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Patients with end-stage liver disease after liver transplantation constantly suffer from malnutrition due to primary diseases and transplantation-related factors. Malnutrition will worsen clinical condition of the patients, increase the incidence of complication, length of hospital stay and medical expense after transplantation, and lower the survival rate. Sufficient nutritional support at all stages of liver transplantation is of significance. Accurate assessment of nutritional status and timely intervention are prerequisites for perioperative nutritional treatment in liver transplantation. In this article, the latest nutritional risk screening indexes and evaluation tools, nutritional support methods and other perioperative nutritional intervention measures for liver transplantation were reviewed, aiming to deepen the understanding and cognition of perioperative nutritional therapy for liver transplantation and provide reference for improving nutritional status and clinical prognosis of liver transplant recipients.
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ObjectiveWe conducted a two-sample Mendelian randomization （MR） study to assess the causal relationship between circulating isoleucine， leucine and valine levels and the risk of peripheral atherosclerosis. MethodsBased on the large-scale genome-wide association study （GWAS） database， single nucleotide polymorphisms （SNPs） closely related to the circulating levels of isoleucine， leucine and valine were identified as instrumental variables （IVs）. Two-sample MR analysis applying the inverse variance weighted （IVW） method and the weighted median estimator （WME） method were performed to estimate the causal relationship between the risk of peripheral atherosclerosis and the exposure with more than three SNPs that were available as IVs. The pleiotropy was evaluated by using the MR-Egger regression and MR-PRESSO method， and the leave-one-out method was used in sensitivity analysis. ResultsFour， one and one SNPs were identified as IVs for circulating isoleucine， leucine and valine levels， respectively. For isoleucine， the IVW model demonstrated there was no evidence of heterogeneity among the IVs （P=0.715）， and there was a significant causal relationship between the increase of circulating isoleucine level and a higher risk of peripheral atherosclerosis risk. Per every 1 elevated standard deviation （SD） of circulating isoleucine level resulted in increasing 31% of peripheral atherosclerosis risk （OR=1.31， 95%CI： 1.07‒1.61）. Similarly， the OR（95%CI） was 1.33 （1.04‒1.71） in the WME model. The MR-Egger regression and MR-PRESSO analysis indicated no evidence of pleiotropy in IVs （all P>0.05）. The result of the leave-one-out sensitivity analysis was stable. The Wald ratio model displayed that the causal relationship between circulating leucine and valine levels and the risk of peripheral atherosclerosis was not statistically significant. The OR （95%CI） for leucine and valine was 1.13 （0.78‒1.63） and 1.11 （0.82‒1.50）， respectively. ConclusionThere is a significant causal relationship between the increase of circulating isoleucine level and a higher peripheral atherosclerosis risk. The causal relationships between circulating leucine and valine levels and the risk of peripheral atherosclerosis need to be further confirmed in future studies.
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At present, the incidence and mortality of cancers are increasing year by year, which has become a major global public health problem and the main cause of death of global population. In recent years, studies have shown that branched-chain amino acids levels play an important part in the incidence and prognosis of some malignant tumors, such as colorectal cancer, pancreatic cancer, liver cancer, breast cancer and so on. Therefore, this article summarizes the studies on the relationship between the level of branched-chain amino acids and cancers, providing clues for further exploration of the correlation between the two.
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Objective To evaluate the clinical efficacy of heterozygous living donor liver transplantation for pediatric maple syrup urine disease. Methods A 3-year-old boy was admitted to the hospital on July 5, 2017 due to maple syrup urine disease for half a year. The child presented with paroxysmal dysarthria and motor dysfunction of the lower limbs under fasting status for half a year, accompanied with obvious maple syrup urine odor and slow language development. No other growth abnormality or mental defects were observed. Serum branched chain amino acid (BCAA) assay detected that the level of leucine was 684 μmol/L and 559 μmol/L for the valine. The child was diagnosed with maple syrup urine disease type b based on gene detection combined with BCAA assay. Living donor liver transplantation from his biological father was performed. Postoperatively, routine immunosuppression, anti-virus, anti-infection therapies, maintenance of fluid, electrolyte, and acid-base balance and other necessary nutritional support were given. The dose of tacrolimus was adjusted according to biochemical parameters and cytochrome P450(CYP)3A5 genotype of the recipient. Glucocorticoid administration was terminated at approximately 6 months after operation. Results The liver function of the recipient was recovered to normal range at postoperative 1 month, and basically stabilized at 3 years after surgery. The amino acid level was decreased to normal level immediately after operation, and BCAA was continually declined after normal diet for postoperative 1 month. As of the submission date, the recipient grew well in a stable condition and achieved high quality of life. Conclusions Heterozygous living donor liver transplantation is a safe and effective treatment of maple syrup urine disease, which reduces the possibility of sudden acute metabolic events, significantly improves the quality of life of the recipient and provides a novel idea for surgical treatment of maple syrup urine disease.
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Objective To investigate the regulatory effect of branched chain amino acids (BCAA) on the expression of apoptosis related proteins after cerebral ischemia reperfusion injury and the protective effects of BCAA on ischemic brain injury in rats.Methods 40 male SD rats were randomly divided into normal diet group (n =20) and branched chain amino acid (BCAA) group (n=20) according to the random number table,and each group was randomly divided into control group (n=6),sham operation group (n=6) and model group (n =8) which used suture method to make ischemia reperfusion model.After modeling,modified Neurological Severity Scores (mNSS) was used to access the neurological impairment degree of 2,6,24,48 and 72 h in each group.The expression of apoptosis related proteins (Cleaved,Bax/Bcl-2) after 72 h was detected by the method of immune protein imprinting (Caspase3) and compared between normal diet group and BCAA group.Results Compared with the normal diet rats,the mNSS of BCAA diet rats after modeling at 2,6,24,48,72 h decreased (11.35±2.78 vs.7.15±2.41,P=0.019;9.35±1.75 vs.5.82±1.17,P=0.002;6.11±1.16vs.4.39±1.46,P=0.048;5.87±1.32vs.3.55±1.94,P=0.036;4.98±2.24vs.2.09±1.33,P=0.022).The expression of cleaved caspase3 protein and the ratio of Bax/Bcl-2 decreased in BCAA group.Conclusion BCAA can alleviate the apoptosis of rats after ischemia and reperfusion,reduce the damage of nerve function,and has a positive protective effect on ischemic brain injury.
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As a key enzyme that catalyzes the metabolism of branched chain amino acids,branched chain amino acid transferase 1(BCAT1)is often involved in a variety of biosynthetic pathways. Reaserches show that BCAT1 is highly expressed in many kinds of malignant tumors such as leukemia,glioma,nasopharyn-geal carcinoma,gastric cancer and breast cancer,et al,suggesting a close relationship with the proliferation, invasion and metastasis of tumor cells. Thus,BCAT1 plays an important role in the genesis and progression of tumor,and may have the potential to be a new therapeutic target.
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In this study, we evaluated the effect of the herbicide propyl 4-(2-(4,6-dimethoxypyrimidin-2-yloxy)benzylamino) benzoate (ZJ0273) on barley growth and explored the potential to trigger growth recovery through the application of branched-chain amino acids (BCAAs). Barley plants were foliar-sprayed with various concentrations of ZJ0273 (100, 500, or 1000 mg/L) at the four-leaf stage. Increasing either the herbicide concentration or measurement time after herbicide treatment significantly impaired plant morphological parameters such as plant height and biomass, and affected physiological indexes, i.e. maximal photochemical efficiency (Fv/Fm), quantum yield of photosystem II (ФPSII), net photosynthetic rate (Pn), and chlorophyll meter value (soil and plant analyzer development (SPAD)). Cellular injury of herbicide-treated plants was also evidenced by increased levels of reactive oxygen species (ROS) and antioxidative enzyme activity. Elevated levels of herbicide significantly reduced the activity of acetolactate synthase (ALS)—a key enzyme in the biosynthesis of BCAAs. In a separate experiment, growth recovery in herbicide-stressed barley plants was studied using various concentrations of BCAAs (10, 50, 100, and 200 mg/L). Increasing BCAA concentration in growth media significantly increased the biomass of herbicide-stressed barley seedlings, but had no significant effect on non-stressed plants. Further, BCAAs (100 mg/L) significantly down-regulated ROS and consequently antioxidant enzyme levels in herbicide-stressed plants. Our results showed that exogenous application of BCAAs could reverse the inhibitory effects of ZJ0273 by restoring protein biosynthesis in barley seedlings.
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In this study, we evaluated the effect of the herbicide propyl 4-(2-(4,6-dimethoxypyrimidin-2-yloxy)benzylamino) benzoate (ZJ0273) on barley growth and explored the potential to trigger growth recovery through the application of branched-chain amino acids (BCAAs). Barley plants were foliar-sprayed with various concentrations of ZJ0273 (100, 500, or 1000 mg/L) at the four-leaf stage. Increasing either the herbicide concentration or measurement time after herbicide treatment significantly impaired plant morphological parameters such as plant height and biomass, and affected physiological indexes, i.e. maximal photochemical efficiency (Fv/Fm), quantum yield of photosystem II (ФPSII), net photosynthetic rate (Pn), and chlorophyll meter value (soil and plant analyzer development (SPAD)). Cellular injury of herbicide-treated plants was also evidenced by increased levels of reactive oxygen species (ROS) and antioxidative enzyme activity. Elevated levels of herbicide significantly reduced the activity of acetolactate synthase (ALS)-a key enzyme in the biosynthesis of BCAAs. In a separate experiment, growth recovery in herbicide-stressed barley plants was studied using various concentrations of BCAAs (10, 50, 100, and 200 mg/L). Increasing BCAA concentration in growth media significantly increased the biomass of herbicide-stressed barley seedlings, but had no significant effect on non-stressed plants. Further, BCAAs (100 mg/L) significantly down-regulated ROS and consequently antioxidant enzyme levels in herbicide-stressed plants. Our results showed that exogenous application of BCAAs could reverse the inhibitory effects of ZJ0273 by restoring protein biosynthesis in barley seedlings.
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Amino Acids, Branched-Chain/administration & dosage , Antioxidants/metabolism , Benzoates/pharmacology , Biomass , Chlorophyll/metabolism , Herbicides/pharmacology , Hordeum/metabolism , Photosynthesis/drug effects , Plant Leaves/metabolism , Reactive Oxygen Species/metabolism , Seedlings/metabolismABSTRACT
OBJECTIVE:To compare the effects of equilibrium amino acid and it rich in branched chain amino acid on nutrition metabolism after surgery and prognosis of severe abdominal trauma patients. METHODS:A total of 60 severe abdominal trauma patients selected from our hospital during Sept. 2016-Jun. 2017 were divided into group A and B according to block randomization,with 30 cases in each group. Both groups were all given iso nitrogenous and iso caloric parenteral nutrition support on the basis of surgery and routine treatment after surgery;group A was additionally given 8.5％ Compound amino acid injection (18AA-Ⅱ)1.2 g/(kg·d)for 12 h each day at least;group B was additionally given 10％ Compound amino acid injection(20AA) 1.2 g/(kg·d)for 12 h each day at least. Both groups were treated for 7 d. The levels of nitrogen balance and serum protein(total protein,albumin,prealbumin and transferrin),plasma amino spectrum were observed in 2 groups before and after treatment. Hospitalization time,survival rate,the occurrence of complication and ADR were compared between 2 groups. RESULTS:Two patients of group A and one patient of group B were discharged,and totally of 57 patients completed the study. Before treatment, there was no statistical significance in the levels of nitrogen balance,serum protein or plasma amino spectrum (P>0.05). After treatment,the cumulative nitrogen balance of group B was significantly better than that of group A. The level of nitrogen balance was increased significantly in observation group 3-7 d after treatment and control group 5-7 d after treatment. Since 4 d after treatment,the level of nitrogen balance in group B was significantly better than control group,with statistical significance (P<0.05). The levels of albumin,prealbumin and transferring in group A were decreased significantly,and were significantly lower than group B, with statistical significance (P<0.05). The levels of glycine and threonine in 2 groups were increased significantly. The level of arginine in group B was decreased significantly, while the levels of valine and branched chainaimino acid were increased significantly;those indexes of group B were significantly lower or higher than those of group A respectively,with statistical significance(P<0.05). The incidence of gastrointestinal complications and disruption of wound,total incidence of complications in group B were significantly lower than group A,with statistical significance(P<0.05). There was no statistical significance in hospitalization time,survival rate or the incidence of infection between 2 groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Compared to equilibrium amino acid,equilibrium amino acid rich in branched chain amino acid can further improve and maintain the nitrogen balance,the levels of serum protein and plasma amino acid of severe abdominal trauma patients after surgery with low incidence of complication.
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Background: Special diet with restricted branched-chain-amino-acids used for treating maple syrup urine disease can lead to specific amino acid deficiencies. Case characteristics: We report a neonate who developed skin lesions due to isoleucine deficiency while using specialised formula. Intervention/Outcome: Feeds were supplemented with expressed breast milk. This caused biochemical and clinical improvement with resolution of skin lesions. Message: Breast milk is a valuable and necessary adjunct to specialized formula in maple syrup urine disease to prevent specific amino acid deficiency in the neonatal period.
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A cirrose hepática (CH) é uma doença com altas taxas de mortalidade e que apresenta, como único tratamento definitivo, o transplante hepático (TH). Infelizmente, nem todos os pacientes têm acesso ao TH e muitos acabam morrendo ainda na lista de transplante. O uso de aminoácidos de cadeia ramificada (AACR) já é amplamente conhecido como tratamento eficaz para a melhora da qualidade de vida destes pacientes. Neste relato, pela primeira vez, documentou-se uma grande melhora clínica e laboratorial em um paciente após o tratamento com AACR, que permitiu ao paciente sair inclusive da lista de transplante. Além da diminuição do escore MELD, houve reestabilização do peso corporal e melhora da qualidade de vida, documentada pelo questionário SF-36.
Liver cirrhosis (LC) is a disease with high mortality rates and its only definitive treatment is the orthotopic liver transplantation (OLT). Unfortunately, not all patients have access to OLT and many of them end up dying on the transplant waiting list. The use of branched chain amino acids (BCAA) is widely known as an effective treatment for improving the quality of life of these patients. For the first time, in this paper we documented a great improvement of clinical and laboratorial tests of a patient treated with BCAA, which allowed him to be out of the transplant waiting list. In addition to the increase of the MELD score, the patient achieved restabilization of body weight and recovery of the quality of life registered by the SF-36 questionnaire.
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Humans , Male , Middle Aged , Hepatic Encephalopathy , Amino Acids, Branched-Chain , Liver Transplantation , Liver Cirrhosis/mortality , Liver Cirrhosis, AlcoholicABSTRACT
Objective To evaluate the prognosis and safety of long-term oral Branched-Chain Amino Acids (BCAAs) for patients with cirrhosis.Methods Randomized controlled trials (RCTs) were identified from CBM (between January 1978 and September 2013),CNKI (between January 1979 and September 2013),PubMed (between January 1970 and September 2013),EMBASE (between January 1970 and September 2013),and Cochrane Library (issue 4,2013).Publications of the RCTs on the treatment of cirrhosis with oral BCAAS were included and analyzed according to the criteria of Cocbrane handbook.Results Six RCTs involving 1 047 patients were included.The results showed that oral BCAAs improved the event-free survival when compared with the control group [RR =1.13,95％ CI =(1.05,1.23),P =0.001].BCAAs supplements had no effect on mortality or had no definite effect on the deteriorative rate of minimal hepatic encephalopathy (MHE) or quality of life (QOL).As reported in some trials,the main side effects of BCAAs were gastrointestinal symptoms.Conclusions Long-term oral BCAAs may improve event-free survival in cirrhotic patients.However,no definite conclusion can be made without evidences from larger,randomized,double-blind,placebo-controlled,and multicenter trials.
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Objective To evaluate the effects of branched-chain amino acids-enriched early parenteral and enteral nutrition on the liver function and serum aminograms in cirrhotic rats after partial hepatectomy. Methods In this prospective randomized controlled study, 24 cirrhotic rats, induced by thioacetamide, were randomized into three groups: enteral nutrition (EN) group, EN + branched-chain amino acid (BCAA) group, and parenteral nutrition (PN) + BCAA group. After receiving partial hepatectomy, rats in all three groups were nutritionally supported with equal amount of calorie and nitrogen contents from the 1st postoperative day ( PO day 1 ) to PO day 5. On PO day 6, parameters including body weight, liver functions, prealbumin, transferring, and serum aminograms were measured or determined, and the level of liver albumin mRNA was detected by reversal transcription-polymerase chain reaction and morphological examinations such as HE staining and immunohistochemical staining, which were assessed by index of Ki67 protein index. Results Body weight was significantly decreased in all three groups on PO day 6 (P ＜0.05 ). Compared with EN + BCAA group, serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase after partial hepatectomy were significantly higher in PN + BCAA group (P ＜0.05 ). Serum alkaline phosphatase level was significantly higher in PN + BCAA group than in EN group ( P ＜0. 05). The level of prealbumin was significantly lower in PN + BCAA group when compared with EN group or EN +BCAA group ( both P ＜ 0. 05 ), although no such significant difference was noted in terms of transferrin ( P ＞0. 05 ). The levels of leucine and isoleucine elevated while those of tyrosine, phenylalanine, arginine and tryptophan declined in PN + BCAA group or EN + BCAA group when compared with EN group ( P ＜ 0. 05 ). Aminograms were not significantly different between EN + BCAA group and PN + BCAA group ( P ＞ 0. 05 ). Levels of total amino acid and aromatic amino acid (AAA) were significantly lower while BCAA and ratio between BCAA and AAA (BCAA/AAA) were significantly higher in PN + BCAA group or EN + BCAA group than in EN group (P ＜ 0. 05 ).Significantly lower level of albumin mRNA and index of Ki67 were observed in PN + BCAA group than in EN group or EN + BCAA group (P ＜ 0.05 ) on PO day 6. Conclusions BCAA-enriched EN or PN reverses amino acid disequilibrium and restores BCAA/AAA in cirrhotic rats after partial hepatectomy. Compared with PN, EN is superior in improving postoperative liver function, promoting protein synthesis, and speed up tissue regeneration in the postoperative liver. However, it still can not restore serum albumin in a short term.
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Objective To observe the effect of liver disease special-purpose enteral nutrition preparation on protein metabolism and liver function in children with liver injury.Methods Sixty cases of severe ill with liver injury in hospital,with mean age of (7.8?6.3) years old.All patients were randomly divided into experimental group (n=30) and control group(n=30).The experimental group was treated by adding the liver disease special-purpose enteral nutrition preparation homogenized diet and control group was treated by adding entire protein entire nutrition type enteral nutrition preparation.All patients in both 2 groups were nasally fed with intestinal nutrition,which contained 418-628 kJ/(kg?d).One day before nutritional support and 14 days after nutritional support,the liver function,total serum protein,albumin,hemoglobin were recorded.SPSS 11.5 software was used to analyze the data.Results The baseline indicators were similar before nutritional supports.Fourteen days after nutritional support,alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were all significantly lower in experimental group than in control group(Pa
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No abstract available.
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Humans , Liver Cirrhosis/therapy , Nutrition Assessment , Nutritional SupportABSTRACT
The purpose of this study was to clarify the effects of amino acid supplementation on mental and physical stress during severe exercise. 20 male college students were assigned to amino acid treated group (group AA) and placebo treated group (group P), each containing 10 subjects, and performed 1600 m-run relay for 24 hours. Each subjects of AA group received 1 g of amino acid powder, containing 34% of branched-chain amino acid (BCAA), after each work bout. The score of rating of perceived exertion (RPE) and category rate of pain scale (CPS) for each work bout were recorded. Scoring of profile of mood states (POMS) was performed and blood samples were drawn at pre-, mid-, and post-session. Total running distance was similar in both groups. In group AA, compared with group P, (1) total score of RPE and CPS through 25 work bouts and plasma cortisol concentration (C) at post- was significantly lower, and (2) molar ratio of plasma free testosterone concentration (FTS) to C (FTS/C) at mid- was significantly greater. In group P alone, plasma BCAA concentration, FTS, FTS/C, and POMS score about ‘tension-anxiety’, ‘anger-hostility’ and ‘vigor’ decreased significantly over time. Our data suggest that BCAA administration during severe exercise may diminish mental or physical stress, inhibit FTS/C decrease and be effective in maintaining aggressive mentality.
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Objective: To investigate the metabolic effects of two different formula of amino acids on postoperative patients . Methods: According to prospective ,randomized , single blind and controlled rule, 120 patients after abdominal operation were randomized to receive parenteral nutrition with either amino acid enriched BCAA or balanced amino acid (18 F).From the second day after operation, total parenteral nutrition was infused to the patients with equal calorie and equal nitrogen by central or peripheral vein for 6 days. Meanwhile, every day nitrogen balance was monitored by collecting urine in 24 hours .The indices were investigated such as amino acids patterns, and serum levels of total protein, albumin, prealbumin, thansferrin and fibronectin. Results: Nitrogen balance of patients in study group on day5 was higher than those of control group. The decreased serum levels of albumin in study group were lower than the control group. Concentrations of valine increased more significantly in study group than that of the control group. Conclusions: The formula of amino acid enriched BCAA may be more suitable and effective for the postoperative traumatic patients on protein metabolism.
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The enriched soybean high branched chain amino acid mixture (II) was a special hydrolytic soybean protein enriched with a small amount of individual amino acids. The content of its essential amino acids was 68.89% and branched chain amino acids 42.85%.The results of this experiment show that the mixture (II) can improve negative nitrogen balance and elevate the level of serum albumin, and is a good nitrogen source for elemental diet after trauma.
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The soybean high branched-chain amino acid mixture was composed of soybean protein hydrolyzed by special method with a few types additional amino acids in small amount. The mixture contained 68.9% of essential ami-no acids and 42.9% of branched-chain amino acids.The animal experiment showed that the mixture could promote the growth of young rats and maintain the normal levels of Hb, serum total protein and albumin. Its protein efficiency ratio (PER), true protein digestibility (TD), biological value (BV) and net protein utilization (NPU) were 2.78, 94.0%, 85.0 and 80.0% respectively. These values were significantly higher than that of casein. The results indicated that the soybean high branched-chain amio acid mixture did not produce amino acid antagonism caused by the high amount of branched-chain amino acids and had higher nutritional quality.
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Forty patients who underwent sub-total gastrectomy were divided into four groups, one of them for comparison, the other three groups received 10%, 30% and 100% branched-chain amino acid (BCAA) respectively. The results showed that in BCAA-10 and BCAA-3H group, negative balance was partially corrected, but in BCAA-10 group nitrogen remained an obvious negative balance on the 3rd postoperative day. There were more than ten of plasma AA lower than preoperative day in these two groups. In BCAA-30 group, after surgery, negative nitrogen balance was significantly corrected, and changes of plasma AA had no statistic significance compared with that before operation.Creatinine of urine had no significant difference between each group.In BCAA-30 group, transferrin (Tf) was increased compared with that before operation. It is suggested that the protein synthesis is corrected but the catabolism is not restrained.BCAA may play a regulatory role in muscle protein metabolism, BCAA can serve as fuel substrate to promote synthesis and reduce breakdown of muscle protein to correct negative nitrogen balance.Application of large quantities of BCAA should be based on isotonic AA solution.