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De Nardi L, Sala M, Turoldo F, Zanon D, Maestro A, Barbi E, Faganel Kotnik B, Maximova N. Parenteral Nutrition in the Pediatric Oncologic Population: Are There Any Sex Differences? Nutrients 2023; 15:3822. [PMID: 37686854 PMCID: PMC10490019 DOI: 10.3390/nu15173822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/15/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
Gender-based medicine is attracting increasing interest every day, but studies on pediatric populations are still limited. In this setting, sex differences among patients undergoing total parenteral nutrition (TPN) have not been previously reported. This study investigated the presence of sex differences in parenteral nutrition composition and outcomes among a cohort of pediatric patients admitted at the Oncohematology and Bone Marrow Transplant Unit of the Institute for Maternal and Child Health "Burlo Garofolo" of Trieste, Italy. For all 145 recruited patients (87 males, 58 females), the following data were collected: age, sex, volume and duration of TPN, macro- and micronutrient composition of TPN bags, electrolytic or blood gases imbalance, glycolipid alterations, liver damage during TPN, and the incidence of sepsis and thrombosis. The analysis showed that females required higher daily phosphate intake (p = 0.054) and essential amino acid supplementation (p = 0.07), while males had a higher incidence of hypertriglyceridemia (p < 0.05) and cholestasis. A higher incidence of sepsis was found in the non-transplanted male population (p < 0.05). No significant differences were appreciable in other analyzed variables. This study aims to create a basis for future gender-based nutritional recommendations in the pediatric field.
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Affiliation(s)
- Laura De Nardi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy; (L.D.N.); (M.S.); (F.T.); (E.B.)
| | - Mariavittoria Sala
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy; (L.D.N.); (M.S.); (F.T.); (E.B.)
| | - Federico Turoldo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy; (L.D.N.); (M.S.); (F.T.); (E.B.)
| | - Davide Zanon
- Pharmacy and Clinical Pharmacology Department, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy; (D.Z.); (A.M.)
| | - Alessandra Maestro
- Pharmacy and Clinical Pharmacology Department, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy; (D.Z.); (A.M.)
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy; (L.D.N.); (M.S.); (F.T.); (E.B.)
- Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
| | - Barbara Faganel Kotnik
- Department of Hematology and Oncology, University Children’s Hospital, 1000 Ljubljana, Slovenia;
| | - Natalia Maximova
- Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137 Trieste, Italy
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Supramolecular Self-Assembly of Atomically Precise Silver Nanoclusters with Chiral Peptide for Temperature Sensing and Detection of Arginine. NANOMATERIALS 2022; 12:nano12030424. [PMID: 35159774 PMCID: PMC8839151 DOI: 10.3390/nano12030424] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/24/2022] [Accepted: 01/24/2022] [Indexed: 01/27/2023]
Abstract
Metal nanoclusters (NCs) as a new type of fluorescent material have attracted great interest due to their good biocompatibilities and outstanding optical properties. However, most of the studies on metal NCs focus on the synthesis, atomic or molecular assembly, whereas metal NCs ability to self-assemble to higher-level hierarchical nanomaterials through supramolecular interactions has rarely been reported. Herein, we investigate atomic precise silver NCs (Ag9-NCs, [Ag9(mba)9], where H2mba = 2-mercaptobenzoic acid) and peptide DD-5 were used to induce self-assembly, which can trigger an aggregation-induced luminescence (AIE) effect of Ag9-NCs through non-covalent forces (H-bond, π–π stacking) and argentophilic interactions [Ag(I)–Ag(I)]. The large Stokes shift (~140 nm) and the microsecond fluorescence lifetime (6.1 μs) indicate that Ag9-NCs/DD-5 hydrogel is phosphor. At the same time, the chirality of the peptide was successfully transferred to the achiral Ag9-NCs because of the supramolecular self-assembly, and the Ag9-NCs/DD-5 hydrogel also has good circularly polarized luminescence (CPL) properties. In addition, Ag9-NCs/DD-5 luminescent hydrogel is selective and sensitive to the detection of small biological molecule arginine. This work shows that DD-5 successfully induces the self-assembly of Ag9-NCs to obtain high luminescent gel, which maybe become a candidate material in the fields of sensors and biological sciences.
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Wang Q, Xu Z, Ai Q. Arginine metabolism and its functions in growth, nutrient utilization, and immunonutrition of fish. ACTA ACUST UNITED AC 2021; 7:716-727. [PMID: 34466676 PMCID: PMC8379419 DOI: 10.1016/j.aninu.2021.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
Fish have limited ability in endogenous biosynthesis of arginine. Arginine is an indispensable amino acid for fish, and the arginine requirement varies with fish species and fish size. Recent studies on fish have demonstrated that arginine influences nutrient metabolism, stimulates insulin release, is involved in nonspecific immune responses and antioxidant responses, and elevates disease resistance. Specifically, arginine can regulate energy homeostasis via modulating the adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) pathway, and also regulate protein synthesis via activating the target of rapamycin (TOR) signaling pathway. The present article reviews pertinent knowledge of arginine in fish, including dietary quantitative requirements, endogenous anabolism and catabolism, regulation of the endocrine and metabolic systems, and immune-regulatory functions under pathogenic challenge. Our findings showed that further data about the distribution of arginine after intake into specific cells, its sub-cellular sensor to initiate downstream signaling pathways, and its effects on fish mucosal immunity, especially the adaptive immune response against pathogenic infection in different species, are urgently needed.
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Affiliation(s)
- Qingchao Wang
- Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Ministry of Education, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Zhen Xu
- Engineering Research Center of Green Development for Conventional Aquatic Biological Industry in the Yangtze River Economic Belt, Ministry of Education, College of Fisheries, Huazhong Agricultural University, Wuhan, China.,Laboratory for Marine Fisheries Science and Food Production Processes, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China
| | - Qinghui Ai
- Laboratory for Marine Fisheries Science and Food Production Processes, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China.,Key Laboratory of Aquaculture Nutrition and Feed (Ministry of Agriculture), Ocean University of China, Qingdao, China
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Gostyńska A, Stawny M, Dettlaff K, Jelińska A. Clinical Nutrition of Critically Ill Patients in the Context of the Latest ESPEN Guidelines. ACTA ACUST UNITED AC 2019; 55:medicina55120770. [PMID: 31810303 PMCID: PMC6955661 DOI: 10.3390/medicina55120770] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
The group of patients most frequently in need of nutritional support are intensive care patients. This year (i.e., 2019), new European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines of clinical nutrition in intensive care were published, updating and gathering current knowledge on the subject of this group of patients. Planning the right nutritional intervention is often a challenging task involving the necessity of the choice of the enteral nutrition (EN) or parenteral nutrition (PN) route of administration, time of initiation, energy demand, amino acid content and demand as well as the use of immunomodulatory nutrition. The aim of this study was to specify and discuss the basic aspects of the clinical nutrition of critically ill patients recommended by ESPEN guidelines. Clinical nutrition in intensive care seems to be the best-studied type of nutritional intervention. However, meta-analyses and clinical studies comparing EN and PN and their impact on the prognosis of the intensive care patients showed ambiguous results. The nutritional interventions, starting with EN, should be initiated within 24-48 h whereas PN, if recommended, should be implemented within 3-7 days. The recommended method of calculation of the energy demand is indirect calorimetry, however, there are also validated equations used worldwide in everyday practice. The recommended protein intake in this group of patients and the results of insufficient or too high supply was addressed. In light of the concept of immunomodulatory nutrition, the use of appropriate amino acid solutions and lipid emulsion that can bring a positive effect on the modulation of the immune response was discussed.
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Zhang H, Lin Y, Zhen Y, Hu G, Meng X, Li X, Men X. Therapeutic Effect of Glycyrrhizin Arginine Salt on Rat Cholestatic Cirrhosis and its Mechanism. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2018; 46:1111-1127. [DOI: 10.1142/s0192415x18500581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To investigate the therapeutic effect of glycyrrhizin arginine salt on rat cholestatic cirrhosis, we subjected male Sprague Dawley rats to common bile duct ligation for 14 days and treated them with distilled water (model group), arginine, or a low or high dose of glycyrrhizin arginine salt by gavage. A sham-operated group was used as a control group. Treatment with glycyrrhizin arginine salt substantially improved animal growth rates, reduced the ratio of liver weight to body weight and decreased total bilirubin, aspartate aminotransferase, 8-isoprostane and malondialdehyde compared with the values measured in the model group. The progress of liver fibrosis, as detected by hematoxylin and eosin and Masson’s trichrome staining, was slower in the glycyrrhizin arginine salt groups than in the model group or the arginine group. Reductions of bile salt pool size, hepatic hydroxyproline content and fibrosis score were also seen in the glycyrrhizin arginine salt groups compared with the model group. Furthermore, glycyrrhizin arginine salt significantly reduced the expression of transforming growth factor [Formula: see text]1 (TGF-[Formula: see text]1), [Formula: see text]-smooth muscle actin, tumor necrosis factor-[Formula: see text] and matrix metalloproteinases 2 and 9. Glycyrrhizin arginine salt also inhibited the expression of [Formula: see text]-SMA and matrix metalloproteinases 2 and 9 in response to TGF-[Formula: see text]1 in LX-2 cells and primary rat hepatic stellate cells and mitigated the cytotoxicity induced by rat bile in HepG2 cells and primary rat hepatocytes.
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Affiliation(s)
- Huan Zhang
- Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan 063000, P. R. China
| | - Yajun Lin
- The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, P. R. China
| | - Yongzhan Zhen
- Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan 063000, P. R. China
| | - Gang Hu
- The Key Laboratory of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing 100730, P. R. China
| | - Xu Meng
- Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan 063000, P. R. China
| | - Xingxin Li
- Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan 063000, P. R. China
| | - Xiuli Men
- Tangshan Key Laboratory for Preclinical and Basic Research on Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan 063000, P. R. China
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Häberle J. Clinical and biochemical aspects of primary and secondary hyperammonemic disorders. Arch Biochem Biophys 2013; 536:101-8. [PMID: 23628343 DOI: 10.1016/j.abb.2013.04.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/16/2013] [Accepted: 04/17/2013] [Indexed: 02/08/2023]
Abstract
An increased concentration of ammonia is a non-specific laboratory sign indicating the presence of potentially toxic free ammonia that is not normally removed. This does occur in many different conditions for which hyperammonemia is a surrogate marker. Hyperammonemia can occur due to increased production or impaired detoxification of ammonia and should, if associated with clinical symptoms, be regarded as an emergency. The conditions can be classified into primary or secondary hyperammonemias depending on the underlying pathophysiology. If the urea cycle is directly affected by a defect of any of the involved enzymes or transporters, this results in primary hyperammonemia. If however the function of the urea cycle is inhibited by toxic metabolites or by substrate deficiencies, the situation is described as secondary hyperammonemia. For removal of ammonia, mammals require the action of glutamine synthetase in addition to the urea cycle, in order to ensure lowering of plasma ammonia concentrations to the normal range. Independent of its etiology, hyperammonemia may result in irreversible brain damage if not treated early and thoroughly. Thus, early recognition of a hyperammonemic state and immediate initiation of the specific management are of utmost importance. The main prognostic factors are, irrespective of the underlying cause, the duration of the hyperammonemic coma and the extent of ammonia accumulation. This paper will discuss the biochemical background of primary and secondary hyperammonemia and will give an overview of the various underlying conditions including a brief clinical outline and information on the genetic backgrounds.
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Affiliation(s)
- Johannes Häberle
- Division of Metabolism, University Children's Hospital Zurich, Steinwiesstr. 75, 8032 Zurich, Switzerland.
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Hoffer LJ, Bistrian BR. Appropriate protein provision in critical illness: a systematic and narrative review. Am J Clin Nutr 2012; 96:591-600. [PMID: 22811443 DOI: 10.3945/ajcn.111.032078] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Widely varying recommendations have been published with regard to the appropriate amount of protein or amino acids to provide in critical illness. OBJECTIVE We carried out a systematic review of clinical trials that compared the metabolic or clinical effects of different protein intakes in adult critical illness and comprehensively reviewed all of the available evidence pertinent to the safe upper limit of protein provision in this setting. DESIGN MEDLINE was searched for clinical trials published in English between 1948 and 2012 that provided original data comparing the effects of different levels of protein intake on clinically relevant outcomes and evidence pertinent to the safe upper limit of protein provision to critically ill adults. RESULTS The limited amount and poor quality of the evidence preclude conclusions or clinical recommendations but strongly suggest that 2.0-2.5 g protein substrate · kg normal body weight⁻¹ · d⁻¹ is safe and could be optimum for most critically ill patients. At the present time, most critically ill adults receive less than half of the most common current recommendation, 1.5 g protein · kg⁻¹ · d⁻¹, for the first week or longer of their stay in an intensive care unit. CONCLUSION There is an urgent need for well-designed clinical trials to identify the appropriate level of protein provision in critical illness.
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Affiliation(s)
- L John Hoffer
- Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Canada.
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Abstract
Despite our knowledge of how to prevent pressure ulcers, and improvements in treatment, pressure ulcers remain prevalent and impose a significant burden on financial and labor resources in the healthcare industry. Although there is no known role for specific nutrients in the prevention of pressure ulcers, undernutrition is a risk factor, and nutrition therapy plays a crucial role in pressure ulcer treatment. Limitations in research make it difficult to develop evidence-based nutrition guidelines, so it is important that clinicians conduct a comprehensive assessment that includes weight and intake history, biochemical data, and comorbidities as well as symptoms that may affect the intake, absorption, or excretion of nutrients. These data, combined with clinical judgment, must be used to estimate energy and protein needs, considering the size and severity of the pressure ulcer. Micronutriture is difficult to assess; usual intake, comorbidities and disease symptoms must be considered in addition to biochemical data. Micronutrients should be replaced if depleted, but routine supplementation of vitamins and minerals in all pressure ulcer patients is not warranted.
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Affiliation(s)
- Jennifer Doley
- Nutritional Services, 1601 W. St. Mary's Rd, Tucson, AZ 85745, USA.
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Bertolo RF, Burrin DG. Comparative aspects of tissue glutamine and proline metabolism. J Nutr 2008; 138:2032S-2039S. [PMID: 18806120 DOI: 10.1093/jn/138.10.2032s] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The cellular metabolism of glutamine and proline are closely interrelated, because they can be interconverted with glutamate and ornithine via the mitochondrial pathway involving pyrroline-5-carboxylate (P5C). In adults, glutamine and proline are converted via P5C to citrulline in the gut, then citrulline is converted to arginine in the kidney. In neonates, arginine is a semiindispensable amino acid and is synthesized from proline completely in the gut; because of low P5C synthase activity, glutamine is not an important precursor for neonatal arginine synthesis. Thus, splanchnic metabolism of glutamine and proline is important, because both amino acids serve as key precursors for arginine synthesis with some developmental differences. Studies investigating splanchnic extraction demonstrate that about two-thirds of dietary glutamine and almost all dietary glutamate are extracted on first pass and the vast majority is oxidized in the gut. This capacity to extract glutamine and glutamate appears to be very large, so diets high in glutamine or glutamate probably have little impact on circulating concentrations and consequent potential toxicity. In contrast, it appears that very little proline is extracted by the gut and liver, at least in the neonate, which may result in hyperprolinemia and potential toxicity. Therefore, the upper limits of safe dietary intake for glutamine and proline, and other amino acids, appear to be substantially different depending on the extent of first-pass splanchnic extraction and irreversible catabolism.
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Affiliation(s)
- Robert F Bertolo
- Department of Biochemistry, Memorial University of Newfoundland, St. John's, NL, Canada.
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