RESUMO
Nucleotides are low molecular weight biological molecules key to biochemical processes. Sources include de novo synthesis, recovery via salvage mechanisms, and dietary intakes. Although endogenous production serves as the main nucleotide source, evidence suggests that exogenous sources are essential to immune competence, intestinal development, and recovery. Dietary nucleotides serve a marked role in rapidly proliferating cells where they are necessary for optimal function. Accordingly, dietary nucleotides are deemed conditionally essential in the presence of various physiological stresses, including growth and development, recovery from injury, infection, and certain disease states. Clinical studies that evaluated nutrition formulations of nucleotides in combination with other specific nutrient substances demonstrated improved clinical outcomes in patients characterized as critically ill, injured, immune suppressed, or with chronic gastrointestinal conditions. However, conclusions regarding specific benefits of nucleotides are limited. Scientific substantiation of nucleotide supplementation in infant formula has been reported to improve the maturation and development of the intestinal tract as well as immune function. All medical nutrition products except for one immune-modulating formulation are devoid of nucleotides. In an effort to build on this, the current review presents the data to support potential clinical applications for nucleotides in enteral nutrition that may contribute to improved outcomes in physiologically stressed patients.
Assuntos
Nutrição Enteral , Gastroenteropatias/tratamento farmacológico , Trato Gastrointestinal/efeitos dos fármacos , Doenças do Sistema Imunitário/tratamento farmacológico , Sistema Imunitário/efeitos dos fármacos , Nucleotídeos/uso terapêutico , Estresse Fisiológico/efeitos dos fármacos , Dieta , Suplementos Nutricionais , Gerenciamento Clínico , Alimentos Formulados , Gastroenteropatias/terapia , Humanos , Doenças do Sistema Imunitário/terapia , Imunidade/efeitos dos fármacos , Nucleotídeos/farmacologiaAssuntos
Ácidos Graxos/química , Ácidos Graxos/uso terapêutico , Nutrição Parenteral , Hidratação , Galactanos/química , Galactanos/metabolismo , Galactanos/uso terapêutico , Gastroenteropatias/metabolismo , Gastroenteropatias/terapia , Humanos , Mananas/química , Mananas/metabolismo , Mananas/uso terapêutico , Gomas Vegetais/química , Gomas Vegetais/metabolismo , Gomas Vegetais/uso terapêuticoRESUMO
OBJECTIVE: This paper provides a review of research on partially hydrolyzed guar gum that is relevant to clinical nutrition practice. METHODS: All relevant papers published on partially hydrolyzed guar gum were reviewed and the results summarized. RESULTS: Partially hydrolyzed guar gum (PHGG) is a water-soluble dietary fiber with a wide range of uses in clinical nutrition. Its low viscosity allows its use in enteral products and beverages. PHGG can be added to enteral formulas and food products as a dietary fiber source. PHGG provides the benefits associated with dietary fiber ingestion. Addition of PHGG to the diet reduced laxative dependence in a nursing home population. PHGG also reduced the incidence of diarrhea in septic patients receiving total enteral nutrition and reduced symptoms of irritable bowel syndrome. PHGG also increased production of Bifidobacterium in the gut. CONCLUSION: The ease of use of PHGG and its clinical effectiveness make it a good choice in clinical nutrition practice.