Glutamine effects on heat shock protein 70 and interleukines 6 and 10: Randomized trial of glutamine supplementation versus standard parenteral nutrition in critically ill children

详细信息    查看全文

• 作者：Iolanda Jordan^a ; ^{ijordan@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Mò ; nica Balaguer^a ; ^{mbalaguer@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; M.Esther Esteban^b ; ^c ; ^{mesteban@ub.edu" class="auth_mail" title="E-mail the corresponding author} ; Francisco José ; Cambra^a ; ^{fjcambra@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Aida Felipe^a ; ^{afelipe@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Lluï ; sa Herná ; ndez^a ; ^{lhernandez@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Laia Alsina^d ; ^{lalsina@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Marta Molero^e ; ^{mmolero@hsjdbcn.org" class="auth_mail" title="E-mail the corresponding author} ; Miquel Villaronga^f ; ^{mvillaronga@hsjdbc.org" class="auth_mail" title="E-mail the corresponding author} ; Elisabeth Esteban^a ; ^{eesteban@hsjdbc.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Glutamine ; HSP-70 ; Inflammatory mediators ; Parenteral nutrition ; Pediatric intensive care unit
• 刊名：Clinical Nutrition
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：35
• 期：1
• 页码：34-40
• 全文大小：703 K

文摘

To determine whether glutamine (Gln) supplementation would have a role modifying both the oxidative stress and the inflammatory response of critically ill children.

Methods

Prospective, randomized, double-blind, interventional clinical trial. Selection criteria were children requiring parenteral nutrition for at least 5 days diagnosed with severe sepsis or post major surgery. Patients were randomly assigned to standard parenteral nutrition (SPN, 49 subjects) or standard parenteral nutrition with glutamine supplementation (SPN + Gln, 49 subjects).

Results

Glutamine levels failed to show statistical differences between groups. At day 5, patients in the SPN + Gln group had significantly higher levels of HSP-70 (heat shock protein 70) as compared with the SPN group (68.6 vs 5.4, p = 0.014). In both groups, IL-6 (interleukine 6) levels showed a remarkable descent from baseline and day 2 (SPN: 42.24 vs 9.39, p < 0.001; SPN + Gln: 35.20 vs 13.80, p < 0.001) but only the treatment group showed a statistically significant decrease between day 2 and day 5 (13.80 vs 10.55, p = 0.013). Levels of IL-10 (interleukine 10) did not vary among visits except in the SPN between baseline and day 2 (9.55 vs 5.356, p < 0.001). At the end of the study, no significant differences between groups for PICU and hospital stay were observed. No adverse events were detected in any group.

Conclusions

Glutamine supplementation in critically-ill children contributed to maintain high HSP-70 levels for longer. Glutamine supplementation had no influence on IL-10 and failed to show a significant reduction of IL-6 levels.