Glutamine is the preferred oxidative fuel for the small bowel endothelium, and enteral administration of a glutamine-supplemented diet has been shown to preserve mucosal cellularity, to promote recovery, and to improve nitrogen balance in animal studies.
Finally, branched-chain amino acids are used as energy sources during the acute phase of injury. When given alone or with glucose to postoperative patients, branched-chain amino acids improved nitrogen balance and increased whole-body protein synthesis and albumin renewal. They may also play a regulatory role in skeletal muscle synthesis.
Micronutrients in Cellular Nutrition
Because oxygen free radicals are released throughout the course of the inflammatory process, it is especially desirable to maximize the oxygen-scavenging potential of the plasma with adequate zinc, copper, selenium, and vitamin E. Addition of these substances to feeding regimens can prevent microsomal, mitochondrial, and membrane lipid damage. A potentially hazardous property of fish oil is its propensity to peroxidation. This leads to rapid perishability in vitro, and can be measured in vivo via ethane excretion. In rats fed cod liver oil, membrane peroxidation induced by CCl4 was 5 times that of lard-fed rats; mortality was also greater, but, with the administration of antioxidants, was restored to control levels. The addition of antioxidants such as vitamin E and terf-butylhydroquinone in any dietary preparation containing long-chain polyunsaturated fatty acids such as fish oil is therefore vital to prevent lipid peroxidation.
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