Williams JZ, Abumrad N, Barbul A, et al.
Annals of surgery. Date of publication 2002 Sep 1;volume 236(3):369-74; discussion 374-5.
1. Ann Surg. 2002 Sep;236(3):369-74; discussion 374-5.
Effect of a specialized amino acid mixture on human collagen deposition.
Williams JZ(1), Abumrad N, Barbul A.
Author information:
(1)Department of Surgery, Sinai Hospital of Baltimore, Johns Hopkins Medical
Institutions, Baltimore, Maryland 21215, USA.
OBJECTIVE: To examine the effect of arginine, beta-hydroxy-beta-methylbutyrate
(HMB), and glutamine supplementation on wound collagen accumulation in a
double-blind, randomized study.
SUMMARY BACKGROUND DATA: Control of wound collagen synthesis has been an elusive
goal for clinicians and scientists alike. In many clinical instances, it is
desired to increase collagen deposition as a means of enhancing wound strength
and integrity. Arginine, a semiessential amino acid, has been shown to increase
wound collagen accumulation in rodents and humans. HMB, a metabolite of leucine,
regulates muscle proteolysis in animals and humans and increases collagen
deposition in rodents.
METHODS: Thirty-five healthy, nonsmoking human volunteers 70 years or older were
enrolled and underwent subcutaneous implantation of two small, sterile
polytetrafluoroethylene (PTFE) tubes into the deltoid region under strict aseptic
techniques. The tubes were 1 mm in diameter and 6 cm in length with pore size of
90 to 120 microm to allow optimal ingrowth of fibroblasts and the deposition of
matrix. Eighteen volunteers (mean age 75.4 years; 2 men, 16 women) were
randomized to receive daily supplementation of 14 g arginine, 3 g HMB, and 14 g
glutamine (total nitrogen 3.59 g) in two divided doses. The control group (n =
17; mean age 75.3 years; 6 men, 11 women) received an isonitrogenous, isocaloric
supplementation of nonessential amino acids. Catheters were removed at 7 and 14
days postimplantation and analyzed for hydroxyproline (OHP, nmol/cm catheter, an
index of collagen accumulation) and alpha-amino nitrogen (alpha-AN, mmol/cm, an
index of total protein deposition).
RESULTS: Supplements were well tolerated, without any reported side effects.
Supplementation with the specialized amino acid mixture led to a significant rise
in plasma arginine and ornithine levels. The specialized amino acid supplement
led to a significant increase in collagen deposition (as reflected by OHP
content) in the PTFE tubes without an effect on total protein accumulation.
CONCLUSIONS: Collagen synthesis is significantly enhanced in healthy elderly
volunteers by the oral administration of a mixture of arginine, HMB, and
glutamine. This provides a safe nutritional means for increasing wound repair in
patients.
DOI: 10.1097/00000658-200209000-00013
PMCID: PMC1422590
PMID: 12192323 [Indexed for MEDLINE]
