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Cellular immunity changes after total parenteral nutrition enriched with glutamine in patients with systemic inflammatory response syndrome

The immune status is altered in patients with systemic inflammatory response syndrome (SIRS). Nutrition is one of the most important treatments for these patients, improving body protein and immune function, reducing the rate of infection and shortening hospitalization. In this study, we administered intravenous glutamine supplementation to patients with SIRS in order to investigate the effect of glutamine supplementation on immune states.

This study is a prospective, randomized clinical trial. The APACHE II score and the SAPS II were used to evaluate the patients after admission. All patients received total parenteral nutrition (TPN) given continuously during 6 days. Thirty patients with SIRS were allocated to either a glutamine group (L-glutamine 0.4 g/kg/day) or a control group (glutamine-free, isonitrogenous, isocaloric formula). Blood samples were collected on day 1 and day 6 after admission for C-reactive protein, IgM, IgG, IgA, C3, C4 and lymphocyte analysis.

Although there was tendency to decrease T-sitotoxic cells and natural killer cells in the control group, no significant difference was observed between the two groups. However, an increase in lymphocyte and lymphocyte subgroups in the glutamine group was observed but there was no difference between groups. A low SAPS II was observed on the sixth day in the glutamine group whereas no difference in SAPS II and the APACHE II score were observed between the two groups.

The administration of TPN supplemented with glutamine causes enhancement in T-cell function in SIRS patients.

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Cetinbas, F., Yelken, B. & Gulbas, Z. Cellular immunity changes after total parenteral nutrition enriched with glutamine in patients with systemic inflammatory response syndrome. Crit Care 10, P209 (2006). https://doi.org/10.1186/cc4556

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Keywords

  • Natural Killer
  • Glutamine
  • Natural Killer Cell
  • Systemic Inflammatory Response Syndrome
  • Total Parenteral Nutrition