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A Clinical Study of the Effectiveness of Oral Glutamine Supplementation During Total Parenteral Nutrition: Influence on Mesenteric Mononuclear Cells
Author(s) -
Aosasa Suefumi,
Mochizuki Hidetaka,
Yamamoto Tetsuhisa,
Ono Satoshi,
Ichikura Takashi
Publication year - 1999
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/014860719902300511
Subject(s) - parenteral nutrition , glutamine , medicine , gastroenterology , sepsis , cytokine , peripheral blood mononuclear cell , tumor necrosis factor alpha , biology , biochemistry , amino acid , in vitro
Bacterial translocation (BT) is a well‐known insult during total parenteral nutrition (TPN) and a high incidence of morbidity has been reported in septic patients receiving TPN. Inflammatory cytokines were shown to play an important role in the pathogenesis of critical complications following sepsis. Previous studies have indicated that supplementation of TPN with glutamine is effective in preventing BT in animals, but its effectiveness in humans is unclear. The aim of this study was to determine the effectiveness of oral glutamine supplementation to patients receiving TPN in suppressing cytokine production of mesenteric blood mononuclear cells (M‐MNC). Fifteen colorectal cancer patients were divided into 3 groups according to preoperative nutrition management. (1) TPN group: TPN with conventional glutamine‐free amino acid solution. (2) Gln group: TPN with oral glutamine supplementation of 30 g/d. (3) Control group: oral intake of normal food. M‐MNC were obtained immediately after laparotomy and tumor necrosis factor‐alpha (TNF‐α) and interleukin‐10 (IL‐10) production of M‐MNC was evaluated with or without lipopolysaccharide (LPS) stimulation. TNF‐α and IL‐10 production by LPS‐stimulated M‐MNC was increased in the TPN group and suppressed in the Gln group. In conclusion, oral glutamine supplementation to patients with TPN was shown to be effective for the prevention of M‐MNC activation to avoid excessive production of cytokines. (Journal of Parenteral and Enteral Nutrition23:S41‐S44, 1999)