title: Weight gain and increased concentrations of receptor proteins for tumor necrosis factor after patients with symptomatic HIV infection received fortified nutrition support.
abstract: OBJECTIVE
  To determine whether certain nutrients and dietary factors act as modulators of the immune system and improve the nutritional status of immunocompromised patients.
  
  
  METHODS
  Controlled, double-blind, crossover phase trials of the effects of a fortified formula in patients infected with the human immunodeficiency virus (HIV). Patients consumed a control formula for 4 months and a study formula for 4 months.
  
  
  METHODS
  Ten men with symptomatic HIV infection who were following stable medication regimens and had no malignancies, mycobacteriosis, or additional virus infection requiring systemic treatment.
  
  
  METHODS
  Formula fortified with alpha-linolenic acid (1.8 g/day), arginine (7.8 g/day), and RNA (0.75 g/day) and a standard formula.
  
  
  METHODS
  Nutritional status determined by anthropometric, bioelectrical, biochemical, and dietary assessment; energy expenditure determined by indirect calorimetry; disease progression; CD4 lymphocyte counts; HIV p24 antigen plasma concentrations; tumor necrosis factor (TNF) receptor proteins; and compliance control parameters.
  
  
  METHODS
  Student's t tests for paired and unpaired data.
  
  
  RESULTS
  Fortified nutrition resulted in a weight gain (+ 2.9 kg/4 months vs -0.5 kg/4 months with the control formula, P < .05), an incorporation of eicosaenoic acid into erythrocyte cell membranes (+ 47% of baseline values, P < .05), and increased plasma arginine concentrations (96.8 +/- 45.1 vs 51.8 +/- 20.9 mumol/L, P < .01). The serum concentrations of the soluble tumor necrosis factor receptor (sTNFR) proteins increased during the study period (sTNFR 55 = + 0.23 vs -0.40 ng/mL, P < .001; sTNFR 75 = + 0.90 vs -0.36 ng/mL, P < .01), whereas no changes in CD4+ lymphocyte counts were observed.
  
  
  CONCLUSIONS
  Increasing dietary intakes of n-3 polyunsaturated fatty acids, L-arginine, and RNA increased body weight, possibly by modulating the negative effects of TNF.
authors.affiliation: Zentrum Innere Medizin und Dermatologie, Abteilung Klinische Immunologie, Lehrte, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Süttmann
authors.forename: J
authors.initials: J
authors.lastname: Ockenga
authors.forename: H
authors.initials: H
authors.lastname: Schneider
authors.forename: O
authors.initials: O
authors.lastname: Selberg
authors.forename: A
authors.initials: A
authors.lastname: Schlesinger
authors.forename: H
authors.initials: H
authors.lastname: Gallati
authors.forename: G
authors.initials: G
authors.lastname: Wolfram
authors.forename: H
authors.initials: H
authors.lastname: Deicher
authors.forename: M J
authors.initials: MJ
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001120:Arginine / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000502:physiology; D005526:Food, Formulated; D005527:Food, Fortified; D015488:HIV Antigens / Q000097:blood; D015658:HIV Infections / Q000097:blood* / Q000178:diet therapy*; D006801:Humans; D007107:Immune System / Q000502:physiology; D019787:Linoleic Acid; D008041:Linoleic Acids / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012313:RNA / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis*; D015430:Weight Gain / Q000502:physiology*
chemical_list: D015488:HIV Antigens; D008041:Linoleic Acids; D018124:Receptors, Tumor Necrosis Factor; D012313:RNA; D001120:Arginine; D019787:Linoleic Acid