Glutamine-enriched total parenteral nutrition preserves respiratory immunity and improves survival to a Pseudomonas Pneumonia.
BACKGROUND
Addition of 2% glutamine (GLN), a specific lymphocyte fuel, prevents deleterious effects of TPN on gut-associated lymphoid tissue and IgA while preserving IgA-mediated upper respiratory immunity to influenza virus. We examined whether a 2% GLN-enhanced TPN solution preserves respiratory immunity to a lethal and clinically relevant pneumonia challenge.


METHODS
Male ICR mice were randomized to chow (n = 20), TPN (n = 20), or an isonitrogenous, isocaloric TPN-2% GLN solution (n = 17). All groups were immunized 10 days before surgery with Pseudomonas polysaccharide-containing liposomes (LIP) to confer immunity except for a nonimmune chow-fed LIP control group (n = 21) which received LIP without Pseudomonas. Mice received 5 days of diet and then were given an LD90 dose of 1.2 x 10(8) intratracheal Pseudomonas bacteria, and mortality was recorded.


RESULTS
Immunization reduced mortality compared with LIP alone. TPN impaired immunity and reduced survival while GLN maintained immunization effectiveness.


CONCLUSIONS
Pseudomonas immunization reduces mortality to Pseudomonas pneumonia, but this immunity is lost with TPN. Addition of 2% GLN to TPN preserves immunity in the respiratory tract and reduces mortality to a lethal bacterial challenge compared with standard TPN.
DeWitt
R C
RC
Department of Surgery, University of Tennessee, Memphis, Tennessee, 38163, USA.
Wu
Y
Y
Renegar
K B
KB
Kudsk
K A
KA
D000818:Animals; D005973:Glutamine / Q000008:administration & dosage* / Q000627:therapeutic use; D007109:Immunity / Q000187:drug effects; D008297:Male; D051379:Mice; D008813:Mice, Inbred ICR; D010289:Parenteral Nutrition, Total; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D011552:Pseudomonas Infections / Q000276:immunology*; D012137:Respiratory System / Q000187:drug effects / Q000276:immunology*; D016019:Survival Analysis
D005973:Glutamine