Best temperature for static liver graft storage is 1°C.

BACKGROUND: The best storage temperature in liver transplantation remains an unsolved question. METHODS: After storage for 24h in University of Wisconsin solution at +4°C, +1°C, or -0.5°C, rat livers were subjected, or not, to 15min of warm ischemia, rinsed with Ringer lactate, and subsequently reperfused with oxygenated Krebs-Henseleit buffer. RESULTS: In the presence of warm ischemia, for livers stored at +4°C, creatine kinase (CK) peaked at 21±5IUg(-1)h(-1), hepatic resistance at 34,700±1500dynscm(-5), bile flow reached 18±4µLg(-1)h(-1) after 10min, and oxygen consumption stabilized at about 25µmolg(-1)h(-1) after 20min. When livers were stored at +1°C, CK and hepatic resistance were lowered, bile production was 33±6µLg(-1)h(-1) (P<0.05 versus +4°C), and oxygen consumption was 105±10µmolg(-1)h(-1) (P<0.001). For livers stored at-0.5°C, results were not statistically different from those of the +1°C group except for bile flow, which was significantly lower. Without warm ischemia, the peak of CK (P=0.015) and the peak hepatic resistance (P<0.001) of the +4°C group were significantly increased compared with the +1°C or -0.5°C groups. However, no difference in bile flow or oxygen consumption was observed. The number of trypan blue-positive nonparenchymal cells (P=0.003) and the gain in liver weight during the reperfusion (P=0.015) were minimal after storage at +1°C. CONCLUSIONS: Static storage at +1°C improved liver function compared with +4°C or -0.5°C. Main beneficial effect was observed with parameters reflecting sinusoidal cells injury.

Endotoxemia affects citrulline, arginine and glutamine bioavailability.

BACKGROUND: Sepsis considerably alters the intestinal barrier functions, which in turn modify the absorption and bioavailability of nutrients. However, the effects of septic shock on aminoacid (AAs) bioavailability are poorly documented. The aim of this study was to compare the bioavailability of citrulline, arginine and glutamine during endotoxemia. MATERIALS AND METHODS: Thirty-six rats were randomised into two groups: control and lipopolysaccharides (LPS). The LPS group received an intraperitoneal injection of endotoxins (7·5 mg/kg). After 12 h, each group was again randomised into three subgroups, each of which received an oral bolus of citrulline, arginine or glutamine (5·7 mmol/kg). Blood samples were collected at various times from 0 to 600 min after AA administration. The concentrations of citrulline, arginine, glutamine and their metabolites arginine and ornithine were measured to determine pharmacokinetic parameters Area Under Curve (AUC), C(max) and T(max). RESULTS: The AUC values of citrulline decreased in LPS rats [citrulline, control: 761 ± 67 and LPS: 508 ± 72 µmol min/mL (P = 0·02)]. Maximum concentrations of citrulline were also significantly decreased by endotoxemia (P = 0·01). The pharmacokinetic parameters of arginine and glutamine were not significantly modified by endotoxemia. The AUC value of arginine from citrulline conversion was diminished in endotoxemic rats. The other pharmacokinetic parameters of arginine were not significantly modified after arginine or citrulline supply in either group (control or LPS). CONCLUSION: Endotoxemia affects the bioavailability of AAs differently according to the amino acid considered. This feature may be important for nutritional strategy in ICU patients.

Development of gastro intestinal sustained release tablet formulation containing acryl-EZE and pH-dependent swelling HPMC K 15 M.

BACKGROUND: The aim of this study was to evaluate physical properties and release from matrix tablets containing different ratios of HPMC 15 M and Acryl-EZE. A further aim is to assess their suitability for pH dependent controlled release. METHODS: Matrix tablets containing HPMC 15 M and Acryl-EZE were manufactured using a fluidized bed. The release from this matrix using Sodium Diclofenac (SD) as model drug is studied in two dissolution media (0.1 N HCl or pH = 6.8 phosphate buffer solution); the release rate, mechanism, and pH dependence were characterized by fitting four kinetic models and by using a similarity factor analysis. RESULTS: The obtained results revealed that the presence of Acryl-EZE in the matrix tablets is effective in protecting the dosage forms from release in acid environments such as gastric fluid. In pH = 6.8 phosphate buffer, the drug release rate and mechanism of release from all matrices is mainly controlled by HPMC 15 M. The model of Korsmeyer-Peppas was found to fit experimental dissolution results.

Altered HepG2 cell models using etomoxir versus tert-butylhydroperoxide.

Energetic failure which occurs in both ischemia/reperfusion and acute drug-induced hepatotoxicity is frequently associated with oxidative stress. This study displays the setting of a new cell culture model for hepatic energetic failure, i.e., HepG2 models modified by etomoxir [ETO] addition [0.1 mM to 1 mM] and compares the cell impact versus tert-butylhydroperoxide [TBOOH; 0.2 mM], an oxidative stress inducer. As it was observed with Minimum Essential Medium (MEM) without any interfering agent, decreasing temperature drastically lowered adenosine triphosphate (ATP) levels, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) viability test, and protein content, compared to 37 °C (p=0.02, p<0.001 and p<0.001, respectively), but to a larger extent in the presence of ETO or TBOOH. The alteration was generally highly dependent on the ETO concentration, time, and temperature. At 37 °C 24 h after (T24h), regarding ETO concentration, R² correlation ratio was 0.65 (p<0.001), 0.70 (p<0.001), and 0.89 (p<0.001) for ATP levels, protein content, and viability, respectively. The lowest ETO concentration producing a significant effect was 0.25 mM. Concerning time dependency (i.e., T24h versus after 5 h (T5h)), at 37 °C with ETO, ATP level continued to significantly decrease between T5h and T24h. In a similar way, at 37 °C, the MTT viability test decrease was accelerated only between T5h and T24h for ETO concentrations higher than 0.5 mM (p=0.016 and p=0.0001 for 0.75 and 1 mM, respectively). On the contrary, with TBOOH, comparing T24h versus T5h, cellular indicators were improved but generally remained lower than MEM without any interfering agent at T24h, suggesting that TBOOH action was time limited probably in relation with its oxidation in cell medium. This study confirms the interest of altered ETO cell model to screen agents (or formulation) prone to prevent or treat energetic depletion in relation with oxidative stress.

Freeze-drying of ATP entrapped in cationic, low lipid liposomes.

Concerning the instability of ATP liposomes formulated to easily diffuse through the liver (size approximately 100 nm), this work targets the key parameters that influence the freeze-drying of a preparation that combines cholesterol, DOTAP and phosphatidylcholine (either natural soybean or egg (SPC or EPC) or hydrogenated (HSPC)). After freeze-drying blank liposomes, size increased significantly when initial lipid concentration was lowered from 20 to 5mM (p=0.0018). With low lipid concentration preparation (5mM), SPC limited size increase (SI) more efficiently compared to EPC or HSPC. With SPC and EPC, sucrose showed better size results compared to trehalose (Lyoprotectant/Lipid ratio (w/w) avoiding any SI: approximately 5 and approximately 10 (for SPC), approximately 10 and approximately 15 (for EPC), for sucrose and trehalose, respectively), but the opposite was evidenced with HSPC liposomes where a Trehalose/Lipid ratio of 25 barely prevented SI. In addition, slow versus quick cooling rate led to limiting SI for HSPC liposomes (p=0.0035). With sucrose or trehalose at both Lyoprotectant/Lipid ratios ensuring size stabilisation (10:1 and 15:1, respectively), ATP leakage ranged between 38.8+/-7.9% and 58.2+/-1.4%. In conclusion, this study emphasizes that using strict size maintenance as the primary objective does not result in drug complete retention inside the liposome core.

Formulation and evaluation of ATP-containing liposomes including lactosylated ASGPr ligand.

An original ligand (Lac-10-Chol) designed to interact with asialoglycoprotein receptors to potentially target hepatocyte was synthesised by grafting a lactose head to a cholesteryl structure, which was then included in liposomes. Preliminary formulation tests led to the selection of conventional formulations based on soybean phosphatidylcholine/cholesterol/DOTAP (+/- DOPE) (+/- Lac-10-Chol) that present reproducible absolute entrapment value (1.45 +/- 0.10%), with a size of 109 +/- 7 nm and a slight positive charge (3.77 +/- 1.59 mV). Cell viability (via the MTT test), expressed as the percentage of nontreated cells in HepG2 cells, was very close to the control. Internalization tests evidenced an intracellular penetration of fluorescent liposomes, but no specific ligand effect was demonstrated (P > 0.05). Nevertheless, regarding the adenosine triphosphate (ATP) assay, a slight increase was obtained with liposome loaded with ATP incorporating Lac-10-chol after 24 hours (P < 0.05).

Effect of high calcium and phosphate concentrations on the physicochemical properties of two lipid emulsions used as total parenteral nutrition for neonates.

Premature infants require protein and energy for their growth and an adequate intake of calcium and phosphorus for their bone formation. However, several factors can affect the stability of intravenous lipid emulsions intended to be administered as neonatal total parenteral nutrition. This study evaluated the effect of additives and various concentrations of both calcium gluconate and glucose-1-phosphate on two intravenous lipid emulsions (Clinoleic 20% and Ivelip 20%) when using Primene 10% as source of amino acids and simulating clinical conditions (24-h storage at 37 degrees C). Two series of experiments for each lipid emulsion were carried out. One used separate ingredients (water, glucose, or amino acids) with various calcium phosphate concentrations; and the second included total parenteral nutrition admixtures with varied amino acid (1%, 2%, or 3.5%) and glucose (8% or 14%) concentrations. Evaluation was performed by visual and microscopic examination and pH, particle size, and zeta potential measurements. Calcium concentrations were determined before and after filtration by atomic absorption spectroscopy. Samples were stored 24 h at 37 degrees C. Investigations of lipid-nutrient admixtures showed a significant decrease of the pH with Primene and a visual instability when mixing with sterile water alone, while total parenteral nutrition admixtures made of Clinoleic 20% or Ivelip 20% were stable regarding pH, particle sizing, and zeta potential after storage conditions. Samples containing only calcium have their zeta potential charge reduced compared to samples containing both calcium and phosphate. Also, the evaluation of calcium phosphate solubility showed a significant decrease of the calcium concentration after filtration of the samples. Our data indicated that total parenteral nutrition admixtures could contribute to protect the lipid emulsion from its physicochemical degradation and that using organic phosphate with calcium gluconate has a less deleterious effect than using calcium alone with total parenteral nutrition. Also, the use of inline filters remains necessary for good protection from hazards of precipitates during the administration of total parenteral nutrition regimens.

Evidence for impairment of hepatic energy homeostasis in head-injured rat.

Traumatic brain injury (TBI) is known to induce a metabolic adaptation characterized by a nitrogen transfer from the periphery to the liver. However, the consequences of TBI on liver energy status are poorly documented. We evaluated the consequences of TBI on liver energy homeostasis in rats. In a first set of experiments, rats were randomized into two groups: a TBI group traumatized by fluid percussion, and an ad libitum fed group (AL) of healthy rats. The rats were sacrificed at 2, 3, or 4 days (D2, D3, and D4, respectively to determine the kinetic of hepatic energy changes). Since TBI leads to a profound anorexia, in a second set of experiments TBI rats received enteral nutrition (TBI-EN group) for 4 days to specifically assess the role of anorexia in the hepatic disturbances. TBI led to a decrease in hepatic glycogen (D2: TBI 3.9 +/- 1.9 vs. AL 18.9 +/- 2.6 mg/g, p < 0.05) and ATP (D2: TBI 540 +/- 57 vs. AL 850 +/- 44 nmol/g, p < 0.05) contents. These effects were not linked to anorexia, since they were observed when rats were fed using continuous enteral nutrition. Interestingly, there was no adaptation of the mitochondrial oxidative capacity to compensate for the increase in energy requirements (cytochrome C oxidase activity: AL, 82 +/- 5; TBI, 82 +/- 4; and TBI-EN, 87 +/- 3 micromol/min/g, NS). These findings demonstrate that TBI is responsible for an impairment of liver energy homeostasis. Moreover, these alterations are related neither to anorexia nor to decreased mitochondrial oxidative capacity.

Influence of pH conditions on the viability of Saccharomyces boulardii yeast.

Saccharomyces boulardii is a probiotic with proven health benefits. However its survival is challenged by gastrointestinal transit, and a ratio between 1 and 3% of living yeast is recovered in the feces after oral administration. The aim of the study was to determine to what extent the yeast was sensitive to gastrointestinal pH conditions. Therefore we explored the survival of different concentrations of S. boulardii in conditions mimicking the stomach pH (pH 1.1 0.1 N HCl) and the intestinal pH (pH 6.8 phosphate buffer) in vitro. The probiotic being commercialized as a freeze-dried powder obtained from an aqueous suspension, both forms were evaluated. In phosphate buffer pH 6.8, the viability remained stable for both forms of S. boulardii for 6 h. In HCl pH 1.1, viability of both forms (200 mg L(-1)) significantly decreased from 5 min. Observation under scanning/transmission electron microscopy showed morphological damages and rupture of the yeast wall. Threshold value from which S. boulardii viability was unaltered was pH 4. At the highest concentration of 200 g L(-1), the initial pH value of 1.1 rose to 3.2, exerting a protective effect. In conclusion, although the yeast in aqueous suspension was less sensitive than the freeze-dried yeast to acidic conditions, a gastric protection for improvement of oral bioavailability of viable S. boulardii appears necessary.

PEGylation of microspheres for therapeutic embolization: preparation, characterization and biological performance evaluation.

In this study, microspheres designed for embolization, defined as GF2000-Trisacryl MS (GF-MS) and DEAE-Trisacryl MS (DEAE-MS), were originally PEGylated using (3-amino propyl) triethoxy silane as coupling agent. Indomethacin was loaded into both PEGylated and non-PEGylated DEAE-MS, displaying ion-exchange ability, through a batch process with a respective capacity of 1.2 and 0.25 g/g. The morphology of naked and PEGylated MS was evaluated by scanning electron microscopy (SEM). Both micosphere resins surface looked like orange skin, although DEAE-MS showed a slightly rougher surface due to the copolymerization process. PEGylated microspheres have a most likely swelling surface owing to the presence of PEG hydrophilic chains. The mean diameters were of about 66 and 60 microm for GF-MS and DEAE-MS, respectively. Data obtained for PEGylated MS by Fourier Transform Infrared spectroscopy (FTIR) confirmed that microspheres were successfully PEGylated. Finally, complement activation in vitro was performed to evaluate the activating capacity of different microspheres. Both PEGylated GF-MS and DEAE-MS activated the complement system of about 33% less than their corresponding naked microspheres, while loading PEGylated DEAE-MS with indomethacin almost suppressed complement activation. This inhibiting role implies that PEGylation as well as loading the microspheres with anti-inflammatory drug has a compact effect on the interaction of microspheres with blood proteins.

Effect of an immune-enhancing diet on lymphocyte in head-injured rats: what is the role of arginine?

OBJECTIVE: The benefit of immune-enhancing diets (IEDs) in the intensive care unit remains controversial. Considering their complexity, the role of each component, in particular arginine (Arg), in their properties is largely unknown. The aim of this study was to determine the role of arginine in the immunomodulatory effects of an IED (Crucial) in head-injured rats. DESIGN: Thirty-four rats were randomized into five groups: AL (ad libitum), HI (head-injured), HI-STD (HI + standard enteral nutrition, EN), HI-STD-Arg (HI + standard EN + Arg in equimolar concentration to Arg in IED), and HI-IED (HI + IED). These isocaloric and isonitrogenous diets were administered over 4 days. After death, the thymus was removed and weighed. The density of CD25, CD4 and CD8 on lymphocytes from blood and from Peyer patches was evaluated. Mesenteric lymph nodes, liver and spleen were cultured for analysis of enterobacterial translocation and dissemination. MEASUREMENTS AND RESULTS: HI induced an atrophy of the thymus which was not corrected by the standard diet (HI 0.27 +/- 0.03, HI-STD 0.35 +/- 0.03 vs. AL 0.49 +/- 0.02 g; p < 0.05). However, the standard diet supplemented with arginine limited the thymic atrophy and the IED restored thymus weight. CD25 density and interleukin-2 production were increased only in the HI-STD-Arg and HI-IED groups (p < 0.05). Head injury induced enterobacterial translocation and dissemination which were blunted only in the HI-STD-Arg group (p < 0.05). CONCLUSIONS: In this rat HI model, arginine appears to be safe, contributes to a large extent to the immunomodulatory effects of the IED, and seems to limit enterobacterial translocation and dissemination more efficiently alone than in an IED.

Impairment of lymphocyte function in head-injured rats: effects of standard and immune-enhancing diets for enteral nutrition.

BACKGROUND: The metabolic response to head injury (HI) is characterized by a dysimmunity which may be a risk factor of a septic state. The use of immune enhancing diets (IEDs) could be a promising approach to improve immune functions. The aim of the study was to investigate the consequences of HI on lymphocyte function and to determine the effects of an enteral IED comparatively to a standard enteral nutrition. METHOD: A rat model of HI by fluid percussion was used. Twenty-five male Sprague-Dawley rats were randomized into 4 groups: rats receiving standard chow diet ad libitum (AL), rats sustaining HI and receiving standard chow diet and enteral saline (HI), rats receiving the enteral standard diet Sondalis HP (HIS), and rats receiving the IED Crucial (HIC). The two enteral diets were infused continuously during 4 days after the HI and were isocaloric, isonitrogenous and isovolumic. RESULTS: HI induced a thymus atrophy (HI vs. AL, P<0.05), and an impairment in lymphocyte CD25 receptor density responsiveness to stimulation. The IED blunted thymus atrophy and allowed to preserve the stimulation of blood and Peyer patches lymphocytes (HIC: Stimulated vs. Basal, P<0.05). CONCLUSION: IED seems more adapted for preserving lymphocyte function than standard diet in HI patients.

Arginine-enriched diet limits plasma and muscle glutamine depletion in head-injured rats.

OBJECTIVE: Injury is associated with a depletion in glutamine (GLN) pools, which may contribute to impairment of immune and nutritional statuses. Total parenteral nutrition enriched with arginine (ARG) is able to generate GLN in surgical patients. We hypothesized that this same concept may be applicable to enteral administration and could be extended to muscle GLN reserves. This study investigated the ability of an enteral formula enriched with ARG to restore the GLN pools in an experimental model of head injury. METHODS: Twenty-five male Sprague-Dawley rats were randomized into 4 groups: ad libitum access to food, head injury plus free access to nutrition, head injury plus standard enteral nutrition (Sondalis), and an immune-enhancing diet (IED). The two enteral diets were adjusted to be isocaloric (290 kcal.kg(-1).d(-1)) and isonitrogenous (3.29 g.kg(-1).d(-1)) and were delivered for 4 d (24 h/24 h). After sacrifice, plasma and muscle amino acids were determined. RESULTS: Head injury was associated with a large depletion of muscle and plasma GLN pools that were restored by IED administration but not by the standard diet. Moreover, the IED but not the standard diet improved or normalized ornithine and glutamate pools, suggesting that the modification of GLN pools is related to ARG administration. CONCLUSION: In our model of head injury, our IED, a diet without free GLN, is efficient in restoring the plasma and muscle pools of GLN, probably due to its high ARG content.

[Calcium and phosphates compatibilities in parenteral nutrition admixtures]. / Compatibilité et stabilité phosphocalcique dans les mélanges pour nutrition parentérale.

Parenteral nutrition is actually a known method of administration of nutriments but not without risk. During the compounding of parenteral nutrition (PN) mixtures, the most pharmaceutical problem is the addition of calcium and phosphates. Since this two minerals can form insoluble precipitate that will lead to catheter occlusions and/or pulmonary emboli. Several reports has been related about suspect deaths following a PN infusion contaminated by precipitates or particles, this situation led the Food and Drug Administration (FDA) to recommend the use of filters. The precipitation of calcium phosphate is not easily predictable when the concentrations of these two salts are high and this situation constitute one of the major danger that can destabilise the parenteral nutrition admixture. Although such events still appear to be rare, it should be possible to eliminate them with improved pharmaceutical practice.

Adsorption of an ionizable drug onto microspheres: experimental and modeling studies.

The purpose of this work was to study the in vitro equilibria and the adsorption kinetics of an ionizable drug, indomethacin, onto commercially available cationic polymeric microspheres: DEAE Trisacryl LS and QA Trisacryl LS. Isotherms were fitted to theoretical equations allowing accurate predictions of drug loading at different salt concentrations. Isotherm measurements were quickly obtained by simple column breakthrough experiments. The nature of the ion exchange group of the microspheres was observed to be preponderant for adsorption, as the tertiary amine derivative exhibited 53% more capacity than its quaternary amine counterpart. The maximum equilibrium uptake capacity in a 5 mM Tris-HCl buffer at pH 7.4 is 303 mmol/ml of particle volume, for DEAE microspheres. Transport properties of indomethacin into the tertiary amine microspheres were obtained in agitated contactor. Microbeads loading was completed in a 1-6 min range and was found to be controlled by pore diffusion mechanism. Equilibrium uptake data was fitted to the Langmuir and the mass action law models. Adsorption kinetics were fitted to a pore diffusion model. Good correlation was obtained between the theoretical models and the experimental data. The methodology outlined in this work provided a simple approach of estimating adsorption behavior of drugs onto ion-exchange macroporous microspheres. Although significant indomethacin loading was obtained onto the DEAE microspheres, the rapid rate of diffusion is not compatible with sustained release properties sought for this type of microspheres.

Resveratrol self-emulsifying system increases the uptake by endothelial cells and improves protection against oxidative stress-mediated death.

The aim of the present study was to develop and characterize a resveratrol self-emulsifying drug delivery system (Res-SEDDS), and to compare the uptake of resveratrol by bovine aortic endothelial cells (BAECs), and the protection of these cells against hydrogen peroxide-mediated cell death, versus a control resveratrol ethanolic solution. Three Res-SEDDSs were prepared and evaluated. The in vitro self-emulsification properties of these formulations, the droplet size and the zeta potential of the nanoemulsions formed on adding them to water under mild agitation conditions were studied, together with their toxicity on BAECs. An optimal atoxic formulation (20% Miglyol® 812, 70% Montanox® 80, 10% ethanol 96% v/v) was selected and further studied. Pre-incubation of BAECs for 180 min with 25 µM resveratrol in the nanoemulsion obtained from the selected SEDDS significantly increased the membrane and intracellular concentrations of resveratrol (for example, 0.076±0.015 vs. ethanolic solution 0.041±0.016 nmol/mg of protein after 60 min incubation, p<0.05). Resveratrol intracellular localization was confirmed by fluorescence confocal microscopy. Resveratrol nanoemulsion significantly improved the endothelial cell protection from H2O2-induced injury (750, 1000 and 1500 µM H2O2) in comparison with incubation with the control resveratrol ethanolic solution (for example, 55±6% vs. 38±5% viability after 1500 µM H2O2 challenge, p<0.05). In conclusion, formulation of resveratrol as a SEDDS significantly improved its cellular uptake and potentiated its antioxidant properties on BAECs.

Citrulline: from metabolism to therapeutic use.

Citrulline possesses a highly specific metabolism that bypasses splanchnic extraction because it is not used by the intestine or taken up by the liver. The administration of citrulline may be used to deliver available nitrogen for protein homeostasis in peripheral tissues and as an arginine precursor synthesized de novo in the kidneys and endothelial and immune cells. Fresh research has shown that citrulline is efficiently transported across the intestinal luminal membrane by a set of transporters belonging to the B°,⁺, L, and b°,⁺ systems. Several pharmacokinetic studies have confirmed that citrulline is efficiently absorbed when administered orally. Oral citrulline could be used to deliver arginine to the systemic circulation or as a protein anabolic agent in specific clinical situations, because recent data have suggested that citrulline, although not a component of proteins, stimulates protein synthesis in skeletal muscle through the mammalian target of rapamycin signaling pathway. Hence, citrulline could play a pivotal role in maintaining protein homeostasis and is a promising pharmaconutrient in nutritional support strategies for malnourished patients, especially in aging and sarcopenia.

High plasma citrulline and arginine levels ensured by sustained-release citrulline supplementation in rats.

OBJECTIVE: Dietary-supplemented arginine has been shown to have positive effects on cardiovascular disease, but several drawbacks exist and could potentially be avoided by using L-citrulline, since it is recycled to L-arginine. However, citrulline is very rapidly metabolized. We therefore developed a sustained-release form of citrulline and evaluated its metabolic behavior in rats. METHODS: Male Sprague Dawley rats were divided into three groups: receiving "empty microcapsule" (control group), 1 g/kg/d immediate-release citrulline (IR citrulline group), or 1 g/kg/d sustained-release citrulline (SR citrulline group). Citrulline was given each day at 9 a.m. after blood samples for 9 d, and on day 10, blood samples were drawn every 4 h to study the decrease in plasma amino acid concentrations. RESULTS: SR citrulline led to a sustained increase in citrullinemia and argininemia compared to IR citrulline, and on day 6 argininemia was significantly (P < 0.01) higher with SR compared to IR citrulline. Moreover, argininemia was significantly higher in the SR citrulline group than in controls throughout the study and SR citrulline maintained high argininemia and citrullinemia, at least over 12 h. CONCLUSION: This experimental study provides a strong rationale for using this new formulation for atherosclerosis treatment.

Consequences of head injury and static cold storage on hepatic function: ex vivo experiments using a model of isolated perfused rat liver.

The purpose of the study was to evaluate the effect of head injury (HI) on the metabolic and energy functions of the liver and its consequences after cold storage. In male SD rats with HI, livers were isolated 4 days after injury and perfused either immediately (HI) or after 24 hours of cold preservation. Livers isolated from healthy rats were treated identically. The hepatic functions were explored with an isolated perfused liver model. Head injury induced a liver atrophy without significant difference in the intrahepatic energy level versus healthy rats. After cold storage, hepatic adenosine triphosphate and glycogen contents in HI rats were similar to those of healthy rats. The livers of the HI group that underwent cold preservation had a lower protein catabolism. The portal flow rate at the time of reperfusion was significantly increased in the HI group. In conclusion, static cold storage of livers harvested from HI rats revealed a net protein catabolism reduction and a modification of hepatic microcirculation.

Metabolic response and nutritional support in traumatic brain injury: evidence for resistance to renutrition.

Abstract Traumatic brain injury (TBI) is one of the most severe injuries encountered in intensive care units. TBI patients exhibit protein wasting and gastrointestinal dysfunction, which may be risk factors for a septic state. Specific nutritional support may be required for these patients, and we hypothesize that standard nutritional support does not allow restoration of the nutritional state of TBI patients. A well-validated rat model of TBI by fluid percussion was used. Rats were randomized into three groups: healthy rats receiving standard chow diet ad libitum (AL), rats sustaining TBI and receiving standard chow diet (TBI), and rats sustaining TBI and receiving a standard enteral diet (TBI-EN) for 4 days. TBI in rats was characterized by anorexia, body weight loss (AL: +15 +/- 5 g versus TBI: -11 +/- 4 g and TBI-EN: -8 +/- 4 g; p < 0.05), decrease in nitrogen balance (AL: 2.9 +/- 0.2 g versus TBI: 1.0 +/- 0.2 g and TBI-EN: 0.2 +/- 0.2 g, p < 0.05) associated with decrease in muscular protein content (extensor digitorum longus [EDL]: AL: 36 +/- 2 mg versus TBI: 26 +/- 3 mg and TBI-EN: 28 +/- 2 mg; p < 0.05), and intestinal atrophy (ileum: AL: 673 +/- 42 mg versus TBI: 442 +/- 23 mg and TBI-EN: 377 +/- 27 mg; p < 0.05). Interestingly, standard enteral nutrition was not effective in restoring any of these parameters. This work confirms that TBI is associated with profound nutritional alterations and has a major impact on nitrogen metabolism and on intestinal trophicity. It also demonstrates that using standard enteral nutrition cannot reverse this phenomenon. Thus, developing new nutritional strategies to cover TBI patients' specific nutritional requirements appears mandatory.