The Effects of Parenteral Glutamine Supplementation on Immunological Modulation in Extensive Burn Injury Patients

Chang-Cheng Chang, Jui-Yung Yang, Chun-Yuan Huang, Chung-Ho Feng, Shiow-Shuh Chuang

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background:
Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.
Aim and Objectives:
The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.
Materials and methods:
From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59%, range: 50%-90%) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios (%), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.
Results:
There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72% and 71.27±10.94%, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96% and 19.93±12.08%, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99% and 43.96±3.21%, P=0.01).
Conclusion:
Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.
Original languageEnglish
Pages (from-to)27-34
Number of pages8
Journal中華民國整形外科醫學會雜誌
Volume18
Issue number1
Publication statusPublished - 2009
Externally publishedYes

Fingerprint

Glutamine
Wounds and Injuries
CD4 Lymphocyte Count
Cell Count
T-Lymphocytes
B-Lymphocytes
Therapeutics
Clinical Trials
CD4-CD8 Ratio
Lymphocyte Count
Helper-Inducer T-Lymphocytes

Keywords

  • glutamine
  • extensive burns
  • immunologic modulation

Cite this

The Effects of Parenteral Glutamine Supplementation on Immunological Modulation in Extensive Burn Injury Patients. / Chang, Chang-Cheng; Yang, Jui-Yung; Huang, Chun-Yuan; Feng, Chung-Ho; Chuang, Shiow-Shuh.

In: 中華民國整形外科醫學會雜誌, Vol. 18, No. 1, 2009, p. 27-34.

Research output: Contribution to journalArticle

Chang, Chang-Cheng ; Yang, Jui-Yung ; Huang, Chun-Yuan ; Feng, Chung-Ho ; Chuang, Shiow-Shuh. / The Effects of Parenteral Glutamine Supplementation on Immunological Modulation in Extensive Burn Injury Patients. In: 中華民國整形外科醫學會雜誌. 2009 ; Vol. 18, No. 1. pp. 27-34.
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abstract = "Background:Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.Aim and Objectives:The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.Materials and methods:From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59{\%}, range: 50{\%}-90{\%}) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios ({\%}), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.Results:There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72{\%} and 71.27±10.94{\%}, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96{\%} and 19.93±12.08{\%}, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99{\%} and 43.96±3.21{\%}, P=0.01).Conclusion:Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.",
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T1 - The Effects of Parenteral Glutamine Supplementation on Immunological Modulation in Extensive Burn Injury Patients

AU - Chang, Chang-Cheng

AU - Yang, Jui-Yung

AU - Huang, Chun-Yuan

AU - Feng, Chung-Ho

AU - Chuang, Shiow-Shuh

PY - 2009

Y1 - 2009

N2 - Background:Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.Aim and Objectives:The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.Materials and methods:From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59%, range: 50%-90%) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios (%), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.Results:There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72% and 71.27±10.94%, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96% and 19.93±12.08%, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99% and 43.96±3.21%, P=0.01).Conclusion:Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.

AB - Background:Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.Aim and Objectives:The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.Materials and methods:From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59%, range: 50%-90%) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios (%), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.Results:There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72% and 71.27±10.94%, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96% and 19.93±12.08%, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99% and 43.96±3.21%, P=0.01).Conclusion:Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.

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KW - extensive burns

KW - immunologic modulation

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VL - 18

SP - 27

EP - 34

JO - 中華民國整形外科醫學會雜誌

JF - 中華民國整形外科醫學會雜誌

SN - 1025-1375

IS - 1

ER -