title: Alanyl-glutamine enriched total parenteral nutrition improves local, systemic, and remote organ responses to intraperitoneal bacterial challenge.
abstract: BACKGROUND
  Standard total parenteral nutrition (STD-TPN) may diminish host defense against infection. Glutamine (Gln) is suggested to enhance host immunity. This study investigated the effects of antecedent alanyl-glutamine enriched TPN (Ala-Gln-TPN) on host responses to intraperitoneal bacterial challenge compared with STD-TPN.
  
  
  METHODS
  Rats were divided into STD-TPN and Ala-Gln-TPN groups. They received isocaloric and isonitrogenous nutrition for 7 days and were challenged intraperitoneally with E. coli. Rats were killed before (0 hour) challenge and at 2 and 6 hours after challenge. Bacterial numbers in peritoneal lavage fluid (PLF), liver, spleen, and blood were determined. Tumor necrosis factor-alpha (TNF), interleukin (IL)-8, and interferon-gamma (IFN) in plasma and PLF were measured. Hepatic TNF, splenic TNF, and splenic IFN levels were determined.
  
  
  RESULTS
  The numbers of E. coli in systemic blood at 2 hours after intraperitoneal bacterial challenge were significantly lower in the Ala-Gln-TPN than in STD-TPN group. E. coli numbers in blood significantly correlated with those in the liver. The Ala-Gln-TPN also resulted in significantly higher PLF and hepatic TNF levels, higher splenic IFN levels, and lower plasma IL-8 levels at 6 hours after challenge compared with the STD-TPN.
  
  
  CONCLUSIONS
  Antecedent Ala-Gln enriched TPN enhance local, systemic, and remote organ immune responses to intraperitoneal bacterial challenge. Ala-Gln-TPN may enhance host defense and be more beneficial than standard TPN in sepsis.
authors.affiliation: Department of Surgery, National Taiwan University, Taipei. linmt@ha.mc.ntu.edu.tw
authors.forename: M T
authors.initials: MT
authors.lastname: Lin
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: S
authors.initials: S
authors.lastname: Furukawa
authors.forename: R
authors.initials: R
authors.lastname: Fukushima
authors.forename: F
authors.initials: F
authors.lastname: Kazuhiko
authors.forename: P H
authors.initials: PH
authors.lastname: Lee
authors.forename: K J
authors.initials: KJ
authors.lastname: Chang
authors.forename: W J
authors.initials: WJ
authors.lastname: Chen
mesh_terms: D000818:Animals; D001202:Ascitic Fluid / Q000166:cytology / Q000276:immunology / Q000382:microbiology; D016470:Bacteremia / Q000276:immunology; D004151:Dipeptides / Q000008:administration & dosage*; D004926:Escherichia coli / Q000254:growth & development* / Q000276:immunology; D004927:Escherichia coli Infections / Q000276:immunology* / Q000628:therapy*; D007274:Injections, Intraperitoneal; D007371:Interferon-gamma / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D008099:Liver / Q000276:immunology / Q000382:microbiology; D008168:Lung / Q000166:cytology / Q000276:immunology; D008297:Male; D010289:Parenteral Nutrition, Total; D010533:Peritoneal Lavage; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013154:Spleen / Q000276:immunology* / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D004151:Dipeptides; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; C054122:alanylglutamine