Intervention and Mechanisms of Alanyl-glutamine for Inflammation, Nutrition, and Enteropathy : A Randomized Controlled Trial
OBJECTIVE: Determine the minimum dosage of alanyl-glutamine (Ala-Gln) required to improve gut integrity and growth in children at risk of environmental enteropathy (EE).
METHODS: This was a double-blinded randomized placebo-controlled dose-response trial. We enrolled 140 children residing in a low-income community in Fortaleza, Brazil. Participants were 2 to 60 months old and had weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) z-scores less than -1. We randomized children to 10 days of nutritional supplementation: Ala-Gln at 3 g/day, Ala-Gln at 6 g/day, Ala-Gln at 12 g/day, or an isonitrogenous dose of glycine (Gly) placebo at 12.5 g/day. Our primary outcome was urinary lactulose-mannitol excretion testing. Secondary outcomes were anthropometry, fecal markers of inflammation, urine metabolic profiles, and malabsorption (spot fecal energy).
RESULTS: Of 140 children, 103 completed 120 days of follow-up (24% dropout). In the group receiving the highest dose of Ala-Gln, we detected a modest improvement in urinary lactulose excretion from 0.19% on day 1 to 0.17% on day 10 (P = 0.05). We observed significant but transient improvements in WHZ at day 10 in 2 Ala-Gln groups, and in WHZ and WAZ in all Ala-Gln groups at day 30. We detected no effects on fecal inflammatory markers, diarrheal morbidity, or urine metabolic profiles; but did observe modest reductions in fecal energy and fecal lactoferrin in participants receiving Ala-Gln.
CONCLUSIONS: Intermediate dose Ala-Gln promotes short-term improvement in gut integrity and ponderal growth in children at risk of EE. Lower doses produced improvements in ponderal growth in the absence of enhanced gut integrity.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:71 |
|---|---|
| Enthalten in: |
Journal of pediatric gastroenterology and nutrition - 71(2020), 3 vom: 01. Sept., Seite 393-400 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Moore, Sean R [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
0RH81L854J |
|---|
| Anmerkungen: |
Date Completed 18.06.2021 Date Revised 10.11.2021 published: Print ClinicalTrials.gov: NCT01832636 Citation Status MEDLINE |
|---|
| doi: |
10.1097/MPG.0000000000002834 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM314003754 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM314003754 | ||
| 003 | DE-627 | ||
| 005 | 20231225151807.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/MPG.0000000000002834 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1046.xml |
| 035 | |a (DE-627)NLM314003754 | ||
| 035 | |a (NLM)32826717 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Moore, Sean R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Intervention and Mechanisms of Alanyl-glutamine for Inflammation, Nutrition, and Enteropathy |b A Randomized Controlled Trial |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 18.06.2021 | ||
| 500 | |a Date Revised 10.11.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a ClinicalTrials.gov: NCT01832636 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Determine the minimum dosage of alanyl-glutamine (Ala-Gln) required to improve gut integrity and growth in children at risk of environmental enteropathy (EE) | ||
| 520 | |a METHODS: This was a double-blinded randomized placebo-controlled dose-response trial. We enrolled 140 children residing in a low-income community in Fortaleza, Brazil. Participants were 2 to 60 months old and had weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) z-scores less than -1. We randomized children to 10 days of nutritional supplementation: Ala-Gln at 3 g/day, Ala-Gln at 6 g/day, Ala-Gln at 12 g/day, or an isonitrogenous dose of glycine (Gly) placebo at 12.5 g/day. Our primary outcome was urinary lactulose-mannitol excretion testing. Secondary outcomes were anthropometry, fecal markers of inflammation, urine metabolic profiles, and malabsorption (spot fecal energy) | ||
| 520 | |a RESULTS: Of 140 children, 103 completed 120 days of follow-up (24% dropout). In the group receiving the highest dose of Ala-Gln, we detected a modest improvement in urinary lactulose excretion from 0.19% on day 1 to 0.17% on day 10 (P = 0.05). We observed significant but transient improvements in WHZ at day 10 in 2 Ala-Gln groups, and in WHZ and WAZ in all Ala-Gln groups at day 30. We detected no effects on fecal inflammatory markers, diarrheal morbidity, or urine metabolic profiles; but did observe modest reductions in fecal energy and fecal lactoferrin in participants receiving Ala-Gln | ||
| 520 | |a CONCLUSIONS: Intermediate dose Ala-Gln promotes short-term improvement in gut integrity and ponderal growth in children at risk of EE. Lower doses produced improvements in ponderal growth in the absence of enhanced gut integrity | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Dipeptides |2 NLM | |
| 650 | 7 | |a Glutamine |2 NLM | |
| 650 | 7 | |a 0RH81L854J |2 NLM | |
| 650 | 7 | |a alanylglutamine |2 NLM | |
| 650 | 7 | |a U5JDO2770Z |2 NLM | |
| 700 | 1 | |a Quinn, Laura A |e verfasserin |4 aut | |
| 700 | 1 | |a Maier, Elizabeth A |e verfasserin |4 aut | |
| 700 | 1 | |a Guedes, Marjorie M |e verfasserin |4 aut | |
| 700 | 1 | |a Quetz, Josiane S |e verfasserin |4 aut | |
| 700 | 1 | |a Perry, Madeline |e verfasserin |4 aut | |
| 700 | 1 | |a Ramprasad, Chethan |e verfasserin |4 aut | |
| 700 | 1 | |a Lanzarini Lopes, Gabriela M L |e verfasserin |4 aut | |
| 700 | 1 | |a Mayneris-Perxachs, Jordi |e verfasserin |4 aut | |
| 700 | 1 | |a Swann, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Soares, Alberto M |e verfasserin |4 aut | |
| 700 | 1 | |a Filho, José Q |e verfasserin |4 aut | |
| 700 | 1 | |a Junior, Francisco S |e verfasserin |4 aut | |
| 700 | 1 | |a Havt, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Lima, Noelia L |e verfasserin |4 aut | |
| 700 | 1 | |a Guerrant, Richard L |e verfasserin |4 aut | |
| 700 | 1 | |a Lima, Aldo A M |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of pediatric gastroenterology and nutrition |d 1982 |g 71(2020), 3 vom: 01. Sept., Seite 393-400 |w (DE-627)NLM012621927 |x 1536-4801 |7 nnns |
| 773 | 1 | 8 | |g volume:71 |g year:2020 |g number:3 |g day:01 |g month:09 |g pages:393-400 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/MPG.0000000000002834 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 71 |j 2020 |e 3 |b 01 |c 09 |h 393-400 | ||