Examining Special Nutritional Requirements in Disease States Proceedings of a Workshop (2018) / Chapter Skim
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4 Disease-Induced Deficiency and Conditionally Essential Nutrients in Disease
4 Disease-Induced Deficiency and Conditionally Essential Nutrients in Disease
Pages 63-76
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From page 63... ...
The session closed with a moderated panel discussion and question and answer session with workshop participants. ARGININE AS AN EXAMPLE OF A CONDITIONALLY ESSENTIAL NUTRIENT: SICKLE CELL ANEMIA AND SURGERY1 Morris began her remarks by defining conditionally essential amino acids as amino acids that become indispensable under stress and critical illness when the capacity of endogenous synthesis is surpassed.
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From page 64... ...
Ornithine and arginine use the same amino acid transporter, CAT-1 and CAT-2, so when ornithine levels rise, cellular uptake of arginine is inhibited, depending on how high the ornithine levels are. This could ultimately translate to decreased arginine and nitric oxide bioavailability.
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compete for rginine, their common substrate. a In sickle cell disease and trauma, bioavailability of arginine and nitric oxide (NO)
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This construct takes into account the impact of arginase, the impact on elevated ornithine levels and intracellular transport, and the effects of renal dysfunction as well as plasma arginine levels. Sickle Cell Disease Sickle cell disease is an autosomal recessive disease of the red blood cells that results in hemoglobin polymerization leading to a cascade of events that eventually cause decreased blood flow, tissue hypoxemia, and acute and chronic end organ damage in every organ system.
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From Mechanisms of vasculopathy in sickle cell disease and thalassemia, Morris, C
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Patients with sickle cell disease, for example, have a multitude of nutritional deficiencies that all must be addressed.
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Scrimgeour stated that his group has measured blood glucose in animal models with blast injuries compared to con 2 This section summarizes information presented by Angus Scrimgeour.
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To date, no human studies have been done since the 2011 report was published, although preclinical studies have shown that after an initial period of total parenteral nutrition, zinc supplementation increases visceral pro tein mass in post-TBI patients (Cope et al., 2012)
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. Disease Relationships with Vitamin B6 Since the mid- to late 1990s, a number of published papers have shown a relationship between low plasma PLP and risk of vascular disease, which includes heart disease, risk of death from heart disease, stroke, and venous thrombosis (e.g., Rimm et al., 1998)
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The ratios of tryptophan catabolites do seem like an encouraging approach to developing a biomarker that is less sensitive to inflammation, but validation in terms of cutoffs, adequacy, and deficiency is needed. MODERATED PANEL DISCUSSION AND Q&A In response to a question related to L-arginine and wound healing, Morris replied that in adults, decreased mortality and morbidity are seen in some cohorts of patients who were fed arginine-fortified formulas.
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She added that she has some pharmacokinetics data showing that a single dose of oral glutamine results in a significant increase in arginine bioavailability in patients with sickle cell disease. That suggests, she said, that glutamine does convert to arginine in sickle cell disease, which will ultimately improve arginine bioavailability both in plasma and within the red blood cell.
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For example, he said a Walter Reed lab has had very good success in drug studies repairing cognitive deficits as well as biochemical repair in the rat model, but it has not been possible to translate any of these findings into humans. It was noted that the same is true for IBD, in that animal models of IBD have terrible prognostic markers of therapeutics in human biology.
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2014. Resveratrol protects astrocytes against traumatic brain injury through inhibiting apoptotic and autophagic cell death.
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2015. Progesterone and vitamin D combination therapy modulates inflammatory response after traumatic brain injury.
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