Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity

Ming Tsan Lin, Sung Pao Kung, Sung Ling Yeh, Kuong Yi Liaw, Ming Yang Wang, Ming Liang Kuo, Po Houng Lee, Wei Jao Chen

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22 Citations (Scopus)

Abstract

Aim: To evaluate whether the effect of Gln dipeptide-enriched total parenteral nutrition (TPN) on postoperative cytokine alteration depended on the disease severity of surgical patients. Methods: Forty-eight patients with major abdominal surgery were allocated to two groups to receive isonitrogenous (0.228 g nitrogen/kg per d) and isocaloric (30 kcal/kg per d) TPN for 6 d. Control group (Conv) using conventional TPN solution received 1.5 g amino acids/kg per day, whereas the test group received 0.972 g amino acids/kg per day and 0.417 g L-alanyl-L-glutamine (Ala-Gln)/kg per day. Blood samples were collected on d 1 and d 6 postoperatively for plasma interleukin (IL)-2, IL-6, IL-8, and interferon (IFN)-γ analysis. Results: Plasma IL-2 and IFN-γ were not detectable. IL-6 concentrations were significantly lower on the 6th postoperative day in the Ala-Gln group than those in the Conv group in patients with APACHE II≤6, whereas no difference was noted in patients with APACHE II>6. There was no difference in IL-8 levels between the two groups. No difference in cumulative nitrogen balance was observed on d 2-5 after the operation between the two groups (Ala-Gln -3.2±1.6 g vs Conv -6.5±2.7 g). A significant inverse correlation was noted between plasma IL-6 levels and cumulative nitrogen balance postoperatively in the Ala-Gln group, whereas no such correlation was observed in the Conv group. Conclusion: TPN supplemented with Gin dipeptide had no effect on plasma IL-8 levels after surgery. However, Gln supplementation had a beneficial effect on decreasing systemic IL-6 production after surgery in patients with low admission illness severity, and lower plasma IL-6 may improve nitrogen balance in patients with abdominal surgery when Gln was administered.

Original languageEnglish
Pages (from-to)6197-6201
Number of pages5
JournalWorld Journal of Gastroenterology
Volume11
Issue number39
Publication statusPublished - Oct 21 2005

Keywords

  • Abdominal surgery
  • Glutamine
  • Interleukin-6
  • Total parenteral nutrition

ASJC Scopus subject areas

  • Gastroenterology

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    Lin, M. T., Kung, S. P., Yeh, S. L., Liaw, K. Y., Wang, M. Y., Kuo, M. L., Lee, P. H., & Chen, W. J. (2005). Glutamine-supplemented total parenteral nutrition attenuates plasma interleukin-6 in surgical patients with lower disease severity. World Journal of Gastroenterology, 11(39), 6197-6201.