Adequate range for sulfur-containing amino acids and biomarkers for their excess: Lessons from enteral and parenteral nutrition

被引:36
作者
de Poll, Marcel C. G. van
Dejong, Cornelis H. C.
Soeters, Peter B. [1 ]
机构
[1] Univ Maastricht, Dept Surg, Univ Hosp Maastricht, Maastricht, Netherlands
[2] Univ Maastricht, Nutr & Toxicol Res Inst Maastricht NUTRIM, Maastricht, Netherlands
关键词
glutathione; deficiency; N-acetylcysteine supplementation;
D O I
10.1093/jn/136.6.1694S
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
The adequacy range of dietary requirements of specific amino acids in disease states is difficult to determine. In health, several techniques are available allowing rather precise quantification of requirements based on growth of the organism, rises in plasma concentration, or increases in the oxidation of marker amino acids during incremental administration of the amino acid under study. Requirements may not be similar in disease with regard to protein synthesis or with regard to specific functions such as scavenging of reactive oxygen species by compounds including glutathione. Requirements for this purpose can be assessed only when such a function can be measured and related to clinical outcome. There is apparent consensus concerning normal sulfur amino acid (SAA) requirements. WHO recommendations amount to 13 mg/kg per 24 h in healthy adults. This amount is roughly doubled in artificial nutrition regimens. In disease or after trauma, requirements may be altered for methionine, cysteine, and taurine. Although in specific cases of congenital enzyme deficiency, prematurity, or diminished liver function, hypermethionemia or hyperhomocysteinemia may occur, SAA supplementation can be considered safe in amounts exceeding 2-3 times the minimal recommended daily intake. Apart from some very specific indications (e.g., acetaminophen poisoning), the usefulness of SAA supplementation is not yet established. There is a growing body of data pointing out the potential importance of oxidative stress and resulting changes in redox state in numerous diseases including sepsis, chronic inflammation, cancer, AIDS/HIV, and aging. These observations warrant continued attention for the potential role of SAA supplementation. In particular, N-acetylcysteine remains promising for these conditions.
引用
收藏
页码:1694S / 1700S
页数:7
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