Modulation of postoperative immune response by enteral nutrition with a diet enriched with arginine, RNA, and omega-3 fatty acids in patients with upper gastrointestinal cancer.
OBJECTIVE
To find out whether an enteral diet supplemented with arginine, RNA, and omega-3 fatty acids modulated the production of interleukin-1 (IL-1), interleukin-2 (IL-2), IL-2 receptor, interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-alpha) after operations for upper gastrointestinal cancer.


METHODS
Prospective double blind clinical study.


METHODS
University hospital, Germany.


METHODS
42 patients randomised into two groups (n = 21 each), one of which was given an isocaloric and isonitrogenous placebo diet and one of which was fed the same diet supplemented with arginine, RNA, and omega-3 fatty acids.


METHODS
The cytokines were measured before operation and on postoperative days 1, 3, 7, 10, and 16.


METHODS
Comparison of concentrations of cytokines in the two groups.


RESULTS
Among those receiving the placebo diet (after spontaneous stimulation) IL-6 concentrations were significantly higher on days 3 and 7 (p < 0.05) and TNF-alpha concentrations on day 7. In contrast (after stimulation with phytohaemagglutinin) mean concentrations of IL-2 receptor were significantly higher on days 3 and 7, and of IL-1 beta and IL-2 on day 16 (p < 0.05) in the group receiving the supplemented diet.


CONCLUSIONS
Supplementation of an enteral diet with arginine, RNA and omega-3 fatty acids can modulate the acute phase reaction as indicated by the reduction in concentrations of TNF-alpha and IL-6 in the group fed the supplemented diet. Patients receiving the supplemented diet also showed accelerated recovery in the concentrations of IL-1 beta and IL-2 receptor.
Senkal
M
M
Department of Surgery, Ruhr-University Bochum, St. Josef Hospital, Germany.
Kemen
M
M
Homann
H H
HH
Eickhoff
U
U
Baier
J
J
Zumtobel
V
V
D000368:Aged; D000704:Analysis of Variance; D001120:Arginine / Q000008:administration & dosage; D004311:Double-Blind Method; D004750:Enteral Nutrition; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005260:Female; D005527:Food, Fortified; D006681:HLA-D Antigens / Q000276:immunology; D006801:Humans; D007378:Interleukins / Q000097:blood; D008297:Male; D010919:Placebos; D011184:Postoperative Period; D012313:RNA / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000178:diet therapy / Q000276:immunology / Q000601:surgery*
D015525:Fatty Acids, Omega-3; D006681:HLA-D Antigens; D007378:Interleukins; D010919:Placebos; D012313:RNA; D001120:Arginine