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Compartmentation of endogenously synthesized amino acids in neonates

R G Miller1, T H Keshen, F Jahoor

  • 1Department of Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas 77030, USA.

Insights

Limited conversion of glucose to proline, aspartate, and cysteine in premature neonates suggests these amino acids are conditionally essential. Further study revealed distinct intracellular aspartate compartmentation but not proline, indicating proline may be essential for neonates.

Area of Science:

  • Biochemistry
  • Neonatal Nutrition
  • Metabolic Research

Background:

  • Premature neonates exhibit limited conversion of D-[U-13C]glucose to proline (Pro), aspartate (Asp), and cysteine (Cys).
  • This limited conversion implies these amino acids (AA) may be conditionally essential for this population.

Purpose of the Study:

  • To investigate whether limited amino acid synthesis in premature neonates stems from insufficient precursor (glucose) dose or intracellular compartmentation.
  • To differentiate between inadequate synthesis and precursor availability or compartmentalization of newly synthesized amino acids.

Main Methods:

  • Two phases of intravenous D-[U-13C]glucose infusions (5 mg/kg/min for 4 hr) in premature neonates receiving total parenteral nutrition.
  • Measurement of isotopic enrichments in free plasma amino acids and glucose via gas chromatography/mass spectrometry.
  • Analysis of isotopic enrichments in amino acids incorporated into hepatically synthesized proteins (fibrinogen, VLDL-apolipoprotein B-100) in phase 2.

Main Results:

  • Despite high glucose enrichment (>66%), Pro, Asp, and Cys showed the lowest enrichments among all amino acids (P < 0.05).
  • Aspartate exhibited high enrichment in apo B-100, indicating significant intracellular compartmentation (P < 0.001).
  • Proline showed low enrichment in free plasma amino acids without evidence of intracellular compartmentation.

Conclusions:

  • Limited conversion of glucose to Pro, Asp, and Cys is not due to low precursor glucose enrichment in premature neonates.
  • Evidence supports intracellular aspartate compartmentation in premature neonates.
  • Low plasma proline enrichment and lack of compartmentation suggest proline is a conditionally essential amino acid for premature neonates.

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