(1) Appropriate enteral nutrition provided immediately after injury or trauma to the gastrointestinal tract may limit or reverse damage to the mucosal barrier. In this regard, diets containing amino acids, such as arginine and glutamine, or fish oil have been identified as beneficial. This report assesses the role of amino acids as “essential nutrients” in the repair of intestinal mucosa damaged by gamma radiation.

(2) The effect of an orally administered glutamine enriched elemental diet was examined following orthotopic small bowel allotransplantation in rats. The recipients was treated with FK 506 and randomized to receive glutamine-free elemental enteral diet solution (glutamine-free group), glutamine-enriched elemental diet solution containing 7500 mg of glutamine per 100 g diet (glutamine-enriched group) or standard chow (chow group). Weight loss in the glutamine-enriched group was significantly less than that of the chow group. In conclusion, orally administered glutamine-enriched elemental diet appears to promote the regeneration and differentiation of the graft mucosa following small bowel allotransplantation.

(3) The polyamines are involved in repair processes after intestinal ischemia. Arginine and ornithine, both precursors of polyamines were therefore expected to exert beneficial effects on mucosal barrier dysfunction. Arginine may also generate NO and there is support for the view that NO( nitric oxide ) may be beneficial after an ischemic insult. Male Wistar rats were given, by gavage, isonitrogenous solutions of L-arginine (0.5 g/kg) or L-ornithine (0.7 g/kg) 17 and 2 h before ischemia. Transient intestinal ischemia was produced in anesthetized rats by occluding the superior mesenteric artery for 90 min. Administration of arginine or ornithine did not prevent ischemic damage but accelerated morphological repair, enhanced cell proliferation, and polyamine content was observed.  Arginine was significantly more effective than ornithine.

 (4) Zinc has been shown to enhance intestinal mucosal repair in patients suffering from acrodermatitis enteropathica; but the impact on mucosal integrity during acute (AD) or persistent (PD) diarrhoea is unknown. One hundred eleven children with AD and 190 with PD aged between 3 and 24 months received, randomly and blind to the investigators, either an elemental zinc supplement of 5 mg/kg body wt/day or placebo in multivitamin syrup. Two-week zinc supplementation significantly reduced lactulose excretion in both AD and PD, whereas the change in mannitol excretion and L/M was similar between study groups in both studies. Changes in lactulose excretion were significantly influenced by zinc supplementation in children with E. coli, Shigella sp., and Campylobacter jejuni stool isolates.

Several studies (5) and (6) have noted that Factor XIII (F XIII), the last coagulation factor in the clotting cascade, plays a role in mucosal repair. Beneficial effects of F XIII supplementation in severe ulcerative colitis (UC) have been observed. The aim of this study was to relate plasma F XIII activity to the severity of inflammatory bowel disease (IBD). RESULTS: F XIII activity was decreased in active UC (p < 0.05) and active CD (p < 0.05) and was inversely correlated with severity in both UC (r = -0.30) and CD (r = -0.46). In six patients with UC (15%) and six patients with CD (19%) F XIII activity was below the lower range of normal. CONCLUSIONS: In active IBD we found decreased plasma F XIII activity and hyperfibrinolysis.
 

References:

1. NUTRITIONAL SUPPORT FOR ADAPTATION TO RADIATION-INDUCED SUPPRESSION OF MUCOSAL IMMUNITY IN THE INTESTINE OF THE RAT. Harari Y; Grossie VB Jr; Castro GA;  Department of Integrative Biology, University of Texas Medical School at Houston 77225, USA.   Radiat Res, 1996 Jun, 145:6, 754-61

 2. EFFECT OF A GLUTAMINE-ENRICHED DIET ON SMALL BOWEL ALLOGRAFT DURING IMMUNOSUPPRESSIVE THERAPY. Yagi M; Sakamoto K; Hasebe K; Ito H; Onishi I; Tani T; Hashimoto T; Shimizu K; Miwa K;Department of Surgery II, School of Medicine, Kanazawa University, Japan.  Nutrition, 1997 Sep, 13:9, 778-82

3. BENEFICIAL EFFECTS OF L-ARGININE ON INTESTINAL EPITHELIAL RESTITUTION AFTER ISCHEMIC DAMAGE IN RATS. Raul F; Galluser M; Schleiffer R; Gosse F; Hasselmann M; Seiler N;  Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD), HÈopitaux Universitaires, Strasbourg, France.  Digestion, 1995, 56:5, 400-5

4. IMPACT OF ZINC SUPPLEMENTATION ON INTESTINAL PERMEABILITY IN BANGLADESHI CHILDREN WITH ACUTE DIARRHOEA AND PERSISTENT DIARRHOEA SYNDROME.  Roy SK; Behrens RH; Haider R; Akramuzzaman SM; Mahalanabis D; Wahed MA; Tomkins AM; Clinical Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.   J Pediatr Gastroenterol Nutr, 1992 Oct, 15:3, 289-96

5. TREATMENT OF CROHN’S DISEASE FISTULAS WITH COAGULATION FACTOR XIII [LETTER] Oshitani N; Nakamura S; Matsumoto T; Kobayashi K; Kitano A;  Lancet, 1996 Jan, 347:8994, 119-20    Abstract unavailable online.

6. FIBRINOLYTIC SPLIT PRODUCTS, FIBRINOLYSIS, AND FACTOR XIII ACTIVITY IN IBD
Van Bodegraven AA; Tuynman HA; Schoorl M; Kruishoop AM; Bartels PC; Dept. of Internal Medicine, Medical Centre Alkmaar, The Netherlands.  Scand J Gastroenterol, 1995 Jun, 30:6, 580-5