Impairment of arginine metabolism in rats after massive intestinal resection: Effect of parenteral nutrition supplemented with citrulline versus arginine

Overview & Synopsis

Background: Arginine homeostasis is impaired in short bowel syndrome, but its supplementation in short bowel syndrome patients remains controversial. Recently, we demonstrated the benefits of citrulline supplementation by enteral route in resected rats. Since the first step in managing short bowel syndrome is to initiate total parenteral nutrition, we hypothesized that parenteral citrulline supplementation would be more appropriate in this situation than arginine supplementation. Material and methods: 24 rats were assigned to 4 groups. The Sham group underwent transection while the 3 other groups underwent resection (R) of 80% of the small intestine. All rats were then fed exclusively by total parenteral nutrition as follows: supplementation with citrulline (R+CIT), with arginine (R+ARG), or no supplementation (R). All the rats received isocaloric and isonitrogenous nutrition for 4 days. Nitrogen balance was measured daily. At sacrifice, the blood was collected and the intestinal mucosa and Extensor Digitorum Longus muscle were removed for amino acid and protein analysis. Results: Citrulline and arginine increased mucosal protein content in the ileum (vs. Sham and R, p