Gut Response to Surgery with Special Reference to Amino Acids and Cytokine

Tetsuji Fujita, Makoto Odaka, Miwako Matsumoto, Kenji Sakurai

First Department of Surgery, The Jikei University School of Medicine

Recently, the gut has come to be considered as a central organ in stress states. The purpose of this study is to investigate the amino acids and cytokine exchange across the gut. Portal and peripheral venous blood samples were obtained simultaneously from 24 patients who underwent abdominal surgery, two hours after the start of the operation, and levels of amino acids, cytokines, insulin, and glucagon were measured. There were no significant differences in portal-peripheral venous amino acid levels of 19 amino acids, excluding glutamine. Portal blood levels of glutamine were significantly (p<0.02) lower than those in the peripheral venous blood (371.06±97.01 nmol/ml vs 452.38±80.29 nmol/ml, mean±SD). The peripheral venous blood levels of glutamine were negatively correlated with portal blood levels of interleukin 6 (r=-0.46, p<0.05). Portal blood levels of glutamine were negatively correlated with the peripheral venous glucagon/insulin concentration ratio (r=-0.46, p<0.05). These data suggest that cytokines may play a role in glutamine uptake by intestinal epithelial cells.

Key words
portal-peripheral venous differences in amino acids level, relationship between plasma glutamine concentration and portal cytokine level

Reprint requests
Tetsuji Fujita First Department of Surgery, The Jikei University School of Medicine
3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
January 13, 1993

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