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Plasma citrulline concentration reflects enterocyte mass in children with short bowel syndrome

Céline Bailly-Botuha1, Virginie Colomb, Elizabeth Thioulouse

  • 1Gastroentérologie et Nutrition Pédiatriques, Hôpital Armand-Trousseau, APHP, Paris 75012, France.

Pediatric Research
|January 8, 2009
PubMed

Insights

Plasma citrulline assays can monitor intestinal adaptation in children with short bowel syndrome. Levels correlate with bowel length and improve when patients are weaned from parenteral nutrition.

Area of Science:

  • Pediatric Gastroenterology
  • Intestinal Failure Research
  • Biomarker Development

Background:

  • Plasma citrulline reflects enterocyte mass in intestinal failure.
  • Limited data exist on its utility in pediatric short bowel syndrome (SBS).

Purpose of the Study:

  • To evaluate the role of plasma citrulline assays in monitoring intestinal adaptation in children with SBS.

Main Methods:

  • Prospective study of 31 children with SBS.
  • Serial plasma citrulline measurements correlated with short bowel length and parenteral nutrition (PN) dependence.

Main Results:

  • Plasma citrulline positively correlated with residual small bowel length.
  • Citulline levels negatively correlated with intestinal failure severity.
  • Citulline increased in patients weaned from PN, remaining low in those dependent on PN.
  • No weaned patients had <40 cm bowel and <11 microM citrulline.

Conclusions:

  • Serial plasma citrulline assays are valuable for monitoring residual small bowel adaptation in pediatric SBS.
  • Citrulline levels can help assess readiness for PN weaning.

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