Format

Send to

Choose Destination
Clin Nutr. 2016 Feb;35(1):34-40. doi: 10.1016/j.clnu.2015.01.019. Epub 2015 Feb 7.

Glutamine effects on heat shock protein 70 and interleukines 6 and 10: Randomized trial of glutamine supplementation versus standard parenteral nutrition in critically ill children.

Author information

1
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: ijordan@hsjdbcn.org.
2
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: mbalaguer@hsjdbcn.org.
3
Department of Animal Biology-Anthropology, Faculty of Biology, University of Barcelona, Barcelona, Spain; Institut de Recerca de la Biodiversitat (IRBIO), University of Barcelona, Barcelona, Spain. Electronic address: mesteban@ub.edu.
4
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: fjcambra@hsjdbcn.org.
5
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: afelipe@hsjdbcn.org.
6
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: lhernandez@hsjdbcn.org.
7
Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Barcelona, Spain. Electronic address: lalsina@hsjdbcn.org.
8
Clinical Pharmacological Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: mmolero@hsjdbcn.org.
9
Clinical Laboratory Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: mvillaronga@hsjdbc.org.
10
Pediatric Intensive Care Unit Service, Hospital de Sant Joan de Déu, Barcelona, Spain. Electronic address: eesteban@hsjdbc.org.

Abstract

BACKGROUND & AIMS:

To determine whether glutamine (Gln) supplementation would have a role modifying both the oxidative stress and the inflammatory response of critically ill children.

METHODS:

Prospective, randomized, double-blind, interventional clinical trial. Selection criteria were children requiring parenteral nutrition for at least 5 days diagnosed with severe sepsis or post major surgery. Patients were randomly assigned to standard parenteral nutrition (SPN, 49 subjects) or standard parenteral nutrition with glutamine supplementation (SPN + Gln, 49 subjects).

RESULTS:

Glutamine levels failed to show statistical differences between groups. At day 5, patients in the SPN + Gln group had significantly higher levels of HSP-70 (heat shock protein 70) as compared with the SPN group (68.6 vs 5.4, p = 0.014). In both groups, IL-6 (interleukine 6) levels showed a remarkable descent from baseline and day 2 (SPN: 42.24 vs 9.39, p < 0.001; SPN + Gln: 35.20 vs 13.80, p < 0.001) but only the treatment group showed a statistically significant decrease between day 2 and day 5 (13.80 vs 10.55, p = 0.013). Levels of IL-10 (interleukine 10) did not vary among visits except in the SPN between baseline and day 2 (9.55 vs 5.356, p < 0.001). At the end of the study, no significant differences between groups for PICU and hospital stay were observed. No adverse events were detected in any group.

CONCLUSIONS:

Glutamine supplementation in critically-ill children contributed to maintain high HSP-70 levels for longer. Glutamine supplementation had no influence on IL-10 and failed to show a significant reduction of IL-6 levels.

KEYWORDS:

Glutamine; HSP-70; Inflammatory mediators; Parenteral nutrition; Pediatric intensive care unit

PMID:
25701159
DOI:
10.1016/j.clnu.2015.01.019
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center