L'alpha-cétoglutarate d'ornithine : mécanismes d’action et place actuelle en nutrition artificielle

Ornithine alpha-ketoglutarate: could it be a new therapeutic option for sarcopenia?

Our current knowledge on the causes of sarcopenia is still fragmentary. One of the most evident candidates to explain muscle loss in elderly includes imbalance in protein turnover, i.e. decreased muscle protein synthesis rate, notably in the post-prandial state. Nutritional strategies such as leucine supplementation, use of fast digested proteins or a pulse protein intake have been show to enhance the synthesis rate of muscle proteins in older individuals. Ornithine alpha-ketoglutarate (OKG) is a precursor of amino acids such as glutamine, arginine and proline, and increases the secretion of anabolic hormones, i.e. insulin and growth hormone. A beneficial anabolic action of OKG has been demonstrate in several pathological conditions associated with muscle loss. Therefore, OKG may be of a potential interest to modulate muscle protein metabolism and to maintain muscle mass during aging.

Dose dependency of the effect of ornithine α-ketoglutarate on tissue glutamine concentrations and hypercatabolic response in endotoxaemic rats

The optimal dosage of ornithine α-ketoglutarate (OKG) for repleting tissue glutamine (Gln) concentrations and maintaining N homeostasis after injury is unknown. We set out to perform ‘dose-ranging’ of OKG supplementation after an endotoxaemic challenge. Sixty-one male Wistar rats were injected with 3 mg lipopolysaccharide (LPS) from Escherichia coli/kg (n 50) or saline vehicle (9 g NaCl/l; controls n 11). After a 24 h fast, survivors were fed by gavage for 48 h with a polymeric standard diet (879 kJ/kg per d and 1·18 g N/kg per d) supplemented with non-essential amino acids (control, n 11; LPS-OKG-0·0, n 9), or with 0·5 g OKG/kg per d (LPS-OKG-0·5, n 12), 1·5 OKG/kg per d (LPS-OKG-1.5, n 11) or 4·5 g OKG/kg per d (LPS-OKG-4·5, n 10). The diets for all groups were made isonitrogenous with the LPS-OKG-4·5 diet by adding an appropriate amount of non-essential amino acids. Rats were killed on day 3 for blood and tissue sampling (muscle, jejunum mucosa, liver). Urine was collected daily for 3-methylhistidine and total N assays. The OKG dose was correlated with Gln concentrations in every tissue and with cumulative N balance (Spearman test, P<0·01). 3-Methylhistidine excretion was increased in endotoxaemic groups compared with controls (ANOVA, P<0·05) except in the LPS-OKG-4·5 group. Only the LPS-OKG-4·5 group achieved a positive post-injury N balance (t test, P<0·05). In conclusion, OKG exerted a dose-dependent effect on tissue Gln concentration and N balance, but only the highest dosage counteracted myofibrillar hypercatabolism and caused a positive N balance.

Ornithine alpha-ketoglutarate supplementation influences motor activity in healthy rats

BACKGROUND

Ornithine alpha-ketoglutarate (OKG) improves nutritional status in malnourished patients. Published and unpublished data suggest OKG may have effects on the central nervous system that may contribute to its action.

OBJECTIVE

We investigated the effect of an OKG-enriched diet on behaviour in healthy rats.

DESIGN

Thirty male Wistar rats were randomised in three groups: the OKG group was fed for 5 days (D0-D5) at 90% of spontaneous food intake with an OKG-enriched diet (5 g/kg/d). The non-essential amino acids (NEAA) group was fed similarly with a regimen enriched with NEAA (glycine, alanine, histidine and serine) to be isonitrogenous to OKG group. The ad libitum (AL) group had no treatment and was fed ad libitum with a standard regimen throughout. Rats were tested at D4 for motor activity by actimetry, and at D5 first for spontaneous alternation behaviour measured in the Y-maze, and then for exploratory behaviour measured using the open-field test (stressful environment).

RESULTS

We found that OKG supplementation enhanced global motricity by actimetry (AL 772 +/- 55, NEAA 811 +/- 54 vs. OKG 966 +/- 24 arbitrary units, P < 0.05) and total numbers of arms visited in the Y-maze (AL 26 +/- 2, NEAA 30 +/- 3 vs. OKG 38 +/- 3, P < 0.05). The lack of any effect of the OKG-enriched diet in the open-field test shows that the enhancement of locomotion activity was most probably not due to an increase in anxiety or fear in the rats.

CONCLUSION

An OKG-enriched diet can induce beneficial stimulant effects that may be involved in the mechanism of action of OKG.

Ornithine alpha-ketoglutarate as a potent precursor of arginine and nitric oxide: a new job for an old friend

Ornithine alpha-ketoglutarate (OKG) is a salt formed of 2 molecules of ornithine and 1 alpha-ketoglutarate. Its administration improves nutritional status in chronically malnourished (e.g., elderly) and acutely malnourished patients (especially burn and trauma patients). There is evidence that OKG activity is not the simple addition of the effects of ornithine (Orn) and alpha-ketoglutarate (alphaKG), because the presence of both moieties is required to induce the generation of key metabolites such as glutamine, proline, and arginine (Arg), whereas this does not occur when one or the other is given separately. This observation is related to the fact that the main feature of Orn at the whole-body level is to be metabolized through the Orn aminotransferase-dependent pathway, whereas the simultaneous administration of Orn and alphaKG saturates this pathway, diverting Orn toward metabolism into Arg. For years, OKG activity has been associated with its ability to induce the secretion of anabolic hormones, such as insulin and growth hormone, and to increase glutamine and polyamine synthesis. Recent studies using chemical inhibitors of nitric oxide synthase (NOS) suggest that nitric oxide derived from Arg could be partly involved in OKG activity. The use of genetically modified animals (i.e., knockout for NOS expression) is required to confirm this hypothesis.