The citrulline generation test: proposal for a new enterocyte function test

• Published in: Alimentary pharmacology & therapeutics 2008-06, Vol.27 (12), p.1300-1310
• Main Authors: PETERS, J. H. C., WIERDSMA, N. J., TEERLINK, T., VAN LEEUWEN, P. A. M., MULDER, C. J. J., VAN BODEGRAVEN, A. A.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Biomarkers - metabolism; Calorimetry; Celiac Disease - metabolism; Celiac Disease - therapy; Citrulline - administration & dosage; Citrulline - metabolism; Cross-Sectional Studies; Digestive system; Enterocytes - metabolism; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intestinal Absorption - physiology; Male; Medical sciences; Pharmacology. Drug treatments; Treatment Outcome
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2008.03678.x

Summary Background  The amino acid citrulline is mainly produced by enterocytes from conversion of glutamine. As fasting plasma citrulline proved disappointing as a biomarker for enterocyte dysfunction in clinical practice, we propose a citrulline generation test (CGT) to assess enterocyte function. Aim  To assess the feasibility of a CGT in healthy subjects and patients with decreased enterocyte mass. Methods  Nineteen healthy subjects, 16 patients with intestinal villous atrophy and nine patients with short bowel syndrome (SBS) were given an oral bolus of 20 g of the dipeptide alanine–glutamine. Subsequent changes in plasma citrulline and other amino acid concentrations were determined using reverse‐phase high‐performance liquid chromatography. Results  Following the oral bolus of alanine–glutamine, plasma citrulline concentrations showed a time dependent rise in healthy subjects of 44 ± 13% (38–55 μmol/L, P