Albaugh VL, Mukherjee K, Barbul A, et al.
The Journal of nutrition. Date of publication 2017 Nov 1;volume 147(11):2011-2017.
1. J Nutr. 2017 Nov;147(11):2011-2017. doi: 10.3945/jn.117.256404. Epub 2017 Oct 4.
Proline Precursors and Collagen Synthesis: Biochemical Challenges of Nutrient
Supplementation and Wound Healing.
Albaugh VL(1), Mukherjee K(2), Barbul A(3).
Author information:
(1)Division of General Surgery, Department of Surgery, Vanderbilt University
School of Medicine, Nashville, TN; and.
(2)Division of Acute Care Surgery, Loma Linda University School of Medicine, Loma
Linda, CA.
(3)Division of General Surgery, Department of Surgery, Vanderbilt University
School of Medicine, Nashville, TN; and adrian.barbul@vanderbilt.edu.
Wound healing is a complex process marked by highly coordinated immune fluxes
into an area of tissue injury; these are required for re-establishment of normal
tissue integrity. Along with this cascade of cellular players, wound healing also
requires coordinated flux through a number of biochemical pathways, leading to
synthesis of collagen and recycling or removal of damaged tissues. The
availability of nutrients, especially amino acids, is critical for wound healing,
and enteral supplementation has been intensely studied as a potential mechanism
to augment wound healing-either by increasing tensile strength, decreasing
healing time, or both. From a practical standpoint, although enteral nutrient
supplementation may seem like a reasonable strategy to augment healing, a number
of biochemical and physiologic barriers exist that limit this strategy. In this
critical review, the physiology of enteral amino acid metabolism and
supplementation and challenges therein are discussed in the context of splanchnic
physiology and biochemistry. Additionally, a review of studies examining various
methods of amino acid supplementation and the associated effects on wound
outcomes are discussed.
© 2017 American Society for Nutrition.
DOI: 10.3945/jn.117.256404
PMCID: PMC5657141
PMID: 28978679 [Indexed for MEDLINE]
Conflict of interest statement: Author disclosures: VLA, KM, and AB, no conflicts
of interest.
