Tags

Type your tag names separated by a space and hit enter

Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients.

Abstract

AIM

To evaluate if the administration of an enteral diet supplemented with glutamine, arginine and omega-3-fatty acids modulates inflammatory and immune responses after surgery.

METHODS

A prospective randomized double-blind, clinical trial was performed. Forty-eight patients with gastrointestinal cancer were randomized into two groups, one group was given an isocaloric and isonitrogenous standard diet and the other was fed with the supplemented diet with glutamine, arginine and omega-3-fatty acids. Feedings were started within 48 hours after operation, and continued until day 8. All variables were measured before operation and on postoperative day 1 and 8. Immune responses were determined by phagocytosis ability, respiratory burst of polymorphonuclear cells, total lymphocytes lymphocyte subsets, nitric oxide, cytokines concentration, and inflammatory responses by plasma levels of C-reactive protein, prostaglandin E2 level.

RESULTS

Tolerance of both formula diets was excellent. There were significant differences in the immunological and inflammatory responses between the two groups. In supplemented group, phagocytosis and respiratory burst after surgery was higher and C-reactive protein level was lower (P<0.01) than in the standard group. The supplemented group had higher levels of nitric oxide, total lymphocytes, T lymphocytes, T-helper cells, and NK cells. Postoperative levels of IL-6 and TNF-alpha were lower in the supplemented group (P <0.05).

CONCLUSION

It was clearly established in this trial that early postoperative enteral feeding is safe in patients who have undergone major operations for gastrointestinal cancer. Supplementation of enteral nutrition with glutamine, arginine, and omega-3-fatty acids positively modulated postsurgical immunosuppressive and inflammatory responses.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of General Surgery, Zhongshan Hospital, Shanghai Medical University, Shanghai 200032,China. wughmc@online.sh.cn

    ,

    Source

    World journal of gastroenterology 7:3 2001 Jun pg 357-62

    MeSH

    Adult
    Aged
    Arginine
    Cytokines
    Double-Blind Method
    Enteral Nutrition
    Enteritis
    Fatty Acids, Omega-3
    Female
    Gastrointestinal Neoplasms
    Glutamine
    Humans
    Lymphocyte Count
    Male
    Middle Aged
    Phagocytosis
    Postoperative Period
    Prospective Studies
    Respiratory Burst

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    11819790

    Citation

    Wu, G H., et al. "Modulation of Postoperative Immune and Inflammatory Response By Immune-enhancing Enteral Diet in Gastrointestinal Cancer Patients." World Journal of Gastroenterology, vol. 7, no. 3, 2001, pp. 357-62.
    Wu GH, Zhang YW, Wu ZH. Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients. World J Gastroenterol. 2001;7(3):357-62.
    Wu, G. H., Zhang, Y. W., & Wu, Z. H. (2001). Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients. World Journal of Gastroenterology, 7(3), pp. 357-62.
    Wu GH, Zhang YW, Wu ZH. Modulation of Postoperative Immune and Inflammatory Response By Immune-enhancing Enteral Diet in Gastrointestinal Cancer Patients. World J Gastroenterol. 2001;7(3):357-62. PubMed PMID: 11819790.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Modulation of postoperative immune and inflammatory response by immune-enhancing enteral diet in gastrointestinal cancer patients. AU - Wu,G H, AU - Zhang,Y W, AU - Wu,Z H, PY - 2002/1/31/pubmed PY - 2002/6/6/medline PY - 2002/1/31/entrez SP - 357 EP - 62 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 7 IS - 3 N2 - AIM: To evaluate if the administration of an enteral diet supplemented with glutamine, arginine and omega-3-fatty acids modulates inflammatory and immune responses after surgery. METHODS: A prospective randomized double-blind, clinical trial was performed. Forty-eight patients with gastrointestinal cancer were randomized into two groups, one group was given an isocaloric and isonitrogenous standard diet and the other was fed with the supplemented diet with glutamine, arginine and omega-3-fatty acids. Feedings were started within 48 hours after operation, and continued until day 8. All variables were measured before operation and on postoperative day 1 and 8. Immune responses were determined by phagocytosis ability, respiratory burst of polymorphonuclear cells, total lymphocytes lymphocyte subsets, nitric oxide, cytokines concentration, and inflammatory responses by plasma levels of C-reactive protein, prostaglandin E2 level. RESULTS: Tolerance of both formula diets was excellent. There were significant differences in the immunological and inflammatory responses between the two groups. In supplemented group, phagocytosis and respiratory burst after surgery was higher and C-reactive protein level was lower (P<0.01) than in the standard group. The supplemented group had higher levels of nitric oxide, total lymphocytes, T lymphocytes, T-helper cells, and NK cells. Postoperative levels of IL-6 and TNF-alpha were lower in the supplemented group (P <0.05). CONCLUSION: It was clearly established in this trial that early postoperative enteral feeding is safe in patients who have undergone major operations for gastrointestinal cancer. Supplementation of enteral nutrition with glutamine, arginine, and omega-3-fatty acids positively modulated postsurgical immunosuppressive and inflammatory responses. SN - 1007-9327 UR - https://www.unboundmedicine.com/medline/citation/11819790/full_citation L2 - http://www.wjgnet.com/1007-9327/full/v7/i3/357.htm DB - PRIME DP - Unbound Medicine ER -