Intervention and mechanisms of alanyl-glutamine for inflammation, nutrition, and enteropathy: a randomized controlled trial
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.
393-400
Moore, Sean R.
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Quinn, Laura A.
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Maier, Elizabeth A.
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Guedes, Marjorie M.
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Quetz, Josiane S.
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Perry, Madeline
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Ramprasad, Chethan
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Lopes, Gabriela M.L. Lanzarini
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Mayneris-Perxachs, Jordi
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Swann, Jonathan
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Soares, Alberto M.
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Filho, José Q.
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Junior, Francisco S.
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Havt, Alexandre
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Lima, Noelia L.
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Guerrant, Richard L.
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Lima, Aldo A.M.
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1 September 2020
Moore, Sean R.
2336a178-2f26-416b-841b-b0b52e7da693
Quinn, Laura A.
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Maier, Elizabeth A.
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Guedes, Marjorie M.
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Quetz, Josiane S.
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Perry, Madeline
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Ramprasad, Chethan
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Lopes, Gabriela M.L. Lanzarini
b61b154a-6371-485c-bada-6c2789e61b5a
Mayneris-Perxachs, Jordi
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Swann, Jonathan
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Soares, Alberto M.
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Filho, José Q.
41223c6f-e980-4283-a2ae-5316759c5de1
Junior, Francisco S.
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Havt, Alexandre
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Lima, Noelia L.
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Guerrant, Richard L.
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Lima, Aldo A.M.
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Moore, Sean R., Quinn, Laura A., Maier, Elizabeth A., Guedes, Marjorie M., Quetz, Josiane S., Perry, Madeline, Ramprasad, Chethan, Lopes, Gabriela M.L. Lanzarini, Mayneris-Perxachs, Jordi, Swann, Jonathan, Soares, Alberto M., Filho, José Q., Junior, Francisco S., Havt, Alexandre, Lima, Noelia L., Guerrant, Richard L. and Lima, Aldo A.M.
(2020)
Intervention and mechanisms of alanyl-glutamine for inflammation, nutrition, and enteropathy: a randomized controlled trial.
Journal of Pediatric Gastroenterology and Nutrition, 71 (3), .
(doi:10.1097/MPG.0000000000002834).
Abstract
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.
Text
Intervention and Mechanisms of Alanyl glutamine.20
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Accepted/In Press date: 19 May 2020
e-pub ahead of print date: 8 July 2020
Published date: 1 September 2020
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Local EPrints ID: 442814
URI: http://eprints.soton.ac.uk/id/eprint/442814
ISSN: 0277-2116
PURE UUID: 63501582-22aa-419c-ae1b-fe218c07ca68
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Date deposited: 28 Jul 2020 16:31
Last modified: 17 Mar 2024 04:00
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Contributors
Author:
Sean R. Moore
Author:
Laura A. Quinn
Author:
Elizabeth A. Maier
Author:
Marjorie M. Guedes
Author:
Josiane S. Quetz
Author:
Madeline Perry
Author:
Chethan Ramprasad
Author:
Gabriela M.L. Lanzarini Lopes
Author:
Jordi Mayneris-Perxachs
Author:
Alberto M. Soares
Author:
José Q. Filho
Author:
Francisco S. Junior
Author:
Alexandre Havt
Author:
Noelia L. Lima
Author:
Richard L. Guerrant
Author:
Aldo A.M. Lima
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