Role of glutamine administration on cellular immunity after total parenteral nutrition enriched with glutamine in patients with systemic inflammatory response syndrome

摘要: Abstract Glutamine is an important substrate for enterocyte and other rapidly proliferating cells. Low plasma tissue levels present in glutamine critically ill patients suggest that demand may exceed endogenous supply. Because commercially available amino acid solutions do not contain because of its instability aqueous solution, conventional total parenteral nutrition (TPN) does prevent stress-induced depletion. In this study, we administered intravenous glutamine-supplemented TPN to with systemic inflammatory response syndrome (SIRS) investigate the effect supplementation on immune states. This study a prospective, randomized clinical trial. All received given continuously 6 days. Thirty SIRS were allocated either group ( l -glutamine 0.4g/[kg d]) (n = 15) or control 15). Blood samples collected day 1 after admission C-reactive protein, immunoglobulin (Ig) M, IgG, IgA, C3, C4, lymphocyte analysis. The Acute Physiologic Chronic Health Evaluation II score Simplified (SAPS II) used evaluate admission. Although there was tendency decreased T cytotoxic cells natural killer group, no significant difference observed between 2 groups. However, increase subgroups observed; but A low SAPS sixth whereas scores There IgM, C4 numbers B-lymphocytes Glutamine-added significantly decreases leukocyte cell count therefore suppresses inflammation. Furthermore, count, B- T-lymphocytes, their (helper T-lymphocytes) are increased; although statistically significant, these increases might be playing role improving system.