Arginine supplementation does not enhance serum nitric oxide levels in elderly nursing home residents with pressure ulcers.
The purpose of this study was to determine whether arginine supplementation enhances in vitro (neutrophil burst and mitogen-induced lymphocyte proliferation) and in vivo (delayed-type hypersensitivity [DTH] and serum nitric oxide) measures of immune function in nursing home elders with pressure ulcers. Twenty-six elders, 65 years of age or older, with one or more pressure ulcers, were randomized to receive 8.5 g of arginine or an isonitrogenous supplement for 4 weeks. Immune function studies and serum arginine, ornithine, citrulline, and nitric oxide were measured at baseline, 4 weeks postsupplementation (Week 4) and after a 6-week washout (Week 10). At Week 4, serum ornithine increased (p = .01) and arginine trended to increase (p = .055), but there was no increase in citrulline or nitric oxide with arginine supplementation. There were no differences in neutrophil burst or DTH responses between groups. Whole blood mitogen-induced proliferation decreased significantly at Week 10 in the isonitrogenous but not in the arginine-supplemented group. There is mounting concern that arginine supplementation during an inflammatory state could be detrimental due to overwhelming nitric oxide production. A key finding of this study is that arginine supplementation did not increase serum nitric oxide levels over that observed in elders with pressure ulcers given an isonitrogenous supplement.
Stechmiller
Joyce K
JK
University of Florida, College of Nursing, Adult& Elderly Nursing, PO Box 100187, Gainesville, FL 32605, USA. Stechjk@nursing.ufl.edu
Langkamp-Henken
Bobbi
B
Childress
Beverly
B
Herrlinger-Garcia
Kelli A
KA
Hudgens
Jan
J
Tian
Lili
L
Percival
Susan S
SS
Steele
Ruby
R
D000284:Administration, Oral; D000368:Aged; D001120:Arginine / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D002956:Citrulline / Q000097:blood / Q000187:drug effects; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D016903:Drug Monitoring; D005260:Female; D005431:Florida; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008934:Mitogens; D018375:Neutrophil Activation / Q000187:drug effects; D009569:Nitric Oxide / Q000097:blood*; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D009952:Ornithine / Q000097:blood / Q000187:drug effects; D003668:Pressure Ulcer / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D016897:Respiratory Burst / Q000187:drug effects; D013997:Time Factors
D008934:Mitogens; D002956:Citrulline; D009569:Nitric Oxide; D001120:Arginine; D009952:Ornithine