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Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of trauma patients.
J Nutr 2002; 132(9):2580-6JN

Abstract

The aim of this study was to investigate the effect of glutamine-(Gln)-enriched enteral nutrition (EN) on human leukocyte antigen (HLA)-DR and FcgammaR1/CD64 expression on monocytes and plasma glutamine concentrations in multi-trauma patients. HLA-DR expression on monocytes is crucial in the presentation of foreign antigen to the immune system and is severely reduced in trauma patients. In vitro monocyte HLA-DR and FcgammaRI/CD64 expression is dependent on glutamine availability. To study the effect of glutamine supplemented enteral nutrition on HLA-DR and FcgammaRI/CD64 expression on CD14(+) monocytes, 55 multi-trauma patients were studied in a randomized, double-blinded, controlled trial. Trauma patients received either a Gln-enriched EN (glutamine group, n = 28) or an isocaloric, isonitrogenous control EN (control group, n = 27) and were compared with a group of age-matched healthy volunteers (healthy volunteers, n = 53). On d 1, 5, 9 and 14 after trauma, expressions of HLA-DR and FcgammaRI/CD64 were determined on CD14(+) monocytes using FACS analysis. Plasma glutamine levels were measured using HPLC. Plasma glutamine was lower in both trauma patient groups compared with healthy volunteers and from d 3 to d 5; glutamine was higher in the glutamine group than in the control group. On d 1, HLA-DR expression was much lower in both trauma patient groups than in healthy volunteers. HLA-DR expression was greater on d 5, 9 and 14 in the glutamine group than in the control group. FcgammaRI/CD64 expression on monocytes of trauma patients was not different than the expression of healthy volunteers. This study showed that glutamine-enriched enteral nutrition was associated with a higher HLA-DR expression on CD14(+) monocytes of trauma patients. No difference in monocyte FcgammaRI/CD64 expression was detected between patients that received the two enteral diets and between trauma patients and the healthy volunteers. Increased HLA-DR expression may improve cellular immune function and may be involved in the beneficial effect of glutamine on the occurrence of infections in trauma patients.

Authors+Show Affiliations

Department of Surgery, Vrije Universiteit Medical Center, Amsterdam 1081 HV, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12221212

Citation

Boelens, Petra G., et al. "Glutamine-enriched Enteral Nutrition Increases HLA-DR Expression On Monocytes of Trauma Patients." The Journal of Nutrition, vol. 132, no. 9, 2002, pp. 2580-6.
Boelens PG, Houdijk AP, Fonk JC, et al. Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of trauma patients. J Nutr. 2002;132(9):2580-6.
Boelens, P. G., Houdijk, A. P., Fonk, J. C., Nijveldt, R. J., Ferwerda, C. C., Von Blomberg-Van Der Flier, B. M., ... Van Leeuwen, P. A. (2002). Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of trauma patients. The Journal of Nutrition, 132(9), pp. 2580-6.
Boelens PG, et al. Glutamine-enriched Enteral Nutrition Increases HLA-DR Expression On Monocytes of Trauma Patients. J Nutr. 2002;132(9):2580-6. PubMed PMID: 12221212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of trauma patients. AU - Boelens,Petra G, AU - Houdijk,Alexander P J, AU - Fonk,Johanna C M, AU - Nijveldt,Robert J, AU - Ferwerda,Charlotte C, AU - Von Blomberg-Van Der Flier,B Mary E, AU - Thijs,Lambertus G, AU - Haarman,Henk J Th M, AU - Puyana,Juan C, AU - Van Leeuwen,Paul A M, PY - 2002/9/11/pubmed PY - 2003/2/7/medline PY - 2002/9/11/entrez SP - 2580 EP - 6 JF - The Journal of nutrition JO - J. Nutr. VL - 132 IS - 9 N2 - The aim of this study was to investigate the effect of glutamine-(Gln)-enriched enteral nutrition (EN) on human leukocyte antigen (HLA)-DR and FcgammaR1/CD64 expression on monocytes and plasma glutamine concentrations in multi-trauma patients. HLA-DR expression on monocytes is crucial in the presentation of foreign antigen to the immune system and is severely reduced in trauma patients. In vitro monocyte HLA-DR and FcgammaRI/CD64 expression is dependent on glutamine availability. To study the effect of glutamine supplemented enteral nutrition on HLA-DR and FcgammaRI/CD64 expression on CD14(+) monocytes, 55 multi-trauma patients were studied in a randomized, double-blinded, controlled trial. Trauma patients received either a Gln-enriched EN (glutamine group, n = 28) or an isocaloric, isonitrogenous control EN (control group, n = 27) and were compared with a group of age-matched healthy volunteers (healthy volunteers, n = 53). On d 1, 5, 9 and 14 after trauma, expressions of HLA-DR and FcgammaRI/CD64 were determined on CD14(+) monocytes using FACS analysis. Plasma glutamine levels were measured using HPLC. Plasma glutamine was lower in both trauma patient groups compared with healthy volunteers and from d 3 to d 5; glutamine was higher in the glutamine group than in the control group. On d 1, HLA-DR expression was much lower in both trauma patient groups than in healthy volunteers. HLA-DR expression was greater on d 5, 9 and 14 in the glutamine group than in the control group. FcgammaRI/CD64 expression on monocytes of trauma patients was not different than the expression of healthy volunteers. This study showed that glutamine-enriched enteral nutrition was associated with a higher HLA-DR expression on CD14(+) monocytes of trauma patients. No difference in monocyte FcgammaRI/CD64 expression was detected between patients that received the two enteral diets and between trauma patients and the healthy volunteers. Increased HLA-DR expression may improve cellular immune function and may be involved in the beneficial effect of glutamine on the occurrence of infections in trauma patients. SN - 0022-3166 UR - https://www.unboundmedicine.com/medline/citation/12221212/Glutamine_enriched_enteral_nutrition_increases_HLA_DR_expression_on_monocytes_of_trauma_patients_ L2 - https://academic.oup.com/jn/article-lookup/doi/10.1093/jn/132.9.2580 DB - PRIME DP - Unbound Medicine ER -