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Endogenous Amino Acid Loss and Its Significance in Infantile Diarrhea

1973; Springer Nature; Volume: 7; Issue: 3 Linguagem: Inglês

10.1203/00006450-197303000-00008

1530-0447

H. Ghadimi, Sudhir Kumar, F Abaci,

Infant Health and Development

Extract: Significant amino acid loss through the stool, analogous to impeded reabsorption of water, fat, and electrolytes, was suspected in infantile diarrhea. The stools of six patients, who had acute diarrhea and received no protein by mouth, were collected and analyzed for amino acids, nitrogen, and protein. Similar determinations were made on five normal controls. In addition, stool collections were made from one patient during a severe protracted diarrhea which necessitated parenteral alimentation, during a subsequent isolated acute episode of diarrhea, and after complete recovery. The results of the analyses showed that free amino acids in the stool are elevated up to 10-fold during diarrhea, as compared with periods of remission and with normal controls. Protein and total nitrogen excretion is also elevated in diarrhea, although to a lesser degree (4− and 2.5-fold, respectively). It is postulated that protracted diarrhea is associated with impaired reabsorption of endogenous nitrogen, which results in a vicious cycle of protein depletion that ultimately leads to an intractable stage. The validity of this assumption is confirmed by the success achieved by parenteral amino acid therapy for protracted diarrhea. Speculation: It is postulated that intestinal mucosa and digestive enzymes, because of their large volume and rapid turnover, are extremely vulnerable to early states of protein deficiency. It is suggested that continuous loss of nitrogenous substances of endogenous origin occurs in protracted diarrhea, resulting in impaired synthesis of intestinal mucosa and digestive enzymes. The ensuing vicious cycle may be responsible for precipitating protracted diarrhea, regardless of etiology, into an intractable stage