Glutamine-supplemented total parenteral nutrition improves immunological status in anorectic patients

Mondello, Stefania; Italiano, Domenico; Giacobbe, Maria Stella; Mondello, Patrizia; Trimarchi, Giuseppe; Aloisi, Carmela; Bramanti, Placido; Spina, Edoardo

doi:10.1016/j.nut.2009.10.008

« PreviousNutrition
Volume 26, Issue 6 , Pages 677-681, June 2010

Glutamine-supplemented total parenteral nutrition improves immunological status in anorectic patients

Stefania Mondello, M.D.
- Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
Domenico Italiano, M.D.
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
Maria Stella Giacobbe, M.D.
- Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
Patrizia Mondello, M.D.
- Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
Giuseppe Trimarchi, Ph.D.
- Institute of Statistical Sciences, University of Messina, Messina, Italy
Carmela Aloisi, M.D.
- Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
Placido Bramanti, M.D.
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
Edoardo Spina, M.D.
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
- Department of Clinical and Experimental Medicine and Pharmacology, School of Medicine, University of Messina, Messina, Italy
- Corresponding author. Tel.: +39-090-221-3647; fax: +39-090-221-3300.

Received 6 July 2009; accepted 21 October 2009. published online 01 February 2010.

Abstract

Objective

Glutamine is an important substrate for critical cells of the immune system, in particular lymphocytes and macrophages, and it is considered a conditionally essential amino acid. Several studies have indicated that glutamine-enriched total parenteral nutrition improves immunologic status and shortens length of stay of critically ill patients. We investigated the effect of total parenteral nutrition supplemented with glutamine on the immune system in anorectic patients.

Methods

Thirty-six anorectic patients were randomized to receive standard parenteral nutrition or parenteral nutrition supplemented with glutamine 0.18 g · kg⁻¹ · d⁻¹ for 20 d. To evaluate the immune system status, we determined serum levels of neopterin and insulin growth factor-1 and lymphocyte count at baseline and after 10 and 20 d from the beginning of the therapy.

Results and Conclusions

The results showed a significant increase of the serum levels of neopterin after 10 d of treatment with glutamine (26.44 ± 3.08 versus 6.75 ± 1.73 nmol/L, P < 0.001), thus proving a probable stimulating action carried out by glutamine on the immune system, as testified by the increase of lymphocytes.

Keywords: Anorexia nervosa, Total parenteral nutrition, Glutamine, Neopterin, Immunologic status