Metabolic and Clinical Effects of the Supplementation of a Functional Mixture of Amino Acids in Cerebral Hemorrhage

Laviano, Alessandro; Aghilone, Flavia; Colagiovanni, Donato; Fiandra, Federica; Giambarresi, Roberta; Tordiglione, Paolo; Molfino, Alessio; Muscaritoli, Maurizio; Rosa, Giovanni; Fanelli, Filippo Rossi

doi:10.1007/s12028-010-9461-z

Cited by 11 publications

(7 citation statements)

References 26 publications

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“…The decrease in blood white cell count was greater in treated patients (–18%) than in the placebo recipients (–4.4%). The improvement in lymphocyte counts found in this study is in line with that observed in a recent investigation carried out in individuals in an ICU treated with the same formula, at the same dose as that used in the current study 45 …”

Section: Methodssupporting

confidence: 92%

Supplementation of Essential Amino Acids May Reduce the Occurrence of Infections in Rehabilitation Patients With Brain Injury

et al. 2012

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Section: Methodssupporting

confidence: 92%

Supplementation of Essential Amino Acids May Reduce the Occurrence of Infections in Rehabilitation Patients With Brain Injury

et al. 2012

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“…The CATHON formulation does not contain arginine and yet proved to be extremely efficient in promoting improved physical activity both in diabetic patients with chronic heart failure [41] and patients with chronic obstructive pulmonary disease, where an impressive improvement in blood PO 2 was documented [42]. Interestingly, a ‘side effect’ of CATHON administration is improved insulin sensitivity, as shown by long-term supplementation studies in the elderly [43] and, more recently, in extremely severe intensive care unit patients [44]. CATHON enhances insulin action thanks to enhanced mTOR activity [45], with important clinical implications [22].…”

Section: Interactions Between Inos and Enos And Control Of Enos Exprementioning

confidence: 99%

To Give or Not to Give? Lessons from the Arginine Paradox

Dioguardi¹

2011

Lifestyle Genomics

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Arginine is one of the 20 amino acids (AA) found in proteins and synthesized by human cells. However, arginine is also the substrate for a series of reactions leading to the synthesis of other AA and is an obligatory substrate for two enzymes with diverging actions, arginases and nitric oxide synthases (NOS), giving origin to urea and NO, respectively. NO is a very potent vasodilator when produced by endothelial NOS (eNOS). The ‘arginine paradox’ is the fact that, despite intracellular physiological concentration of arginine being several hundred micromoles per liter, far exceeding the ∼5 µM K_M of eNOS, the acute provision of exogenous arginine still increases NO production. Clinically, an additional paradox is that the largest controlled study on chronic oral arginine supplementation in patients after myocardial infarction had to be interrupted for excess mortality in treated patients. Expression and activity of arginases, which produce urea and divert arginine from NOS, are positively related to exogenous arginine supplementation. Therefore, the more arginine is introduced, the more it is destroyed, eventually leading to impaired NO production. In this review, conditions influencing the low arginine concentrations found in plasma will be reviewed, revising the paradigm that simple replenishment of what is lacking will always produce beneficial consequences.

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“…In patients with chronic kidney disease, EAA supplementation proved to be more effective than ovalbumin‐similar formulations in promoting synthesis of visceral proteins without altering urea production . Similar findings were observed in diabetic patients affected by chronic heart failure , , and in intensive care unit patients after neurosurgery . Therefore, we should always ask ourselves, if increases in urea excretion are a sign of an ameliorated nitrogen balance, or if such increases simply mirror an inadequate EAA availability as part of excessive non‐essential AA supply, i.e., the failure of supply to match requirements and needs.…”

Section: The Knot Of Calculating Nitrogen Needs By Urea Synthesismentioning

confidence: 71%

Clinical use of amino acids as dietary supplement: pros and cons

Dioguardi

2011

J Cachexia Sarcopenia Muscle

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Nitrogen supply is pivotal for the maintenance of life. Amino acids can be utilized to synthesize both glucose and lipids. The opposite, i.e., production of amino acids from either one of them, is not possible in the absence of other amino acids as donors of nitrogen. The quality of amino acid content in protein has been re-evaluated recently, and the relevance of essential amino acids has been repeatedly underlined. Essential amino acid requirements in different mammals are not identical, and ratios among them should be taken into account when projecting an efficient formulation. Recent research has demonstrated that genes respond to different qualities and quantities of nutritional supply, and increased provision of essential amino acids increases lifespan in animal experiments through mitochondriogenesis and maintenance of elevated rates of synthesis of anti-oxidant molecules. Moreover, genetic expression of key controllers of synthesis, like mTOR, may be particularly important for understanding skeletal muscle maintenance. Losses of muscle mass and impaired immune function are related to reduced protein supply, and there is increasing evidence that regular essential amino acid intake as part of an oral diet is effective in reversing muscle catabolism, promoting muscle anabolism, and restoring immunological function. Therefore, the use of amino acids as supplements to diet would be expanding in the near future. Is this safe? Few data are available on amino acid toxicity, and only one essential amino acid may be considered to have clinically relevant toxicity: methionine, because it is transformed into a toxic intermediate, homocysteine, when cysteine synthesis is required by metabolic needs. Matching of stoichiometric ratios between methionine and cysteine may solve the problem of supplying sufficient amounts of sulfur to the body. Arginine and glutamine are two non-essential amino acids than can become “conditionally essential” because of elevated needs during pathological conditions, and metabolism may not be able to maintain their concentrations at sufficient levels to match metabolic requirements. Chronic exogenous arginine supplementation has not proven to exert positive clinical effects in different trials, and sequential articulation of the knowledge of introduction of arginine-driven transcriptional, translational, and epigenetic adaptations may give us a key for interpreting those puzzling results.

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Metabolic and Clinical Effects of the Supplementation of a Functional Mixture of Amino Acids in Cerebral Hemorrhage

Abstract: Supplementation with specific amino acids in critically ill patients may modulate metabolic response and improve clinical outcome.

Cited by 11 publications

References 26 publications

Supplementation of Essential Amino Acids May Reduce the Occurrence of Infections in Rehabilitation Patients With Brain Injury

Supplementation of Essential Amino Acids May Reduce the Occurrence of Infections in Rehabilitation Patients With Brain Injury

To Give or Not to Give? Lessons from the Arginine Paradox

Clinical use of amino acids as dietary supplement: pros and cons

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