Citrulline levels following proximal versus distal small bowel resection

Ivan M. Gutierrez, Jeremy G. Fisher, Offir Ben-Ishay, Brian A Jones, Kuang Horng Kang, Melissa A. Hull, Nick Shillingford, David Zurakowski, Biren P. Modi, Tom Jaksic

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose Citrulline, a nonprotein amino acid synthesized by enterocytes, is a biomarker of bowel length and the capacity to wean from parenteral nutrition. However, the potentially variant effect of jejunal versus ileal excision on plasma citrulline concentration [CIT] has not been studied. This investigation compared serial serum [CIT] and mucosal adaptive potential after proximal versus distal small bowel resection. Methods Enterally fed Sprague-Dawley rats underwent sham operation or 50% small bowel resection, either proximal (PR) or distal (DR). [CIT] was measured at operation and weekly for 8 weeks. At necropsy, histologic features reflecting bowel adaptation were evaluated. Results By weeks 6-7, [CIT] in both resection groups significantly decreased from baseline (P < 0.05) and was significantly lower than the concentration in sham animals (P < 0.05). There was no difference in [CIT] between PR and DR at any point. Villus height and crypt density were higher in the PR than in the DR group (P ≤ 0.02). Conclusion [CIT] effectively differentiates animals undergoing major bowel resection from those with preserved intestinal length. The region of intestinal resection was not a determinant of [CIT]. The remaining bowel in the PR group demonstrated greater adaptive potential histologically. [CIT] is a robust biomarker for intestinal length, irrespective of location of small intestine lost.

Original languageEnglish (US)
Pages (from-to)741-744
Number of pages4
JournalJournal of pediatric surgery
Volume49
Issue number5
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Citrulline
Biomarkers
Enterocytes
Parenteral Nutrition
Small Intestine
Sprague Dawley Rats
Amino Acids

Keywords

  • Biological markers
  • Citrulline
  • Intestinal adaptation
  • Intestinal failure
  • Short bowel syndrome

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Gutierrez, I. M., Fisher, J. G., Ben-Ishay, O., Jones, B. A., Kang, K. H., Hull, M. A., ... Jaksic, T. (2014). Citrulline levels following proximal versus distal small bowel resection. Journal of pediatric surgery, 49(5), 741-744. https://doi.org/10.1016/j.jpedsurg.2014.02.056

Citrulline levels following proximal versus distal small bowel resection. / Gutierrez, Ivan M.; Fisher, Jeremy G.; Ben-Ishay, Offir; Jones, Brian A; Kang, Kuang Horng; Hull, Melissa A.; Shillingford, Nick; Zurakowski, David; Modi, Biren P.; Jaksic, Tom.

In: Journal of pediatric surgery, Vol. 49, No. 5, 01.01.2014, p. 741-744.

Research output: Contribution to journalArticle

Gutierrez, IM, Fisher, JG, Ben-Ishay, O, Jones, BA, Kang, KH, Hull, MA, Shillingford, N, Zurakowski, D, Modi, BP & Jaksic, T 2014, 'Citrulline levels following proximal versus distal small bowel resection', Journal of pediatric surgery, vol. 49, no. 5, pp. 741-744. https://doi.org/10.1016/j.jpedsurg.2014.02.056
Gutierrez, Ivan M. ; Fisher, Jeremy G. ; Ben-Ishay, Offir ; Jones, Brian A ; Kang, Kuang Horng ; Hull, Melissa A. ; Shillingford, Nick ; Zurakowski, David ; Modi, Biren P. ; Jaksic, Tom. / Citrulline levels following proximal versus distal small bowel resection. In: Journal of pediatric surgery. 2014 ; Vol. 49, No. 5. pp. 741-744.
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AU - Kang, Kuang Horng

AU - Hull, Melissa A.

AU - Shillingford, Nick

AU - Zurakowski, David

AU - Modi, Biren P.

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