REDUCED INTESTINAL-ABSORPTION OF ARGININE DURING SEPSIS

Objective: To investigate the effect of sepsis on the intestinal absor ption of arginine. Design: Controlled, nonintervention study. Setting: Surgical research laboratories of Sinai Hospital of Baltimore, Subjec ts: Male Sprague-Dawley rats. Interventions: Experimental sepsis induc ed by cecal ligation and puncture or intraperitoneal injection of lipo polysaccharide. Measurements and Main Results: Sepsis assessed by peri toneal and blood cultures. Intestinal absorption estimated by measurin g the transfer of H-3-arginine by everted jejunal sacs prepared from s eptic and control animals (n = 6 per group) at multiple time points af ter the induction of sepsis (6, 12, 24, 48, and 72 hrs after cecal lig ation and puncture; 6 and 12 hrs after intraperitoneal injection of li popolysaccharide), Induction of peritonitis in the rat by cecal ligati on and puncture significantly reduced the in vitro uptake of arginine by everted jejunal sacs at 12, 24, and 48 hrs after laparotomy, Argini ne transfer by everted jejunal sacs was also significantly reduced in rats as early as 6 hrs after intraperitoneal injection of endotoxin (e ndotoxin 273 +/- 14; saline 377 +/- 14 nmol/sac/hr). Data are expresse d as mean +/- SEM, Recovery from sepsis was associated with normalizat ion of arginine transfer by intestinal sacs. Conclusions: Experimental sepsis, induced by either cecal ligation and puncture or intraperiton eal injection of lipopolysaccharide, resulted in impaired intestinal a mino acid uptake. Impaired intestinal arginine absorption may explain the lack of benefit of enteral, compared with parenteral, arginine the rapy on survival from a septic insult.