PMID- 12221212
OWN - NLM
STAT- MEDLINE
DCOM- 20030206
LR  - 20180330
IS  - 0022-3166 (Print)
IS  - 0022-3166 (Linking)
VI  - 132
IP  - 9
DP  - 2002 Sep
TI  - Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of 
      trauma patients.
PG  - 2580-6
AB  - 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.
FAU - Boelens, Petra G
AU  - Boelens PG
AD  - Department of Surgery, Vrije Universiteit Medical Center, Amsterdam 1081 HV, The 
      Netherlands.
FAU - Houdijk, Alexander P J
AU  - Houdijk AP
FAU - Fonk, Johanna C M
AU  - Fonk JC
FAU - Nijveldt, Robert J
AU  - Nijveldt RJ
FAU - Ferwerda, Charlotte C
AU  - Ferwerda CC
FAU - Von Blomberg-Van Der Flier, B Mary E
AU  - Von Blomberg-Van Der Flier BM
FAU - Thijs, Lambertus G
AU  - Thijs LG
FAU - Haarman, Henk J Th M
AU  - Haarman HJ
FAU - Puyana, Juan C
AU  - Puyana JC
FAU - Van Leeuwen, Paul A M
AU  - Van Leeuwen PA
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Nutr
JT  - The Journal of nutrition
JID - 0404243
RN  - 0 (HLA-DR Antigens)
RN  - 0 (Receptors, IgG)
RN  - 0RH81L854J (Glutamine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Bacteremia/epidemiology/prevention & control
MH  - Double-Blind Method
MH  - *Enteral Nutrition
MH  - Female
MH  - Glutamine/*administration & dosage/blood
MH  - HLA-DR Antigens/*biosynthesis
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Monocytes/*immunology
MH  - Multiple Trauma/blood/immunology/*therapy
MH  - Pneumonia/epidemiology/prevention & control
MH  - Receptors, IgG/biosynthesis
MH  - Sepsis/epidemiology/prevention & control
EDAT- 2002/09/11 10:00
MHDA- 2003/02/07 04:00
CRDT- 2002/09/11 10:00
PHST- 2002/09/11 10:00 [pubmed]
PHST- 2003/02/07 04:00 [medline]
PHST- 2002/09/11 10:00 [entrez]
AID - 10.1093/jn/132.9.2580 [doi]
PST - ppublish
SO  - J Nutr. 2002 Sep;132(9):2580-6. doi: 10.1093/jn/132.9.2580.