Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer

Braga, Marco; Gianotti, Luca; Vignali, Andrea; Carlo, V. Di

doi:10.1067/msy.2002.128350

Cited by 333 publications

(328 citation statements)

References 34 publications

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“…Studies that evaluated only the population of septic patients identified damage (increased mortality) using this type of formulation. Such effect may be related to the arginine metabolism alterations in sepsis, connected to the demodulation of secondary microcirculation to increased production of nitric oxide, or maximixation of systemic inflammatory response (BERTOLINI et al, 2003).…”

Section: Immunonutrition Componentsmentioning

confidence: 99%

“…Cancer patients who received post-operative supplemental arginine (25g / day) showed significant improvement in T lymphocyte response and T cells percentage (CD4 phenotype) compared to randomized patients who received placebo. One of the most frequent complications in malnourished câncer patients is the delay in wound healing, and it has been verified that early immunonutrition, particularly arginine, appears to be responsible for a more effective tissue regeneration (Daly et al, 1988;Braga et al, 2002;. PEREIRA FILHO, 2012).…”

Section: Immunonutrition Componentsmentioning

confidence: 99%

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Efeitos da imunonutrição no tratamento de pacientes com câncer e suas complicações – uma revisão

Oliveira

et al. 2015

Semin. Cienc. Biol. Saude

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The aim of this study was to review and summarize the data from the literature regarding the effects of pre-and postoperative immunonutrition in the outcome of cancer patients. The review was conducted through literature searches in databases such as Medline/Pubmed, Scielo and Lilacs, from July to September 2014, for articles investigating the effects of immunonutrition related to nutritional recovery and pre-and post-operative procedures in cancer patients. We found 32 articles, 27 of which met the inclusion criteria, including review articles, case-control studies, epidemiological studies and crosssectional studies. From this literature review it was possible to see the benefits of using preoperative immunomodulating diet in cancer patients undergoing major abdominal surgery, including reduction of septic and inflammatory complications during postoperative period and hence the hospital length of stay. Thus, the use of immunonutrition has been shown to be capable to reverse organic and immunological changes caused by both malnutrition and the tumor itself in cancer patients. AbstractResumo O objetivou deste trabalho foi revisar, de forma sucinta e objetiva, as evidências disponíveis nos bancos de dados digitais, sobre os efeitos da imunonutrição para a resposta ao tratamento de pacientes com câncer em pré e pós-operatório. Foi realizada uma revisão de literatura, por meio de buscas bibliográficas nos bancos de dados informatizados Medline/Pubmed, Scielo e Lilacs, no período de julho a setembro de 2014, de artigos que investigaram os efeitos da imunonutrição na recuperação do estado nutricional e

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Section: Immunonutrition Componentsmentioning

confidence: 99%

Section: Immunonutrition Componentsmentioning

confidence: 99%

Efeitos da imunonutrição no tratamento de pacientes com câncer e suas complicações – uma revisão

Oliveira

et al. 2015

Semin. Cienc. Biol. Saude

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“…Other studies have shown that pre-operative arginine-enriched nutrition improves immune function and decreased the production of Th2 cytokines (60,61) . Several clinical studies have shown that a correction of the arginine deficiency by arginine-enriched nutrition restores T-lymphocyte count and function in surgical patients (50,62) .…”

Section: Introductionmentioning

confidence: 99%

Novel nutritional substrates in surgery

et al. 2013

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Pharmaco-nutrients have beneficial effects on protective and immunological mechanisms in patients undergoing surgery, which are important for recovery after injury and in combating infectious agents. The aim of this review article was to outline the potential of the administration of nutritional substrates to surgical patients and the underlying mechanisms that make them particularly important in peri-operative care. Surgery causes a stress response, which has catabolic effects on the body's substrate stores. The amino acid glutamine is a stimulating agent for immune cells. It activates protective mechanisms through its role as a precursor for antioxidants and it improves the barrier function of the gut. Arginine also enhances the function of the immune system, since it is the substrate for T-lymphocytes. Furthermore, n-3 PUFA stabilise surgery-induced hyper-inflammation. Taurine is another substrate that may counteract the negative effects of surgical injury on acid–base balance and osmotic balance. These pharmaco-nutrients rapidly become deficient under the influence of surgical stress. Supplementation of these nutrients in surgical patients may restore their protective and immune-enhancing actions and improve clinical outcome. Moreover, pre-operative fasting is still common practice in the Western world, although fasting has a negative effect on the patient's condition and the recovery after surgery. This may be counteracted by a simple intervention such as administering a carbohydrate-rich supplement just before surgery. In conclusion, there are various nutritional substrates that may be of great value in improving the condition of the surgical patient, which may be beneficial for post-operative recovery.

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“…Immunonutrition is usually given preoperatively, since it prevents the decrease in cellular immunity and phagocytic capacity of polymorphonuclear neutrophils (PMN's) during the early postoperative period [9] . There have been several prospective studies examining the effects of immunonutrition support on the rate of postoperative complications, infection rates, length of hospital stay, wound repair, weight gain, cost, and mortality [10][11][12][13][14][15] . However, the mechanisms through which beneficial effects occur have not been studied in detail.…”

Section: Introductionmentioning

confidence: 99%

Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters

Günerhan¹,

Köksal²,

Sahin³

et al. 2009

WJG

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AIM:To e va l u a t e t h e e f fe c t s o f p r e o p e ra t i v e immunonutrition and other nutrition models on the cellular immunity parameters of patients with gastrointestinal tumors before surgical intervention. In addition, effects on postoperative complications were examined. METHODS:Patients with gastrointestinal tumors were randomized into 3 groups. The immunonutrition group received a combination of arginine, fatty acids and nucleotides. The second and third group received normal nutrition and standard enteral nutrition, respectively. Nutrition protocols were administered for 7 d prior to the operation. Nutritional parameters, in particular prealbumin levels and lymphocyte subpopulations (CD4+, CD8+, CD16+/56+, and CD69 cells) were evaluated before and after the nutrition protocols. Groups were compared in terms of postoperative complications and duration of hospital stay. RESULTS:Of the 42 patients who completed the study, 16 received immunonutrition, 13 received normal nutrition and 13 received standard enteral nutrition. prealbumin values were low in every group, but this parameter was improved after the nutritional protocol only in the immunonutrition group (13.64 ± 8.83 vs 15.98 ± 8.66, P = 0.037). Groups were similar in terms of CD4+, CD16+/56, and CD69+ prior to the nutritional protocol; whereas CD8+ was higher in the standard nutrition group compared to the immunonutrition group. After nutritional protocols, none of the groups had an increase in their lymphocyte subpopulations. Also, groups did not differ in terms of postoperative complications and postoperative durations of hospital stay.CONCLUSION: P re o p e ra t i ve i m m u n o n u t r i t i o n provided a significant increase in prealbumin levels, while it did not significantly alter T lymphocyte subpopulation counts, the rate of postoperative complications and the duration of hospital stay.

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Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer

Cited by 333 publications

References 34 publications

Efeitos da imunonutrição no tratamento de pacientes com câncer e suas complicações – uma revisão

Efeitos da imunonutrição no tratamento de pacientes com câncer e suas complicações – uma revisão

Novel nutritional substrates in surgery

Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters

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