Citrulline is produced by enterocytes and metabolised by kidney. Fasting plasma citrulline directly correlates with small bowel mucosal mass, but it may increase in renal failure. Plasma citrulline and creatinine clearance were evaluated in 17 healthy controls, 16 adult patients with short bowel dependent on home parenteral nutrition (SBS-HPN), in 9 SBS on oral diet alone (SBS-OD) and in 12 intestinal transplantation recipients (ITx). ITx had 63 evaluations (with histological investigation) between 1 and 1250 post-operative day (PO). Statistics: mean ± SD, ANOVA, Mann-Whitney, simple regression. Citrulline (nm/ml) was 36±5 in controls, 33±11 in SBS-OD, 27±10 in SBS-HPN (P<0.05 vs controls) and 8±3, 16±6, 21±11, 43±1, at 7, 15, 30, 45 PO day respectively in ITx (P<0.001). Between 60 and 1250 PO day, mean citrulline was 45 to 90 in absence of mucosal rejection. Citrulline was positively related to small bowel length in SBS (R=0.54; P=0.01) and to PO in ITx (R=0.64; P<0.001) and negatively related to creatinine clearance in both SBS (R= -0.55;P<0.01) and ITx (R= -0.59; P<0.001). The potential for citrulline as a marker of residual small bowel length in SBS was confirmed. In ITx, citrulline suggests the recover of ischemia-reperfusion mucosal stress by the 45 PO day. The occurrence of renal failure may impair the role of citrulline as marker of mucosal mass.
Plasma citrullina in short bowel syndrome and intestinal transplantation
PIRONI, LORIS;D'ERRICO, ANTONIETTA;PINNA, ANTONIO DANIELE
2005
Abstract
Citrulline is produced by enterocytes and metabolised by kidney. Fasting plasma citrulline directly correlates with small bowel mucosal mass, but it may increase in renal failure. Plasma citrulline and creatinine clearance were evaluated in 17 healthy controls, 16 adult patients with short bowel dependent on home parenteral nutrition (SBS-HPN), in 9 SBS on oral diet alone (SBS-OD) and in 12 intestinal transplantation recipients (ITx). ITx had 63 evaluations (with histological investigation) between 1 and 1250 post-operative day (PO). Statistics: mean ± SD, ANOVA, Mann-Whitney, simple regression. Citrulline (nm/ml) was 36±5 in controls, 33±11 in SBS-OD, 27±10 in SBS-HPN (P<0.05 vs controls) and 8±3, 16±6, 21±11, 43±1, at 7, 15, 30, 45 PO day respectively in ITx (P<0.001). Between 60 and 1250 PO day, mean citrulline was 45 to 90 in absence of mucosal rejection. Citrulline was positively related to small bowel length in SBS (R=0.54; P=0.01) and to PO in ITx (R=0.64; P<0.001) and negatively related to creatinine clearance in both SBS (R= -0.55;P<0.01) and ITx (R= -0.59; P<0.001). The potential for citrulline as a marker of residual small bowel length in SBS was confirmed. In ITx, citrulline suggests the recover of ischemia-reperfusion mucosal stress by the 45 PO day. The occurrence of renal failure may impair the role of citrulline as marker of mucosal mass.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
