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@article{Moore:2020:10.1097/MPG.0000000000002834,
author = {Moore, SR and Quinn, LA and Maier, EA and Guedes, MM and Quetz, JS and Perry, M and Ramprasad, C and Lanzarini, Lopes GML and Mayneris-Perxachs, J and Swann, J and Soares, AM and Filho, JQ and Junior, FS and Havt, A and Lima, NL and Guerrant, RL and Lima, AAM},
doi = {10.1097/MPG.0000000000002834},
journal = {Journal of Pediatric Gastroenterology and Nutrition},
pages = {393--400},
title = {Intervention and mechanisms of alanyl-glutamine for inflammation, nutrition, and enteropathy: a randomized controlled trial},
url = {http://dx.doi.org/10.1097/MPG.0000000000002834},
volume = {71},
year = {2020}
}

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TY  - JOUR
AB  - Objective: Determine the minimum dosage of alanyl-glutamine (Ala-Gln) required to improve gut integrity and growth in children at risk of environmental enteropathy (EE).Methods: This was a double-blinded randomized placebo-controlled dose-response trial. We enrolled 140 children residing in a low-income community in Fortaleza, Brazil. Participants were 2 to 60 months old and had weight-for-age (WAZ), height-for-age (HAZ), or weight-for-height (WHZ) z-scores less than −1. We randomized children to 10 days of nutritional supplementation: Ala-Gln at 3 g/day, Ala-Gln at 6 g/day, Ala-Gln at 12 g/day, or an isonitrogenous dose of glycine (Gly) placebo at 12.5 g/day. Our primary outcome was urinary lactulose-mannitol excretion testing. Secondary outcomes were anthropometry, fecal markers of inflammation, urine metabolic profiles, and malabsorption (spot fecal energy).Results: Of 140 children, 103 completed 120 days of follow-up (24% dropout). In the group receiving the highest dose of Ala-Gln, we detected a modest improvement in urinary lactulose excretion from 0.19% on day 1 to 0.17% on day 10 (P = 0.05). We observed significant but transient improvements in WHZ at day 10 in 2 Ala-Gln groups, and in WHZ and WAZ in all Ala-Gln groups at day 30. We detected no effects on fecal inflammatory markers, diarrheal morbidity, or urine metabolic profiles; but did observe modest reductions in fecal energy and fecal lactoferrin in participants receiving Ala-Gln.Conclusions: Intermediate dose Ala-Gln promotes short-term improvement in gut integrity and ponderal growth in children at risk of EE. Lower doses produced improvements in ponderal growth in the absence of enhanced gut integrity.
AU  - Moore,SR
AU  - Quinn,LA
AU  - Maier,EA
AU  - Guedes,MM
AU  - Quetz,JS
AU  - Perry,M
AU  - Ramprasad,C
AU  - Lanzarini,Lopes GML
AU  - Mayneris-Perxachs,J
AU  - Swann,J
AU  - Soares,AM
AU  - Filho,JQ
AU  - Junior,FS
AU  - Havt,A
AU  - Lima,NL
AU  - Guerrant,RL
AU  - Lima,AAM
DO  - 10.1097/MPG.0000000000002834
EP  - 400
PY  - 2020///
SN  - 0277-2116
SP  - 393
TI  - Intervention and mechanisms of alanyl-glutamine for inflammation, nutrition, and enteropathy: a randomized controlled trial
T2  - Journal of Pediatric Gastroenterology and Nutrition
UR  - http://dx.doi.org/10.1097/MPG.0000000000002834
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000570130600024&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://journals.lww.com/jpgn/Fulltext/2020/09000/Intervention_and_Mechanisms_of_Alanyl_glutamine.20.aspx
UR  - http://hdl.handle.net/10044/1/86834
VL  - 71
ER  -

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