ENTERAL ORNITHINE ALPHA-KETOGLUTARATE ENHANCES INTESTINAL ADAPTATION TO MASSIVE RESECTION IN RATS

Ornithine alpha-ketoglutarate (OKG) has been advocated in the treatmen t of critically ill patients for its anabolic effect on protein metabo lism. Since OKG is a precursor of glutamine, arginine, and polyamines, key substrates of intestinal metabolism and function, we investigated the influence of OKG on intestinal adaptation and trophicity and on g lutamine status after small bowel resection. After massive (80%) small bowel resection, rats were enterally fed for 7 days with a standard d iet supplemented with either OKG (2 g/kg/d) or an isonitrogenous amoun t of glycine. OKG induced an adaptative hyperplasia of the villi, demo nstrated in the jejunum by an increase in the villus height to crypt d epth ratio (OKG v control, 4.3 +/- 0.4 v 3.3 +/- 0.5, P < .01) along w ith an increase (P < .05) in ornithine decarboxylase (ODC) activity (80%) and ornithine content (+102%). Plasma glutamine (+25%) and muscle glutamine (anterior tibialis [AT], +43%; extensor digitorum longus [E DL], +54%) and protein (AT, +32%) were significantly higher (P < .05) after OKG administration, supporting its role in the restoration of gl utamine pools. In summary, enterally administered OKG, which enhances intestinal adaptation after massive resection and improves muscle glut amine and protein content, could contribute significantly to nutrition al management after small bowel resection. Copyright (C) 1998 by W.B. Saunders Company.