Effects of oral amino acid supplementation on long-term-care-acquired infections in elderly patients

Aquilani, Roberto; Zuccarelli, Ginetto Carlo; Dioguardi, Francesco Saverio; Baiardi, Paola; Frustaglia, A; Rutili, Carla; E, Comi; Catani, Michele; Iadarola, Paolo; Viglio, Simona; Barbieri, Annalisa; D’Agostino, Luca; Verri, Manuela; Pasini, Evasio; Boschi, Federica

doi:10.1016/j.archger.2010.09.005

Cited by 32 publications

(40 citation statements)

References 28 publications

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“…The lower infection rate that occurred in EAA compared to placebo patients confirms the findings of our previous studies [35,54] and may be due to the fact that EAAs play an important role in improving immunological defences by inducing protein synthesis of immune cells [35]. The proimmunologic EAA activity may explain why infection did not preclude the improvements of Alb and Hb over time.…”

Section: Discussionsupporting

confidence: 84%

“…As described elsewhere [35], a three-day food diary was prepared for each patient by nurses who used a diet sheet to keep a record of the type and weight of cooked/uncooked food selected by patients from the hospital catering menu, both before and after their meals. Subsequently, we performed a nutritional analysis to calculate the actual calories and macro/micronutrients that the patients had ingested [35] by using the computer program Food Database DR3 (Dieta ragionata 3.…”

Section: Methodsmentioning

confidence: 99%

“…Subsequently, we performed a nutritional analysis to calculate the actual calories and macro/micronutrients that the patients had ingested [35] by using the computer program Food Database DR3 (Dieta ragionata 3. Sintesi Informatica.…”

Section: Methodsmentioning

confidence: 99%

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Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

Aquilani

Zuccarelli²,

Condino

et al. 2017

Nutrients

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Essential amino acids (EAAs) are nutritional substrates that promote body protein synthesis; thus we hypothesised that their supplementation may improve circulating albumin (Alb) and haemoglobin (Hb) in rehabilitative elderly patients following hip fractures (HF). Out of the 145 HF patients originally enrolled in our study, 112 completed the protocol. These subjects were divided into two randomised groups, each containing 56 patients. For a period of two months, one group (age 81.4 ± 8.1 years; male/female 27/29) received a placebo, and the other (age 83.1 ± 7.5 years; male/female 25/31) received 4 + 4 g/day oral EAAs. At admission, the prevalence of both hypoAlb (<3.5 g/dL) and hypoHb (<13 g/dL male, <12 g/dL female) was similar in the placebo group (64.3% hypoAlb, 66% hypoHb) and the treated group of patients (73.2% hypoAlb, 67.8% hypoHb). At discharge, however, the prevalence of hypoAlb had reduced more in EAAs than in placebo subjects (31.7% in EAAs vs. 77.8% in placebo; p < 0.001). There was a 34.2% reduction of anaemia in hypoHb in EAA subjects and 18.9% in placebo subjects, but the difference was not statistically significant. Oral supplementation of EAAs improves hypoAlb and, to a lesser extent, Hb in elderly rehabilitative subjects with hip fractures. Anaemia was reduced in more than one third of patients, which, despite not being statistically significant, may be clinically relevant.

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Section: Discussionsupporting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

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Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

Aquilani

Zuccarelli²,

Condino

et al. 2017

Nutrients

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“…Moreover, an increased supplementation of essential AA not only improves energy production even in the most demanding conditions [48], but also improves the synthesis of any non-essential AA, replenishing the citric acid cycle and restoring the anaplerotic export of those intermediates necessary for maintaining the ubiquitous synthesis of any AA, glutamate and arginine included. In my opinion, this is the main reason why immune response is improved in intensive care patients [42] and long-term-care acquired infections are reduced in elderly patients receiving CATHON supplementation [49]. …”

Section: Interactions Between Inos and Enos And Control Of Enos Exprementioning

confidence: 99%

To Give or Not to Give? Lessons from the Arginine Paradox

Dioguardi¹

2011

Lifestyle Genomics

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Arginine is one of the 20 amino acids (AA) found in proteins and synthesized by human cells. However, arginine is also the substrate for a series of reactions leading to the synthesis of other AA and is an obligatory substrate for two enzymes with diverging actions, arginases and nitric oxide synthases (NOS), giving origin to urea and NO, respectively. NO is a very potent vasodilator when produced by endothelial NOS (eNOS). The ‘arginine paradox’ is the fact that, despite intracellular physiological concentration of arginine being several hundred micromoles per liter, far exceeding the ∼5 µM K_M of eNOS, the acute provision of exogenous arginine still increases NO production. Clinically, an additional paradox is that the largest controlled study on chronic oral arginine supplementation in patients after myocardial infarction had to be interrupted for excess mortality in treated patients. Expression and activity of arginases, which produce urea and divert arginine from NOS, are positively related to exogenous arginine supplementation. Therefore, the more arginine is introduced, the more it is destroyed, eventually leading to impaired NO production. In this review, conditions influencing the low arginine concentrations found in plasma will be reviewed, revising the paradigm that simple replenishment of what is lacking will always produce beneficial consequences.

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“…Bei Pflegeheimbewohnern werden aktuell Verbesserungen von Ernährungszustand, Funktionalität und Lebensqualität infolge einer zweimonatigen Gabe von 8 g essenziellen Aminosäuren pro Tag berichtet[14]. Die gleiche Arbeitsgruppe beschreibt bei Patienten einer geriatrischen Rehabilitationseinrichtung, die einen Monat lang die gleiche Aminosäuremischung erhielten, eine um 30 % geringere Infektionshäufig-keit als in der Plazebogruppe[1]. Ob sich diese Befunde reproduzieren lassen, muss allerdings erst noch gezeigt werden.…”

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Der Proteinbedarf älterer Menschen

Volkert

2012

Dtsch med Wochenschr

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Effects of oral amino acid supplementation on long-term-care-acquired infections in elderly patients

Cited by 32 publications

References 28 publications

Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

To Give or Not to Give? Lessons from the Arginine Paradox

Der Proteinbedarf älterer Menschen

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