citrulline

Testicular torsion is a critical urological emergency that can lead to testicular ischemia and significant tissue damage. Citrulline, a supplement known for enhancing cellular metabolism and mitigating oxidative stress and inflammation, has been explored for its protective effects against testicular injury resulting from torsion and detorsion in rat models.

This study involved 42 Wistar rats, divided into six groups: Sham, torsion/detorsion (T/D), and four groups receiving varying doses of Citrulline (300, 600, 900 mg/kg) and vitamin E (20 mg/kg). A surgical procedure was performed to induce torsion by rotating the left testicle for 4 hr, followed by reperfusion. Daily oral administration of the supplements continued for one week post-surgery. Assessments included oxidative stress markers, apoptosis, inflammation, pathology, and sperm parameters. Statistical analysis was conducted using GraphPad Prism.

Citrulline administration at doses of 600 and 900 mg/kg significantly reduced malondialdehyde (MDA) and reactive oxygen species (ROS) levels. Additionally, it increased glutathione (GSH) levels and decreased protein carbonyl levels at the 900 mg/kg dose. The expression of interleukin-6 (IL-6) decreased at 900 mg/ kg, tumor necrosis factor-alpha (TNF-α) levels dropped at 600 and 900 mg/kg, and the pro-apoptotic factor Bax was reduced at all doses. Sperm analysis showed improved sperm count and motility at the 900 mg/kg dose. Histological examination revealed significant positive effects of Citrulline on testicular tissue.

Citrulline effectively lowers oxidative stress, inflammation, while enhancing sperm quality and pathological outcomes. These results indicate that Citrulline has potential as a therapeutic agent for testicular torsion.

ntroduction:Effective parenteral and enteral amino acid replacement is crucial for critically ill patients with alteredamino acid metabolism. This study aimed to assess the effects of l-citrulline supplementation on the clinical and labo-ratory outcomes in critically patients.

This was a double-blind placebo-controlled randomized clinical trial.82 critically ill patients who were expected to receive mechanical ventilation for more than 72 hours were selected. Thepatients were assigned to either a placebo or an intervention group. The patients in the placebo group received 10 gr ofmicrocrystalline cellulose and the ones in the intervention group were given l-citrulline daily for 7 days. Serum levelsof fasting blood sugar (FBS), lipid profile, hepatic enzymes, serum electrolytes, urea nitrogen, creatinine, and C-reactiveprotein (CRP) were evaluated before and after the intervention. Duration of invasive ventilation, intensive care unit(ICU) length of stay, ventilator-free days, and 28-day mortality rate were recorded and compared between groups.Re-sults:Eighty-two patients completed the trial. No statistically significant differences were observed between the twogroups in terms of age (p = 0.46), sex (p = 0.49), body mass index (BMI) (p = 0.41), Sequential Organ Failure Assessment(SOFA) Score (p = 0.08), Clinical Pulmonary Infection Score (CPIS) score (p = 0.76), Acute Physiology and Chronic HealthEvaluation (APACHE II) score (p = 0.58), risk factors (p = 0.13), ICU stay before randomization (p = 0.32), and reason ofadmission (p = 0.50) before the intervention. Citrulline group had a notable reduction in FBS (p = 0.04), total choles-terol (TC) (p = 0.02), low density lipoprotein (LDL-C) (p <0.001) and high-sensitivity CRP (hs-CRP) (p <0.001). Also, asignificant increase in lactate dehydrogenase (LDH) concentration (p <0.001) was observed in the intervention group atthe end of the trial. Total duration of invasive ventilation and the mean SOFA score on 7th day were significantly lowerin the citrulline group compared to the control group. Moreover, a significant increase in days alive and ventilator-freedays within 28 days after admission was found in the citrulline group at the end of the trial. Also, there were no signifi-cant differences between the groups in terms of mortality rate during intervention, serious adverse events, endotrachealintubation, the use of tracheotomy or non-invasive ventilation after extubation, length of ICU stay, ICU-free days at 28days, and CPIS and APACHE II scores. For mortality, in the citrulline group, there was two deaths compared to eightdeaths in the control group. This resulted in an absolute risk reduction (ARR) of 14.05% (95% CI: 0.39–27.71%) and anumber needed to treat (NNT) of 7.1 (95% CI: 3.6–29.5), regarding mortality.

The results of the presentstudy demonstrated the probable positive effects of citrulline supplementation on lipid profile, hs-CRP levels, durationof invasive ventilation, and SOFA score. Also, l-citrulline consumption may increase the probability of survival withoutmechanical ventilation.

Football players often experience muscle fatigue leading to impaired performance in the middle of the game. Watermelon contains citrulline which may detox ammonia and lactic acid in the urea cycle thus could help relieve muscle fatigue. This study analyzed the effect of watermelon beverage ingestion on fatigue index (FI) in young-male, recreational football players. A randomized, 2-periods crossover design involving 26 young-male, recreational football players aged 15 - 17 years was performed. They consumed 500 mL of watermelon beverage in 1 of the 2 periods, and 500 mL of red sucrose syrup as placebo in the other for 7 days respectively. Running-based anaerobic sprint test (RAST) was conducted to measure FI, a day before and on the seventh day of the intervention. Consuming 500 mL of watermelon beverage for 7 days decreased FI significantly (P = 0.001); however, placebo ingestion for 7 days had no significant effect in changing FI (P = 0.495). Watermelon beverage ingestion could relieve muscle fatigue in young-male, recreational football players. They are advised to consume 500 mL of watermelon beverage prior and until the end of the match session for 7 consecutive days to help relieving muscle fatigue and reaching the highest performance.

Specific amino acids seem to have crucial role in the management of critically ill patients. This study aimed to compare the effect of L-arginine and L-citrulline supplementation on overall prognosis of critically ill patients.

A total of 105 head trauma ICU patients were recruited in this double-blind randomized clinical trial. Patients in the treatment groups took 10 gr per day oral L-Arginine or L-citrulline for 10 days. Demographic characteristics and anthropometric measurements were recorded. Nitric oxide (NOx), pre-albumin, pro-oxidant, anti-oxidant balance, fasting blood sugar, lipid profile, liver enzymes, serum electrolytes, blood urea nitrogen, creatinine and serum amino acids were measured. Gastrointestinal complications, ventilator need, length of hospital stay and 28-day mortality were recorded. The K2 testing system was used to compare the qualitative variables. Repeated measures ANOVA were used to compare means across variables. In case of significant time-group interaction, between group comparisons of changes at day 11 were done using ANOVA followed by Tukey or Mann Whitney analysis. When time effect factor was significant, the within-group comparison of values was performed by paired samples t test or Wilcoxon.

We observed no significant changes in NOx and PAB (P= 0.8, P= 0.1 respectively). There was a significant increase in serum LDL (P= 0.02) which was higher in the control group after 10 days of supplementation. There was non-significant increase in serum L-arginine in all three groups (P=0.36). However, changes of serum L-arginine was significant in the citrulline group (P=0.048). Serum L-citrulline was higher in the citrulline group compare to the arginine group (P=0.04).

L-arginine and L-citrulline supplementation did not increased NOx levels more than the control group. Also, PAB balance was not different among the intervention groups and the control group. L-arginine and L-citrulline had no significant effects on length of hospital stay, mortality rate, ventilator need and other factors evaluated in this study.

The majority of patients with glioblastoma multiforme (GBM) suffer dismal outcomes. Adopting a broader, multi-mechanistic, multi-agent approach targeting GBM using readily available and fairly benign agents in combination with standard therapy may improve outcomes. Such agents include fluoxetine, fenofibrate, cimetidine, citrulline, valacyclovir, 1,3 1-6 beta glucan, and tadalafil, among others. In the context of in vitro and animal studies, these agents appear to target GBM cells and modify the tumor microenvironment. The current approach to GBM treatment focuses on limited molecular attributes of the condition. The following article highlights the relevance of the aforementioned agents in GBM treatment and proposes a multi-mechanistic, multi-agent paradigm shift, addressing a broader range of molecular attributes in the quest to improve patient outcomes.