.

RESULTS:

In healthy, placebo-alone swine, GLN levels remained stable throughout the study. Intravenous and combined infusion increased systemic levels (p = 0.001), but after enteral administration alone, a smaller effect was observed (p = 0.026). Portal levels were increased after combined, enteral and intravenous administration (p = 0.001). In endotoxemia, systemic and portal levels decreased significantly. Intravenous and, to a greater extent, combined administration increased systemic levels (p = 0.001), while enteral administration only had a small effect (p = 0.001). In the portal vein, intravenous and combined treatment increased plasma levels (p = 0.001), whereas enteral supplementation alone had again a small, yet significant effect (p = 0.001).

CONCLUSIONS:

The findings indicate that combined GLN supplementation is superior to intravenous treatment alone, in terms of enhanced availability in systemic and portal circulations. Thus, combined treatment at the onset of endotoxemia is a beneficial practice, ensuring adequate GLN to compensate for the resulting intracellular shortage.

• Authors: George Stavrou, Konstantinos Arvanitidis, Eirini Filidou, Kyriakos Fotiadis, Vasilios Grosomanidis, Aris Ioannidis, Georgia Tsaousi, Antonios Michalopoulos, George Kolios, Katerina Kotzampassi
• Journal: Medical principles and practice : international journal of the Kuwait University, Health Science Centre (Med Princ Pract) Vol. 27 Issue 6 Pg. 570-578 ( 2018) ISSN: 1423-0151 [Electronic] Switzerland
• PMID: 30184534 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2018 The Author(s) Published by S. Karger AG, Basel.

Chemical References

• Glutamine

Topics

• Administration, Intravenous
• Animals
• Dietary Supplements
• Disease Models, Animal
• Drug Administration Routes
• Endotoxemia (blood, drug therapy)
• Escherichia coli
• Escherichia coli Infections (blood, drug therapy)
• Female
• Glutamine (administration & dosage, analysis)
• Greece
• Portal System (drug effects)
• Swine
• Swine Diseases (blood, drug therapy, microbiology)