Oral rehydration solutions (ORS) presently in use are effective for the treatment of diarrhea, especially early in life. Current ORS reverse dehydration and sodium (Na) losses, although they do not shorten the duration of the disease. This revised proposal is designed to extend preliminary investigations which showed that certain viscous agents improved ORS capacity for rehydration and Na uptake. We now aim to broaden our observations and substantiate the general hypothesis that the effectiveness of ORS can be enhanced by soluble fibers or gums which alter the rheological characteristics of the intestinal lumen contents. To achieve this goal we will study the role of viscosity, net charge and polymer chain organization at different Na concentrations. We will also examine whether water absorption improvement is due to a reduction of fluid recirculation into the lumen associated with changes in the architecture of the mucosal brush border. An important component of the project is the use of several animal models of childhood gastrointestinal disease and malnutrition which mimic presentations of diarrheal disease in human populations. They include: (1) secretory diarrhea induced by stable E. coli toxin; (2) in situ exposure of the small intestine to theophylline, which acts by the same mechanisms as cholera toxin; (3) protein-energy malnutrition (PEM); (4) a combination of PEM and toxin-induced secretion. The basic experimental technique will be an intestinal perfusion procedure in anesthetized rats. Nonabsorbable markers and labeled tracers will enable us to calculate net and unidirectional flows of water and other ORS components. We will also evaluate the effectiveness of soluble fiber- enhanced ORS in reversing the effects of secretagogues on the intestinal villi and the brush border vicinity by histologic and electron microscopic methods. Quantitative data obtained with intestinal perfusions in rats under anesthesia have been shown to parallel results reported in children with diarrhea treated with the same ORS. This proposal should provide the basis for a new approach intended to make ORS a more effective and economically accessible therapy in the treatment of diarrhea and dehydration, particularly in infancy and childhood.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD029255-03
Application #
2025377
Study Section
Nutrition Study Section (NTN)
Project Start
1995-01-01
Project End
1998-12-31
Budget Start
1997-01-01
Budget End
1998-12-31
Support Year
3
Fiscal Year
1997
Total Cost
Indirect Cost
Name
North Shore University Hospital
Department
Type
DUNS #
City
Manhasset
State
NY
Country
United States
Zip Code
11030
Teichberg, S; Wingertzahn, M A; Moyse, J et al. (1999) Effect of gum arabic in an oral rehydration solution on recovery from diarrhea in rats. J Pediatr Gastroenterol Nutr 29:411-7
Wingertzahn, M A; Teichberg, S; Wapnir, R A (1999) Modified starch enhances absorption and accelerates recovery in experimental diarrhea in rats. Pediatr Res 45:397-402
Wapnir, R A; Wingertzahn, M A; Moyse, J et al. (1998) Proabsorptive effects of modified tapioca starch as an additive of oral rehydration solutions. J Pediatr Gastroenterol Nutr 27:17-22
Wapnir, R A; Wingertzahn, M A; Teichberg, S (1997) L-arginine in low concentration improves rat intestinal water and sodium absorption from oral rehydration solutions. Gut 40:602-7
Wapnir, R A; Wingertzahn, M A; Teichberg, S (1997) Cellulose derivatives and intestinal absorption of water and electrolytes: potential role in oral rehydration solutions. Proc Soc Exp Biol Med 215:275-80
Wapnir, R A; Wingertzahn, M A; Moyse, J et al. (1997) Gum arabic promotes rat jejunal sodium and water absorption from oral rehydration solutions in two models of diarrhea. Gastroenterology 112:1979-85
Wapnir, R A; Sia, M C; Fisher, S E (1996) Enhancement of intestinal water absorption and sodium transport by glycerol in rats. J Appl Physiol 81:2523-7
Wapnir, R A; Teichberg, S; Go, J T et al. (1996) Oral rehydration solutions: enhanced sodium absorption with gum arabic. J Am Coll Nutr 15:377-82