Glutamine as a modulator of the immune system of critical care patients: Effect on Toll-like receptor expression. A preliminary study

Pérez-Bárcena, Jon; Regueiro, Verónica; Marsé, P.; Raurich, J. M.; Rodríguez, Alberto; Ibáñez, J.; Mateos, A. García de Lorenzo y; Bengoechea, José A.

doi:10.1016/j.nut.2008.01.056

Cited by 31 publications

(17 citation statements)

References 35 publications

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“…Lower-dose glutamine Brantley & Pierce (12) Déchelotte et al (15) Fuentes-Orozco et al (18) Griffiths et al (21) Hall et al (22) Jones et al (25) Kumar et al (27) Luo et al (28) Ockenga et al (33) Perez-Barcena et al (36) Sahin et al (38) Tjäder et al (41) Wischmeyer et al (42) Subtotal ( (P=0·11) 14 1 2 2 11 4 0 10 47 32 22 21 72 41 10 59 304 9 6 5 10 21 3 2 4 37 31 22 24 72 39 10 64 299 1·32 0·13 0·34 0·15 0·44 1·30 0·16 3·06 0·66 0·50, 3·51 0·02, 1·19 0·06, 1·98 0·03, 0·78 0·19, 0·99 0·27, 6·21 0·01, 3·85 0·90, Categorisation into critical illness or surgical trials was difficult. Trials in which participants had pancreatitis or surgery followed by complications, e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Critical illness PN de Beaux et al (14) Déchelotte et al (15) Estivariz et al (16) Fuentes-Orozco et al (18) Fuentes-Orozco et al (17) Griffiths et al (21) Ockenga et al (33) Perez-Barcena et al (36) Sahin et al (38) Wischmeyer et al (42) Subtotal (95 % CI) Total events: 104 (treatment), 136 (control) Test for heterogeneity: χ 2 12·9, df 9 (P=0·17), I 2 30·4 % Test for overall effect: Z 2·24 (P=0·03)…”

Section: Methodsmentioning

confidence: 99%

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Symposium 4: Hot topics in parenteral nutrition Current evidence and ongoing trials on the use of glutamine in critically-ill patients and patients undergoing surgery

Avenell

2009

Proc. Nutr. Soc.

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The amino acid glutamine has numerous important roles including particularly antioxidant defence, immune function, the inflammatory response, acid–base balance and N economy. The present systematic review of randomised controlled trials of nutrition support with glutamine up to August 2008 has found that parenteral glutamine in critical illness is associated with a non-significant reduction in mortality (risk ratio 0·71 (95% CI 0·49, 1·03)) and may reduce infections. However, poor study quality and the possibility of publication bias mean that these results should be interpreted with caution. There is no evidence to suggest that glutamine is harmful in terms of organ failure and parenteral glutamine may reduce the development of organ failure.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Symposium 4: Hot topics in parenteral nutrition Current evidence and ongoing trials on the use of glutamine in critically-ill patients and patients undergoing surgery

Avenell

2009

Proc. Nutr. Soc.

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“…In the case of critical care patients the study shows that parenteral nutrition supplemented with glutamine (0.35 g glutamine/kg/day as dipeptide Ala-Gln, Dipeptiven, Fresenius Kabi) for 5 days does not change the expression of TLR2 or TLR-4 receptors in peripheral blood monocytes in 15 septic patients [34]. Moreover expression of TLR-2 and TLR-4 receptors were similar in groups with (15 septic patients) and without (15 septic patients) glutamine supplementation.…”

Section: Discussionmentioning

confidence: 94%

Clinical immunology Glutamine abolishes the TLR4 gene expression levels in pancreatic cancer patients: a preliminary study

Kędziora¹,

Słotwiński²,

Dąbrowska³

et al. 2012

cejoi

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“…In the case of critical care patients a recent study showed that parenteral nutrition supplemented with glutamine does not increase the expression of TLR2 or TLR4 in peripheral blood monocytes [59]. In trauma patients in the ICU, total parenteral nutrition (TPN) supplemented with glutamine does not improve the expression or the functionality of TLRs in peripheral blood monocytes [60].…”

Section: Glutaminementioning

confidence: 99%

Alterations in innate antibacterial response after immunomodulatory nutrition

Słotwiński¹,

Słotwińska²,

Kędziora³

et al. 2012

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Septic infections in malnourished surgical patients show the highest morbidity and mortality rate. The attempt to correct postoperative immune and nutritional disorders by introducing immune-enhancing nutrition (immunonutrition) is a promising way of improving outcome, but as yet little is known about the mechanisms of correcting an extensive postoperative inflammatory response (systemic inflammatory response syndrome [SIRS]) to a massive infection using this type of nutrition. A significant role in the innate antibacterial and inflammatory response is played by Toll-like receptors (TLRs) that recognize pathogen-associated molecular patterns (PAMPs). The regulatory impact of immunonutrition on TLR expression in surgical septic patients seems to be a new research direction. In this paper special emphasis was put on clinical trials and the research results for the TLR-dependent immune response and anti-bacterial/anti-inflammatory response applying immu nomo dulatory nutrition with increased concentrations of glutamine and unsaturated fatty acids. StreszczenieZakażenia septyczne w grupie niedożywionych pacjentów chirurgicznych obarczone są najwyższym wskaźnikiem chorobowości i śmiertelności. Korekcja pooperacyjnych zaburzeń odporności i niedożywienia poprzez żywienie immunomodulujące jest obiecującą metodą uzyskania lepszych wyników leczenia, ale nadal niewiele wiadomo o mechanizmach regulacji zwiększonej pooperacyjnej odpowiedzi zapalnej (systemic inflammatory response syndrome -SIRS) na masywne zakażenie za pomocą tego typu terapii. Istotne znaczenie w regulacji wrodzonej odpowiedzi przeciwbakteryjnej i przeciwzapalnej mają receptory TLRs (Toll-like receptors), rozpoznające związane z patogenami wzory molekularne (pathogen-associated molecular patterns -PAMPs). Ocena regulacyjnego wpływu żywienia immunomodulacyjnego na ekspresję receptorów TLR u septycznych pacjentów chirurgicznych jest nowym kierunkiem badań naukowych. W przedstawionej pracy szczególną uwagę zwrócono na wyniki badań klinicznych i eksperymentalnych dotyczące regulacji zależnej od TLRs odpowiedzi przeciwbakteryjnej/przeciwzapalnej za pomocą żywienia immunomodulacyjnego, zawierającego zwiększone stężenia glutaminy i nienasyconych kwasów tłuszczowych.

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Glutamine as a modulator of the immune system of critical care patients: Effect on Toll-like receptor expression. A preliminary study

Cited by 31 publications

References 35 publications

Symposium 4: Hot topics in parenteral nutrition Current evidence and ongoing trials on the use of glutamine in critically-ill patients and patients undergoing surgery

Symposium 4: Hot topics in parenteral nutrition Current evidence and ongoing trials on the use of glutamine in critically-ill patients and patients undergoing surgery

Clinical immunology Glutamine abolishes the TLR4 gene expression levels in pancreatic cancer patients: a preliminary study

Alterations in innate antibacterial response after immunomodulatory nutrition

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