Supplementing Arginine and Citrulline to Parenteral Nutrition to Enhance Intestinal Recovery

Lay Summary 
Parenteral feeding is a means by which nutrients are delivered directly to the blood via intravenous infusion (direct injection of medication into a vein through an intravenous line, needle, or catheter) and is necessary when infants cannot tolerate oral feedings. Although lifesaving, prolonged parenteral nutrition leads to reduced blood flow to the gut, gut atrophy (reduced number of cells, decreased surface area, and shortened villous height and crypt depth, with subsequent loss of intestinal function) and reduced protein synthesis. The smaller atrophied gut reduces intestinal synthesis of arginine, a key amino acid required for regulation of blood flow via nitric oxide production, protein synthesis and creatine synthesis. Our goal is to increase arginine availability, which will enhance blood flow to the gut, thereby preventing gut atrophy and increasing protein synthesis and growth. However, supplemental arginine is rapidly broken down by the liver and not available to the rest of the body. Therefore, we propose to use supplemental citrulline, the precursor to arginine, as an alternative means of increasing arginine availability. Unlike arginine, citrulline bypasses breakdown by the liver, thereby enhancing arginine availability to a greater extent than arginine supplementation. The objective of the study is to improve arginine availability via supplemental citrulline, a novel ingredient for parenteral nutrition solutions. A miniature Yucatan piglet model is used as a model for the human infant to investigate the clinical outcomes of parenteral nutrition. The results from the study will aid in optimizing a parenteral feeding regimen that will meet all nutritional needs while minimizing the current repercussions related to parenteral feeding. 


Abstracted from:

Faculty of Medicine
Master's Canada Graduate Scholarship 766-2018-0827
St. John's
Newfoundland and Labrador
Industry Sectors 
Health Care and Social Assistance
Start date 
1 May 2020
End date 
30 Apr 2021