Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity

Lin, Ming Tsan; Kung, Sung Pao; Yeh, Sung Ling; Liaw, Koung-Yi; Wang, Ming Yang; Kuo, Min Liang; Lee, Po Houng; Chen, Wei Jao

doi:10.3748/wjg.v11.i39.6197

Cited by 29 publications

(20 citation statements)

References 24 publications

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“…These effects promote patient recovery. Gln ameliorates the function of intestinal mucosal cells, lymphocytes, macrophages, and neutrophils (12–15). This amino acid is indispensible for intestinal mucosal epithelial cell metabolism as it improves intestinal mucosal repair and restoration of barrier function of the intestinal mucosa (26,27).…”

Section: Discussionmentioning

confidence: 99%

Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis

Xiao-liang

Kang

et al. 2016

Experimental and Therapeutic Medicine

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The present meta-analysis was carried out to determine whether supplementation with glutamine (Gln) would reduce the intestinal inflammatory response and mucosal permeability in patients undergoing abdominal surgery. The PubMed, EMBASE, Web of Science, and The Cochrane Library databases were searched for randomized controlled trials on the effects of supplementation with Gln, and published from August, 1966 to June 2014. Inclusion criteria for the meta-analysis were: i) Study design was a randomized controlled trial, ii) study included patients undergoing abdominal surgery, iii) study patients received a supplementation with Gln peptide (Ala-Gln or Gly-Gln) whereas control patients did not use any supplements, and iv) study outcomes included inflammatory markers [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6, and IL-2 receptor] and markers of intestinal permeability [lactulose/mannitol, diamine oxidase, D(−)lactic acid, and endotoxin]. Qualities of controlled trials were assessed using the Jadad score. Meta-analyses were performed with fixed- or random-effect models depending on the heterogeneity of studies. There were 21 trials meeting the inclusion criteria. The meta-analysis revealed that the levels of CRP, TNF-α, and IL-6 in patients supplemented with Gln were significantly lower than those in control patients, whereas the levels of IL-2 receptor were increased by Gln supplementation. Gln also significantly decreased the lactulose/mannitol ratio, the levels of diamine oxidase and endotoxin, and tended to decrease the levels of cyclic D-lactic acid. In conclusion, Gln appears to effectively reduce the inflammatory response and intestinal mucosal permeability in patients after abdominal surgery.

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Section: Discussionmentioning

confidence: 99%

Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis

Xiao-liang

Kang

et al. 2016

Experimental and Therapeutic Medicine

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“…One of the major procedures which result in severe depletion of glutamine from the skeletal muscles, bringing about muscle loss immunosuppression thus resulting in increased risk for post-operative infection and sepsis is surgery. Various studies have indicated that glutamine supplementation in post-operative patients bring about improvement in their clinical outcome and also their intestinal permeability [9][10][11][12]. However, a conclusive data on this aspect have not been explored much in India.…”

Section: Introductionmentioning

confidence: 99%

Enteral/Oral Glutamine Supplementation in Patients Following Surgery and Accidental Injury

John

M²

2017

Asian J Pharm Clin Res

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Objective: The objective of this investigation was to study the effect of enteral/oral glutamine supplementation in patients following abdominal surgery on plasma glutamine levels, rate of infection, and length of hospitalization (LOH).Methods: A randomized control trial was used, and the patients were randomly divided into two groups, namely experimental and control with 30 participants each. Glutamine supplement (0.5 g/kg) was administered (oral and enteral) to the experimental group for 5 days post-surgery immediately after the feeding began. The study was conducted in ESIC hospital, Chennai, India. Results:The incidence of infection in the control group was found to be almost twice that in the experimental group considering the role of glutamine in combating infection. Furthermore, the LOH was found to be slightly higher in the control group as compared to the experimental group. Conclusion:This study has provided evidence that the supplementation of enteral glutamine in post-operative patients decreases the incidence of post-surgical infection, shortening of hospital stay and reduction in the overall hospital costs.

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“…Parenteral GLN supplementation had a beneficial effect in reducing the systemic production of IL-6 after abdominal operations. Lower IL-6 levels probably improved nitrogen balance in these patients 20 . In our study, the increase in IL-6 levels in both groups ( Figure 6) during the postoperative period signals increased inflammatory response regardless of pre-operative use of L-Ala-Gln.…”

Section: Resultsmentioning

confidence: 99%

L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty

Filho¹,

Gonçalves

Guimarães³

et al. 2011

Acta Cir. Bras.

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PURPOSE:To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1-at the beginning of the study, 3 h prior to the surgical procedure; T2-at the end of the infusion (before the surgical procedure), T3-at the end of the surgical procedure, T4-6 h postoperative and T5-12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS:No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P <0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p <0.01). CONCLUSION: Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control. Keywords: Congenital Abnormalities. Surgical Procedures, Operative. Glutamine. Cytokines. Child. RESUMO OBJETIVO:Avaliar os efeitos do pré-tratamento com L-alanil-glutamina (L-Ala-Gln) sobre o estresse oxidativo, o controle glicêmico e a resposta inflamatória em crianças submetidas à palatoplastia. MÉTODOS: Trinta crianças do sexo masculino, agendadas para palatoplastia, faixa etária 2-10 anos, foram distribuídas aleatoriamente em dois grupos (n = 15): Grupo A (salina, controle) e Grupo B (L-Ala-Gln). O grupo A recebeu solução salina 0,9% 100 ml, administrado por via intravenosa utilizando uma bomba de infusão durante 3 horas anteriores ao procedimento cirúrgico. O grupo B foi tratado com L-Ala-Gln, solução a 20% (0,5 g/kg), acrescentando soro fisiológico até completar 100 ml. Amostras de sangue venoso periférico foram coletadas em cinco momentos diferentes: T1 (3 h antes do procedimento cirúrgico); T2 (no final da perfusão), T3 (no final do procedimento cirúrgico), no pós-operatório, após 6 h (T-4) e 12 h (T5). Os parâmetros analisados foram a glutationa (GSH), ácido tiobarbitúrico (TBARS), glicose, insulina, proteína C-reativa (PCR) e interleucina-6 (IL-6). RESULTADOS: Não houve diferença significante entre os grupos comparando as concentrações de glicose, insulina, TBARS, GSH e IL-6. No entanto, os...

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Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity

Cited by 29 publications

References 24 publications

Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis

Effects of glutamine on markers of intestinal inflammatory response and mucosal permeability in abdominal surgery patients: A meta-analysis

Enteral/Oral Glutamine Supplementation in Patients Following Surgery and Accidental Injury

L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty

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