Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy

Barbara S. van der Meij, Nicolaas E. Deutz, Steven Olde Damink, Ramon E. Rodriguez, Marielle P. Engelen

Research output: Contribution to journalMeeting AbstractResearchpeer-review

Abstract

Aims: Chemotherapy can affect the lining of the gut and the digestion of nutrients and consequently cause muscle wasting and physical impairment. This study investigates gut function, by a battery of tests, in advanced cancer patients undergoing chemotherapy.

Methods: In 16 patients with advanced cancer undergoing chemotherapy (T) and 16 healthy controls (H), we performed gut permeability tests using the inert sugars rhamnose (R), lactulose (L), and 3‐O‐Methyl‐D‐glucose (3‐OMG) to measure L/R and 3‐OMG/R ratios. Mucosal function was assessed by pulse IV administration of L‐[5‐13C‐5,5‐2H2]‐CIT to calculate citrulline (CIT) concentration and production rate. Protein digestion capacity and splanchnic extraction of phenyalanine (PHE) were measured after combined intake of a high‐protein meal with enteral [1‐13C]PHE and 15N‐spirulina, and primed continuous infusion of [ring‐2H5]PHE. Blood/urine samples were obtained for inert sugars and amino concentrations/enrichments by LC‐MS/MS, and statistical analysis by unpaired t‐tests and Spearman correlation tests.

Results: Both T and H groups included 7 females (43.8%) and mean age was comparable (T: 60.1±16.6y, H: 59.3±16.0y, ns). L/R ratio and 3‐OMG/R ratios were not different, but 3‐OMG was higher in T (T: 48.4±19.7% vs H: 35.5±13.5%, P = 0.03). Protein digestion capacity tended to be lower in T (0.66±0.08 vs 0.75±0.15, P = 0.07), splanchnic extraction was comparable (T: 0.20 ± 0.1 vs H: 0.21 ± 0.1, ns). Plasma CIT (T: 20.5 ± 8.4 μmol/L vs. H: 29.9 ± 9.6 μmol/L, P = 0.009) and the production of CIT (T: 16.9 ± 7.7 μmol/kg FFM*h vs H: 11.0 ± 3.4 μmol/kg FFM*h, P = 0.02) were lower in T.

Conclusions: Patients with cancer undergoing chemotherapy show early signs of a leaky gut and impaired digestion and mucosal function
Original languageEnglish
Article number362
Pages (from-to)172-172
Number of pages1
JournalAsia-Pacific Journal of Clinical Oncology
Volume14
Issue numberS7
DOIs
Publication statusPublished - Nov 2018
EventCOSA's 45th Annual Scientific Meeting: Mesothelioma and Gastro‐Intestinal Cancers - Technology and Genomics - Perth Convention and Exhibition Centre, Perth, Australia
Duration: 13 Nov 201815 Nov 2018
Conference number: 45th
http://cosa2018.org/
http://www.cosa2018.org

Cite this

van der Meij, Barbara S. ; Deutz, Nicolaas E. ; Damink, Steven Olde ; Rodriguez, Ramon E. ; Engelen, Marielle P. / Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy. In: Asia-Pacific Journal of Clinical Oncology. 2018 ; Vol. 14, No. S7. pp. 172-172.
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title = "Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy",
abstract = "Aims: Chemotherapy can affect the lining of the gut and the digestion of nutrients and consequently cause muscle wasting and physical impairment. This study investigates gut function, by a battery of tests, in advanced cancer patients undergoing chemotherapy.Methods: In 16 patients with advanced cancer undergoing chemotherapy (T) and 16 healthy controls (H), we performed gut permeability tests using the inert sugars rhamnose (R), lactulose (L), and 3‐O‐Methyl‐D‐glucose (3‐OMG) to measure L/R and 3‐OMG/R ratios. Mucosal function was assessed by pulse IV administration of L‐[5‐13C‐5,5‐2H2]‐CIT to calculate citrulline (CIT) concentration and production rate. Protein digestion capacity and splanchnic extraction of phenyalanine (PHE) were measured after combined intake of a high‐protein meal with enteral [1‐13C]PHE and 15N‐spirulina, and primed continuous infusion of [ring‐2H5]PHE. Blood/urine samples were obtained for inert sugars and amino concentrations/enrichments by LC‐MS/MS, and statistical analysis by unpaired t‐tests and Spearman correlation tests.Results: Both T and H groups included 7 females (43.8{\%}) and mean age was comparable (T: 60.1±16.6y, H: 59.3±16.0y, ns). L/R ratio and 3‐OMG/R ratios were not different, but 3‐OMG was higher in T (T: 48.4±19.7{\%} vs H: 35.5±13.5{\%}, P = 0.03). Protein digestion capacity tended to be lower in T (0.66±0.08 vs 0.75±0.15, P = 0.07), splanchnic extraction was comparable (T: 0.20 ± 0.1 vs H: 0.21 ± 0.1, ns). Plasma CIT (T: 20.5 ± 8.4 μmol/L vs. H: 29.9 ± 9.6 μmol/L, P = 0.009) and the production of CIT (T: 16.9 ± 7.7 μmol/kg FFM*h vs H: 11.0 ± 3.4 μmol/kg FFM*h, P = 0.02) were lower in T.Conclusions: Patients with cancer undergoing chemotherapy show early signs of a leaky gut and impaired digestion and mucosal function",
author = "{van der Meij}, {Barbara S.} and Deutz, {Nicolaas E.} and Damink, {Steven Olde} and Rodriguez, {Ramon E.} and Engelen, {Marielle P.}",
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Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy. / van der Meij, Barbara S.; Deutz, Nicolaas E.; Damink, Steven Olde; Rodriguez, Ramon E.; Engelen, Marielle P.

In: Asia-Pacific Journal of Clinical Oncology, Vol. 14, No. S7, 362, 11.2018, p. 172-172.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy

AU - van der Meij, Barbara S.

AU - Deutz, Nicolaas E.

AU - Damink, Steven Olde

AU - Rodriguez, Ramon E.

AU - Engelen, Marielle P.

PY - 2018/11

Y1 - 2018/11

N2 - Aims: Chemotherapy can affect the lining of the gut and the digestion of nutrients and consequently cause muscle wasting and physical impairment. This study investigates gut function, by a battery of tests, in advanced cancer patients undergoing chemotherapy.Methods: In 16 patients with advanced cancer undergoing chemotherapy (T) and 16 healthy controls (H), we performed gut permeability tests using the inert sugars rhamnose (R), lactulose (L), and 3‐O‐Methyl‐D‐glucose (3‐OMG) to measure L/R and 3‐OMG/R ratios. Mucosal function was assessed by pulse IV administration of L‐[5‐13C‐5,5‐2H2]‐CIT to calculate citrulline (CIT) concentration and production rate. Protein digestion capacity and splanchnic extraction of phenyalanine (PHE) were measured after combined intake of a high‐protein meal with enteral [1‐13C]PHE and 15N‐spirulina, and primed continuous infusion of [ring‐2H5]PHE. Blood/urine samples were obtained for inert sugars and amino concentrations/enrichments by LC‐MS/MS, and statistical analysis by unpaired t‐tests and Spearman correlation tests.Results: Both T and H groups included 7 females (43.8%) and mean age was comparable (T: 60.1±16.6y, H: 59.3±16.0y, ns). L/R ratio and 3‐OMG/R ratios were not different, but 3‐OMG was higher in T (T: 48.4±19.7% vs H: 35.5±13.5%, P = 0.03). Protein digestion capacity tended to be lower in T (0.66±0.08 vs 0.75±0.15, P = 0.07), splanchnic extraction was comparable (T: 0.20 ± 0.1 vs H: 0.21 ± 0.1, ns). Plasma CIT (T: 20.5 ± 8.4 μmol/L vs. H: 29.9 ± 9.6 μmol/L, P = 0.009) and the production of CIT (T: 16.9 ± 7.7 μmol/kg FFM*h vs H: 11.0 ± 3.4 μmol/kg FFM*h, P = 0.02) were lower in T.Conclusions: Patients with cancer undergoing chemotherapy show early signs of a leaky gut and impaired digestion and mucosal function

AB - Aims: Chemotherapy can affect the lining of the gut and the digestion of nutrients and consequently cause muscle wasting and physical impairment. This study investigates gut function, by a battery of tests, in advanced cancer patients undergoing chemotherapy.Methods: In 16 patients with advanced cancer undergoing chemotherapy (T) and 16 healthy controls (H), we performed gut permeability tests using the inert sugars rhamnose (R), lactulose (L), and 3‐O‐Methyl‐D‐glucose (3‐OMG) to measure L/R and 3‐OMG/R ratios. Mucosal function was assessed by pulse IV administration of L‐[5‐13C‐5,5‐2H2]‐CIT to calculate citrulline (CIT) concentration and production rate. Protein digestion capacity and splanchnic extraction of phenyalanine (PHE) were measured after combined intake of a high‐protein meal with enteral [1‐13C]PHE and 15N‐spirulina, and primed continuous infusion of [ring‐2H5]PHE. Blood/urine samples were obtained for inert sugars and amino concentrations/enrichments by LC‐MS/MS, and statistical analysis by unpaired t‐tests and Spearman correlation tests.Results: Both T and H groups included 7 females (43.8%) and mean age was comparable (T: 60.1±16.6y, H: 59.3±16.0y, ns). L/R ratio and 3‐OMG/R ratios were not different, but 3‐OMG was higher in T (T: 48.4±19.7% vs H: 35.5±13.5%, P = 0.03). Protein digestion capacity tended to be lower in T (0.66±0.08 vs 0.75±0.15, P = 0.07), splanchnic extraction was comparable (T: 0.20 ± 0.1 vs H: 0.21 ± 0.1, ns). Plasma CIT (T: 20.5 ± 8.4 μmol/L vs. H: 29.9 ± 9.6 μmol/L, P = 0.009) and the production of CIT (T: 16.9 ± 7.7 μmol/kg FFM*h vs H: 11.0 ± 3.4 μmol/kg FFM*h, P = 0.02) were lower in T.Conclusions: Patients with cancer undergoing chemotherapy show early signs of a leaky gut and impaired digestion and mucosal function

U2 - 10.1111/ajco.13089

DO - 10.1111/ajco.13089

M3 - Meeting Abstract

VL - 14

SP - 172

EP - 172

JO - Asia-Pacific Journal of Clinical Oncology

JF - Asia-Pacific Journal of Clinical Oncology

SN - 1743-7555

IS - S7

M1 - 362

ER -