Defining Normal Citrulline Levels as a Diagnostic Tool for Screening of Gastrointestinal Disease in Premature Infants
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Colitis, Women's Studies, Gastrointestinal, Digestive Disease |
| Therapuetic Areas: | Gastroenterology, Reproductive |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 4/21/2016 |
| Start Date: | July 2009 |
| End Date: | December 2016 |
Since the first description of citrulline as a potential marker for intestinal function in
1998, its use has been investigated in a variety of disease processes including Short Bowel
Syndrome, Celiac disease, chemotherapy and radiation induced intestinal injury, infections
producing intestinal cytopathic effects like Adenovirus, and predicting rejection in
intestinal transplantation. The use of citrulline levels as a diagnostic tool to predict
gastrointestinal disease in the premature population has not been properly addressed.
The introduction of enteral nutrition in the premature infant is a process of trial and
error, knowing that the immaturity of the gastrointestinal system may lead to frequent
episodes of feeding intolerance. This is augmented by the fear of the development of
necrotizing enterocolitis (NEC) once feeds are commenced. NEC is a condition characterized
by disruption of the intestinal epithelial barrier, a pathogenic process shared with some of
the conditions mentioned above for which citrulline has proven clinically useful.
A normal pattern of citrulline production has not been established in the premature
population. Previous studies have shown decreased levels of glutamine and arginine in
premature infants up to 10 days prior to the development of necrotizing enterocolitis.
Glutamine and arginine are two amino acids closely involved in the synthesis and catabolism
of citrulline.
The investigators therefore hypothesize that defining a normal pattern of citrulline
production in the premature population may prove to be a clinically useful diagnostic tool
to screen for gastrointestinal disease.
1998, its use has been investigated in a variety of disease processes including Short Bowel
Syndrome, Celiac disease, chemotherapy and radiation induced intestinal injury, infections
producing intestinal cytopathic effects like Adenovirus, and predicting rejection in
intestinal transplantation. The use of citrulline levels as a diagnostic tool to predict
gastrointestinal disease in the premature population has not been properly addressed.
The introduction of enteral nutrition in the premature infant is a process of trial and
error, knowing that the immaturity of the gastrointestinal system may lead to frequent
episodes of feeding intolerance. This is augmented by the fear of the development of
necrotizing enterocolitis (NEC) once feeds are commenced. NEC is a condition characterized
by disruption of the intestinal epithelial barrier, a pathogenic process shared with some of
the conditions mentioned above for which citrulline has proven clinically useful.
A normal pattern of citrulline production has not been established in the premature
population. Previous studies have shown decreased levels of glutamine and arginine in
premature infants up to 10 days prior to the development of necrotizing enterocolitis.
Glutamine and arginine are two amino acids closely involved in the synthesis and catabolism
of citrulline.
The investigators therefore hypothesize that defining a normal pattern of citrulline
production in the premature population may prove to be a clinically useful diagnostic tool
to screen for gastrointestinal disease.
The use of citrulline levels as a diagnostic tool to predict gastrointestinal disease in the
premature population has not been properly addressed.
premature population has not been properly addressed.
Inclusion Criteria:
1. Premature infants with gestational age between <32 weeks regardless of birth weight
Exclusion Criteria:
1. Inborn errors of metabolism
2. Need for exchange transfusion
3. Multiple congenital anomalies
4. Renal failure (defined as urine output <1ml/k/h >24h, creatinine >1.8, or diagnosis
of "non-oliguric renal failure" as determined by Pediatric nephrology)
We found this trial at
1
site
Click here to add this to my saved trials
