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

doi:10.1111/ajco.13089

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 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	https://doi.org/10.1111/ajco.13089
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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2 Active

Oncology Nutrition Research
Isenring, E., Marshall, S., Van der Meij, B., Teleni, L., Crichton, M. & Tang, X.
1/01/14 → …
Project: Research
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

1 Invited talk

Gut function research in chemotherapy and SCT patients
Barbara Van der Meij (Speaker)
27 Jun 2019
Activity: Talk or presentation › Invited talk

1 Meeting Abstract

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

Open Access

Cite this

@article{60fc5ac3665d4e3c9248c076ffc311f5,

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.}",

year = "2018",

month = nov,

doi = "10.1111/ajco.13089",

language = "English",

volume = "14",

pages = "172--172",

journal = "Asia-Pacific Journal of Clinical Oncology",

issn = "1743-7555",

publisher = "Wiley-Academy",

number = "S7",

note = "COSA's 45th Annual Scientific Meeting : Mesothelioma and Gastro‐Intestinal Cancers - Technology and Genomics, COSA ; Conference date: 13-11-2018 Through 15-11-2018",

url = "http://cosa2018.org/, http://www.cosa2018.org",

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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.

N1 - Conference code: 45th

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

SN - 1743-7555

VL - 14

SP - 172

EP - 172

JO - Asia-Pacific Journal of Clinical Oncology

JF - Asia-Pacific Journal of Clinical Oncology

IS - S7

M1 - 362

T2 - COSA's 45th Annual Scientific Meeting

Y2 - 13 November 2018 through 15 November 2018

ER -

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

Abstract

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Oncology Nutrition Research

Nutrition Research for Digestive Health

Related Activities

Gut function research in chemotherapy and SCT patients

Related Research Outputs

Baseline clinical but not metabolic characteristics of cancer subjects dropping out of a clinical trial during chemotherapy are different from non-dropout subjects

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