Evidence map›Paper›PMID 28826699›Full record

ArticleClinical nutrition (Edinburgh, Scotland)2018

Major surgery diminishes systemic arginine availability and suppresses nitric oxide response to feeding in patients with early stage breast cancer.

Mariëlle P K J Engelen, V Suzanne Klimberg, Arianna Allasia, Nicolaas E P Deutz

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical nutrition (Edinburgh, Scotland), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00497380 (Arginine Feeding), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00497380 nacompletednot on this map

Arginine Feeding: a Novel Strategy to Improve Protein Metabolism in Cancer and the Response to Surgery

TypeinterventionalSponsorTexas A&M UniversityRan2009 to 2012Enrolled19ConditionsProtein MetabolismArmsArginine
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
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  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Mariëlle P K J EngelenCenter for Translational Research on Aging and Longevity, Dept. of Health and Kinesiology, Texas A&M University, College Station, TX, USA; Dept. of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA. Electronic address: mpkj.engelen@ctral.org.
V Suzanne KlimbergDivision of Breast Surgical Oncology, Dept. of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Arianna AllasiaDept. of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Nicolaas E P DeutzCenter for Translational Research on Aging and Longevity, Dept. of Health and Kinesiology, Texas A&M University, College Station, TX, USA; Dept. of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
University of Arkansas for Medical Sciences · US

Funding

CTSA INFRASTRUCTURE FOR PEDIATRIC RESEARCHUL1RR029884 · NCRR · UNIV OF ARKANSAS FOR MED SCIS · PI LOWERY, CURTIS L · 2009 to 2011
$11.4M
NCRR NIH HHS UL1 RR029884
6 · The paper itself

Abstract

BACKGROUND &

aimsPlasma arginine (ARG) levels are reduced in breast cancer, suggesting diminished systemic ARG availability. ARG and its product nitric oxide (NO) are important in early postoperative recovery due to its roles in immune function and wound healing. It remains unclear whether major surgery further diminishes systemic ARG availability due to enhanced ARG catabolism and/or insufficient endogenous ARG synthesis negatively affecting NO synthesis in patients with early stage breast cancer.

methodsIn 9 women with early stage breast malignancy and 9 healthy women with genetic predisposition to breast cancer, whole body ARG and citrulline (CIT) rates of appearances were measured to determine their production rates prior to and within 24 h after major breast surgery by stable isotope methodology in the postabsorptive and postprandial state. The conversions of CIT > ARG, ARG > CIT, and ARG > Urea (markers of de novo ARG and NO synthesis, arginase activity, respectively), and ARG clearance (reflecting ARG disposal capacity) were calculated.

resultsPrior to surgery, plasma ARG, CIT and glutamine concentrations were lower in cancer (P < 0.05) but no differences were found in the rate of appearances of ARG, CIT and their conversions. Surgery increased ARG clearance and reduced CIT rate of appearance, conversion of CIT > ARG (P < 0.001), and plasma ARG, CIT, ornithine concentrations (P < 0.001). Furthermore, postprandial increase in ARG > CIT conversion (P < 0.05), plasma ARG (P < 0.001) and CIT (P = 0.06) concentrations were lower after surgery. The cancer group had lower values for postprandial increase in ARG > CIT conversion, plasma CIT (P < 0.05) and glutamine concentrations (P = 0.08).

conclusionsMajor surgery in early stage breast cancer further reduces systemic ARG availability in the early phase of recovery due to a combined process of increased ARG catabolism and impaired endogenous ARG synthesis. The suppressed postprandial NO increase in early stage cancer suggests that specific nutritional approaches are advised to increase ARG availability after major surgery although the effects on postoperative recovery remain unclear. This trial was registered at clinicaltrials.gov as NCT00497380.

Indexed as

AdultArginineBreast NeoplasmsCitrullineFemaleGenetic Predisposition to DiseaseGlutamineHumansMastectomyMetabolic Clearance RateMiddle AgedNitric OxidePostoperative ComplicationsPostprandial PeriodArginineCitrullineGlutamineNitric OxideArginine kineticsBreast surgeryEarly stage breast cancerNitric oxide synthesisStable isotopes

Identifiers

PMID28826699
PMCPMC5799041
OpenAlexW2743169935

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.