Nutrition
Volume 26, Issue 6 , Pages 677-681 , June 2010

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

  • Stefania Mondello, M.D.

      Affiliations

    • Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
  • ,
  • Domenico Italiano, M.D.

      Affiliations

    • IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
  • ,
  • Maria Stella Giacobbe, M.D.

      Affiliations

    • Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
  • ,
  • Patrizia Mondello, M.D.

      Affiliations

    • Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
  • ,
  • Giuseppe Trimarchi, Ph.D.

      Affiliations

    • Institute of Statistical Sciences, University of Messina, Messina, Italy
  • ,
  • Carmela Aloisi, M.D.

      Affiliations

    • Department of Internal Medicine, Messina University Hospital, School of Medicine, University of Messina, Messina, Italy
  • ,
  • Placido Bramanti, M.D.

      Affiliations

    • IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
  • ,
  • Edoardo Spina, M.D.

      Affiliations

    • 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 InformationCorresponding author. Tel.: +39-090-221-3647; fax: +39-090-221-3300.

Received 6 July 2009 ,Accepted 21 October 2009.

References 

  1. Diagnostic and statistical manual of mental disorders. 4th ed. Washington: DC. American Psychiatric Association; 1994;
  2. Fisher M, Gillberg C, Rastam M, Gillberg IC. The course and outcome of eating disorders in adults and in adolescents: a review. Adolesc Med. 2003;14:149–158
  3. Sylvester CJ, Forman SF. Clinical practice guidelines for treating restrictive eating disorder patients during medical hospitalization. Curr Opin Pediatr. 2008;20:390–397
  4. Williams PM, Goodie J, Motsinger CD. Treating eating disorders in primary care. Am Fam Phys. 2008;77:187–195
  5. Gillberg C, Rastam M, Gillberg IC. Anorexia nervosa: who sees the patients and who do the patients see?. Acta Paediatr. 1994;83:967–971
  6. Mehler PS, Weiner KL. Anorexia nervosa and total parenteral nutrition. Int J Eat Disord. 1993;14:297–304
  7. Diamanti A, Basso MS, Castro M, Bianco G, Ciacco E, Calce A, et al. Clinical efficacy and safety of parenteral nutrition in adolescent girls with anorexia nervosa. Adolesc Health. 2008;42:111–118
  8. Rigotti N. Eating disorders. In:  Carlson KJ,  Eisenstar SA editor. Primary care of women. St Louis: Mosby-Year Book; 1995;p. 443–449
  9. Becker AE, Grinspoon SK, Klibanski A, Herzog DB. Eating disorders. N Engl J Med. 1999;340:1092–1098
  10. Andrea PA, Bea P. Changes of the immune functions in patients with eating disorders. Ideggyogy Sz. 2008;61:381–384
  11. Pászthy B, Svec P, Túry F, Kovács L, Vásárhelyi B, Tulassay T, et al. Impact of anorexia nervosa on activation characteristics of lymphocytes. Neuroendocrinol Lett. 2007;28:422–426
  12. Saito H, Nomura K, Hotta M, Takano K. Malnutrition induces dissociated changes in lymphocyte count and subset proportion in patients with anorexia nervosa. Int J Eat Disord. 2007;40:575–579
  13. Mesotten D, Van den Berghe G. Changes within the GH/IGF-I/IGFBP axis in critical illness. Crit Care Clin. 2006;22:17–28
  14. Gomez Candela C, Castillo R, de Cos AI, Iglesias C, Martin MC, Aguado MJ, et al. Effect of parenteral glutamine in patients submitted to bone marrow transplantation. Nutr Hosp. 2006;21:13–21
  15. Wernerman J. Role of glutamine supplementation in critically ill patients. Curr Opin Anaesthesiol. 2008;21:155–159
  16. Wernerman J. Clinical use of glutamine supplementation. J Nutr. 2008;138:2040S–2044S
  17. Bonet A, Grau T. Glutamine, an almost essential amino acid in the critically ill patient. Med Intensiva. 2007;31:402–406
  18. Estívariz CF, Griffith DP, Luo M, Szeszycki EE, Bazargan N, Dave N, et al. Efficacy of parenteral nutrition supplemented with glutamine dipeptide to decrease hospital infections in critically ill surgical patients. JPEN. 2008;32:389–402
  19. Pérez-Bárcena J, Regueiro V, Marsé P, Raurich JM, Rodríguez A, Ibáñez J, et al. Glutamine as a modulator of the immune system of critical care patients: effect on Toll-like receptor expression. A preliminary study. Nutrition. 2008;24:522–527
  20. van den Berg A, van Elburg RM, Vermeij L, van Zwol A, van den Brink GR, Twisk JW, et al. Cytokine responses in very low birth weight infants receiving glutamine-enriched enteral nutrition. J Pediatr Gastroenterol Nutr. 2009;48:94–101
  21. Yang C, Wang XY, Li WQ, Li N, Zhonghua Yi Li JS. Effects of glutamine on the cytokine expression of peripheral blood mononuclear cells. Xue Za Zhi. 2008;88:449–452
  22. Horio Y, Osawa S, Takagaki K, Hishida A, Furuta T, Ikuma M. Glutamine supplementation increases Th1-cytokine responses in murine intestinal intraepithelial lymphocytes. Cytokine. 2008;44:92–95
  23. Moyano D, Vilaseca MA, Artuch R, Lambruschini N. Plasma amino acids in anorexia nervosa. Eur J Clin Nutr. 1998;52:684–689
  24. Zenger F, Russmann S, Junker E, Wüthrich C, Bui MH, Lauterburg BH. Decreased glutathione in patients with anorexia nervosa. Risk factor for toxic liver injury?. Eur J Clin Nutr. 2004;58:238–243
  25. Nova E, Samartín S, Gómez S, Morandé G, Marcos A. The adaptive response of the immune system to the particular malnutrition of eating disorders. Eur J Clin Nutr. 2002;56:S34–S37
  26. Marcos A. The immune system in eating disorders: an overview. Nutrition. 1997;13:853–862
  27. Murr C, Widner B, Wirleitner B, Fuchs D. Neopterin as a marker for immune system activation. Curr Drug Metab. 2002;3:175–187
  28. Plata-Nazar K, Kozielska E, Łuczak G. Clinical value of neopterin. Part I. Med Wieku Rozwoj. 2004;8(2 Pt 2):433–437
  29. Cojocaru IM, Cojocaru M, Burcin C, Atanasiu A. Detection of neopterin as parameter of potential monocyte activation in patients with acute ischemic stroke. Rom J Intern Med. 2007;45:365–369
  30. Wirleitner B, Schroecksnadel K, Winkler C, Fuchs D. Neopterin in HIV-1 infection. Mol Immunol. 2005;42:183–194
  31. Fuchs D, Weiss G, Reibnegger G, Wachter H. The role of neopterin as a monitor of cellular immune activation in transplantation, inflammatory, infectious, and malignant diseases. Crit Rev Clin Lab Sci. 1992;29:307–341
  32. Melichar B, Urbánek L, Krcmová L, Kalábová H, Melicharová K, Malírová E, et al. Urinary neopterin, hemoglobin and peripheral blood cell counts in breast carcinoma patients treated with dose-dense chemotherapy. Anticancer Res. 2008;28(suppl 4C):2389–2396
  33. Behnes M, Brueckmann M, Wiessner M, Kettenmann E, Liebetrau C, Lang S, et al. Time-course of neopterin levels in patients suffering from severe sepsis treated with and without Drotrecogin-alpha (activated). Scand J Infect Dis. 2008;40:503–508
  34. Chin GK, Adams CL, Carey BS, Shaw S, Tse WY, Kaminski ER. The value of serum neopterin, interferon-gamma levels and interleukin-12B polymorphisms in predicting acute renal allograft rejection. Clin Exp Immunol. 2008;152:239–244
  35. Forrest CM, Youd P, Kennedy A, Gould SR, Darlington LG, Stone TW. Purine, kynurenine, neopterin and lipid peroxidation levels in inflammatory bowel disease. J Biomed Sci. 2002;9:436–442
  36. American Dietetic Association. Nutrition intervention in the treatment of anorexia nervosa and bulimia nervosa, and eating disorder not otherwise specified (EDNOS). J Am Diet Assoc. 2001;101:810
  37. Food and Nutrition Board of the Institute of Medicine. Dietary reference intakes (DRI): applications in dietary planning. Washington DC: The National Academies Press; 2003;
  38. Mehler PG, Weiner KA. Treatment of anorexia nervosa with total parenteral nutrition. Nutr Clin Pract. 1995;10:183–187
  39. O'Riordain MG, Fearon KC, Ross JA, Rogers P, Falconer JS, Bartolo DC, et al. Glutamine-supplemented total parenteral nutrition enhances T-lymphocyte response in surgical patients undergoing colorectal resection. Ann Surg. 1994;220:212–221
  40. Roth E. Nonnutritive effects of glutamine. J Nutr. 2008;138:2025–2031
  41. Mittendorfer B, Gore DC, Herndon DN, Wolfe RR. Accelerated glutamine synthesis in critically ill patients cannot maintain normal intramuscular free glutamine concentration. JPEN. 1999;23:243–250
  42. Asprer JM, Llido LO, Sinamban R, Schlotzer E, Kulkarni H. Effect on immune indices of preoperative intravenous glutamine dipeptide supplementation in malnourished abdominal surgery patients in the preoperative and postoperative periods. Nutrition. 2009;25:920–925
  43. Jackson NC, Carroll PV, Russell-Jones DL, Sönksen PH, Treacher DF, Umpleby AM. Effects of glutamine supplementation, GH, and IGF-I on glutamine metabolism in critically ill patients. Am J Physiol Endocrinol Metab. 2000;278:E226–E233
  44. Fan YP, Yu JC, Kang WM, Zhang Q. Effects of glutamine supplementation on patients undergoing abdominal surgery. Chin Med Sci J. 2009;24:55–59
  45. Karwowska KA, Dworacki G, Trybus M, Zeromski J, Szulc R. Influence of glutamine-enriched parenteral nutrition on nitrogen balance and immunologic status in patients undergoing elective aortic aneurysm repair. Nutrition. 2001;17:475–478
  46. Köller M, König W, Brom J, Raulf M, Gross-Weege W, Erbs G, et al. Generation of leukotrienes from human polymorphonuclear granulocytes of severely burned patients. J Trauma. 1988;28:733–740
  47. Kim N, Luster AD. Regulation of immune cells by eicosanoid receptors. Sci World J. 2007;7:1307–1328
  48. Woszczek G, Ly Chen, Nasineni S, Kern S, Barb J, Munson PJ, et al. Leukotriene D(4) induces gene expression in human monocytes through cysteinyl leukotriene type 1 receptor. Allergy Clin Immunol. 2008;121:215–221
  49. Ashare A, Nynon AB, Daerschig KC, Morrison JM. Insulin-like growth factor-1 improves survival in sepsis via enhanced hepatic bacterial clearance. Am J Resp Crit Care Med. 2008;178:149–157
  50. Ziegler TR, Bye RL, Persinger RL, Young LS, Antin JH, Wilmore DW. Effects of glutamine supplementation on circulating lymphocytes after bone marrow transplantation: a pilot study. Am J Med Sci. 1998;315:4–10
  51. Yeh CN, Lee HL, Liu YY, Chiang KC, Hwang TL, Jan YY, et al. The role of parenteral glutamine supplement for surgical patient perioperatively: result of a single center, prospective and controlled study. Langenbecks Arch Surg. 2008;393:849–855

PII: S0899-9007(09)00432-8

doi: 10.1016/j.nut.2009.10.008

Nutrition
Volume 26, Issue 6 , Pages 677-681 , June 2010