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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
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 language | English |
|---|---|
| Article number | 362 |
| Pages (from-to) | 172-172 |
| Number of pages | 1 |
| Journal | Asia-Pacific Journal of Clinical Oncology |
| Volume | 14 |
| Issue number | S7 |
| DOIs | |
| Publication status | Published - Nov 2018 |
| Event | COSA's 45th Annual Scientific Meeting: Mesothelioma and Gastro‐Intestinal Cancers - Technology and Genomics - Perth Convention and Exhibition Centre, Perth, Australia Duration: 13 Nov 2018 → 15 Nov 2018 Conference number: 45th http://cosa2018.org/ http://www.cosa2018.org |
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Dive into the research topics of 'Early signs of impaired gut function in patients with advanced cancer undergoing chemotherapy'. Together they form a unique fingerprint.Related Projects
- 2 Active
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Nutrition Research for Digestive Health
Marshall, S., Crichton, M., Campbell, K., Lohning, A., Marx, W., Van der Meij, B., Angus, R., Canavan, R., Utter, J. & Tang, X.
1/01/14 → …
Project: Research
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Oncology Nutrition Research
Isenring, E., Marshall, S., Van der Meij, B., Rigby, R., Teleni, L., Crichton, M. & Tang, X.
1/01/14 → …
Project: Research
Related Activities
- 1 Invited talk
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Gut function research in chemotherapy and SCT patients
Barbara Van der Meij (Speaker)
27 Jun 2019Activity: Talk or presentation › Invited talk
Related Research Outputs
- 1 Meeting Abstract
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Baseline clinical but not metabolic characteristics of cancer subjects dropping out of a clinical trial during chemotherapy are different from non-dropout subjects
van der Meij, B. S., Deutz, N. E., Rodriguez, R. E., Koeman, F. & Engelen, M. P., Nov 2018, In: Asia-Pacific Journal of Clinical Oncology. 14, S7, p. 172-172 1 p., 363.Research output: Contribution to journal › Meeting Abstract › Research › peer-review
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