title: Arginine supplementation does not enhance serum nitric oxide levels in elderly nursing home residents with pressure ulcers.
abstract: 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.
authors.affiliation: University of Florida, College of Nursing, Adult& Elderly Nursing, PO Box 100187, Gainesville, FL 32605, USA. Stechjk@nursing.ufl.edu
authors.forename: Joyce K
authors.initials: JK
authors.lastname: Stechmiller
authors.forename: Bobbi
authors.initials: B
authors.lastname: Langkamp-Henken
authors.forename: Beverly
authors.initials: B
authors.lastname: Childress
authors.forename: Kelli A
authors.initials: KA
authors.lastname: Herrlinger-Garcia
authors.forename: Jan
authors.initials: J
authors.lastname: Hudgens
authors.forename: Lili
authors.initials: L
authors.lastname: Tian
authors.forename: Susan S
authors.initials: SS
authors.lastname: Percival
authors.forename: Ruby
authors.initials: R
authors.lastname: Steele
mesh_terms: 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
chemical_list: D008934:Mitogens; D002956:Citrulline; D009569:Nitric Oxide; D001120:Arginine; D009952:Ornithine