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Steady State Is Not Achieved for Most Plasma Amino Acids During 12 Hours of Fasting in the Neonatal Piglet

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Steady State Is Not Achieved for Most Plasma Amino Acids During 12 Hours of Fasting in the Neonatal Piglet 0031-3998/00/4805-0701 PEDIATRIC RESEARCH Vol. 48, No. 5, 2000 Copyright © 2000 International Pediatric Research Foundation, Inc. Printed in U.S.A. Steady State Is Not Achieved for Most Plasma Amino Acids during 12 Hours of Fasting in the Neonatal Piglet ROBERT F.P. BERTOLO, JANET A. BRUNTON, PAUL B. PENCHARZ, AND RONALD O. BALL Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada, T6G 2P5 [R.F.P.B., J.A.B., P.B.P., R.O.B.]; Departments of Nutritional Sciences [P.B.P., R.O.B.] and Paediatrics [P.B.P.], University of Toronto, Toronto, ON, Canada M5S 3E2; and The Research Institute, The Hospital for Sick Children, Toronto, ON, Canada M5G 1X8 [P.B.P., R.O.B.] ABSTRACT Kinetics studies in neonates are important to establish the this period (i.v. and i.g.). The greatest change was tyrosine, requirement for amino acids and to understand the mechanisms increasing 13% (i.v.) and 32% (i.g.) per hour. After 12 h of of normal and altered metabolism. During kinetics experiments, refeeding, glycine, serine, threonine, and asparagine concentra- plasma amino acid concentrations should be in steady state. Our tions were lower than baseline (p Ͻ 0.05) in the i.v. group. In i.g. objective was to determine whether 12 h of fasting, after paren- fed piglets, only threonine remained below baseline (p Ͻ 0.05), teral or enteral feeding, resulted in a steady state in concentra- and arginine was greater than baseline (p Ͻ 0.05). Differences tions of amino acids. Two-day-old piglets were implanted with between i.v. and i.g. may be the result of impaired small intes- catheters (d 0), and randomly assigned to either intragastric (i.g., tinal metabolism secondary to parenteral feeding. In neonatal n ϭ 6) or i.v. (n ϭ 6) feeding. On d 5, piglets were fasted for pigs, most plasma amino acids were unstable during 12 h of 12 h. During the first 2 h, plasma concentrations of almost all fasting. Thus, kinetics studies that require a steady state must be amino acids declined except asparagine (i.g. and i.v.), tyrosine conducted in the fed state. (Pediatr Res 48: 701–707, 2000) (i.v.), and glycine (i.v.), which increased. Only i.g. glycine did not change. Between 2 and 12 h, the only indispensable amino Abbreviations acids that did not change were phenylalanine (i.v.) and histidine BCAA, branched-chain amino acids (i.g. and i.v.). The branched-chain amino acids increased during i.g., intragastric The amino acid requirements for neonates have not been isotope tracers are commonly conducted in the fasted or post- empirically determined, but have been extrapolated from the absorptive state in adults (1–3) and sometimes in neonates (4). amino acid concentrations found in human or cow milk. This However, a prolonged fasting state may be inappropriate for simplistic approach is inadequate when considering requirements neonates such as piglets and human infants, which suckle for parenterally fed infants, premature infants, infants with disor- frequently, every 1 to 4 h. However, to determine basal amino ders of amino acid metabolism, or other medical conditions that acid kinetics or to establish requirements for conditionally alter protein metabolism. Furthermore, a possible consequence of indispensable amino acids, the fasted state could be more metabolic immaturity is that certain amino acids that are deemed informative. To conduct kinetic experiments, amino acid con- dispensable in mature animals are actually indispensable, or con- centrations must be in a steady state so that isotopic steady ditionally indispensable, in the neonate. state can be achieved during a constant infusion protocol (5). Elucidating amino acid kinetics in an appropriate animal Whether the fasted state represents a quasi–steady state in the model is the first step to establishing requirements for neo- neonatal piglet, a common model for the human infant, has not nates. An important question that must be resolved for the been determined. The objective of this study was to determine development of such a model is whether to study the subject in whether amino acid concentrations reach a steady state during a fasted or fed state. Studies of amino acid kinetics using 12 h of fasting in piglets previously adapted to either i.g. or i.v. feeding. Received January 27, 2000; accepted June 8, 2000. Correspondence and reprint requests: Dr. Ronald O. Ball, Department of Agricultural, METHODS Food and Nutritional Science, 4–10 Agriculture/Forestry Centre, University of Alberta, Edmonton, AB, Canada T6G 2P5. Supported by the Natural Sciences and Engineering Research Council of Canada and Animals and surgical procedures. Twelve intact, male Alberta Pork Producers Development Corporation. Yorkshire piglets were obtained from a specific pathogen-free 701 702 BERTOLO ET AL. herd. Piglets were left with the sow for 2–4 d after birth, then infusion was reinitiated immediately after the blood sampling were transferred to the laboratory for immediate surgical im- at 12 h. To assess recovery, blood samples were obtained at plantation of catheters under aseptic conditions. Anesthesia 14 h and 24 h after the initiation of the fasting. was induced with an intramuscular injection of acepromazine Plasma free amino acid concentrations were determined by (0.5 mg/kg, Atravet, Ayerst Laboratories, Montreal, PQ, Can- reverse-phase HPLC. Briefly, 100 ␮L of plasma was mixed ada) and ketamine hydrochloride (10 mg/kg, Rogarsetic, Rogar with 20 ␮L of 2.5 mM norleucine (internal standard) and 1 mL STB Inc., Montreal, PQ, Canada) and was maintained during of protein precipitant (0.5% trifluoroacetic acid in methanol), surgery with a mixture of oxygen and halothane (Fluothane, vortexed, and centrifuged at 3000 ϫ g for 5 min to remove Ayerst Laboratories) delivered by mask. Each piglet had a proteins. Preparation of phenylisothiocyanate derivatives for Silastic venous sampling catheter (Ed-Art, Toronto, ON, Can- reverse-phase HPLC was then performed as previously de- ada) implanted, which was inserted into the left femoral vein scribed (9). Whole blood glucose concentration, pH, osmolal- and advanced to the inferior vena cava immediately caudal to ity, and sodium were determined every 2 h (Nova Statprofile the heart. Piglets in the i.v. fed group (n ϭ 6) also received an 9ϩ, Nova Biomedical Inc., Waltham MA, U.S.A.). Plasma infusion catheter, which was inserted into the left external urea (No. 66-UV, Sigma Chemical Co. Diagnostics, St. Louis, jugular vein and advanced to the superior vena cava immedi- MO, U.S.A.) and ammonia (No. 171-UV, Sigma Chemical Co. ately cranial to the heart. In the i.g. fed group (n ϭ 6), a Stamm Diagnostics) concentrations were also measured. gastrostomy was performed (6) to provide continuous enteral Statistics. Plasma amino acid concentrations throughout the feeding. fasting were retrospectively divided into acute and chronic After surgery, piglets were treated immediately with 0.15 phases (baseline to 2 h, and 2 to 12 h, respectively) to accom- mg/kg oxymorphone analgesic (Numorphone, Dupont Canada modate the marked changes that were observed immediately Inc., Mississauga, ON, Canada) and 3.5 mg gentamicin sulfate after cessation of the diet infusions. Significant changes in the (Garasol, Schering Canada Inc., Pointe Claire, PQ, Canada), acute phase were determined by paired t test comparing the followed by 2.5 mg/d gentamicin sulfate for the next 3 d. baseline and 2-h concentrations; recovery of amino acid con- Piglets were housed in individual circular metabolic cages that centrations were also compared by paired t test using the allowed visual and aural contact with other piglets; toys and baseline and 24-h concentrations. For the chronic phase, linear blankets were also provided. The room was lighted from regression was conducted for individual pigs to determine the 0800 h to 2000 h and was maintained at 28°C with supple- change in amino acid concentration per hour (slope). Slopes mental heat provided by heat lamps. All piglets were weighed were used to determine whether group means were signifi- daily, and sampling catheters were flushed with sterile, hepa- cantly different from zero (one-sample t test); means of slopes rinized saline to maintain patency. Piglets and cages were were then converted to percent of baseline concentration cleaned daily. All procedures were in accordance with the (mean) and percent of 2-h concentration (mean). Changes in Canadian Council on Animal Care’s Guide to the Care and Use blood and plasma biochemical variables were similarly ana- of Animals (1993), and were approved by the local animal care lyzed using values from baseline to 12 h. All data are presented committee. as mean Ϯ SD. Diets. An elemental and complete total nutrition diet (7) was infused continuously (24 h) either i.v. or i.g., via pressure- RESULTS sensitive peristaltic pumps, through a swivel-tether system (Alice King Chatham Medical Arts, Los Angeles, CA, U.S.A.). There were no differences in characteristics between groups The infusion regimen was designed to supply all nutrients of piglets receiving i.v. or i.g. diet treatments. Piglets were required by piglets (8). The amino acid composition of the total 2.3 Ϯ 0.5 d of age and 1.83 Ϯ 0.15 kg body weight on the day parenteral nutrition solution (mg/g total L-amino acids) was as of surgery (study d 0). Weight gain (157 Ϯ 41 g/d), measured follows: alanine 105, arginine 60, aspartate 60, cysteine 14, between d 2 and 5, also did not differ between routes of glutamate 104, glycine 31, histidine 30, isoleucine 45, leucine feeding. 103, lysine 102, methionine 19, phenylalanine 40, proline 82, serine 55, taurine 4, threonine 52, tryptophan 21, tyrosine 21, Blood Biochemistry and valine 52.
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