Effects of long-term continuous use of immune-enhancing enteral formula on nutritional and immunologic status in non-surgical patients.
OBJECTIVE
Although the perioperative use of immune-enhancing enteral formula (IEEF) effectively reduces the rate of infectious complications, whether chronic use of IEEF is beneficial is unknown. A prospective randomized clinical trial was performed to examine the safety and effectiveness of long-term IEEF on nutritional and immunologic status in non-surgical patients receiving total enteral nutrition through the gastrostomy access route.


METHODS
A total of 30 patients were randomly assigned to two groups in which they received total enteral nutrition, an IEEF (n = 15) or a regular polymeric enteral formula (control group; n = 15) for 12 wk. Nutritional and immunologic variables were periodically examined.


RESULTS
Serum concentrations of insulin-like growth factor-I increased significantly for the IEEF group throughout the study. Although serum concentrations of dihomo-gamma-linoleic acid decreased significantly in the IEEF group, serum concentrations of eicosapentaenoic acid and docosahexaenoic acid increased significantly, as did concentrations of serum arginine and ornithine. The CD4/CD8 ratio and natural killer cell activity also increased for the IEEF group, but the differences were not significant. The B-cell fraction increased and the T-cell fraction of peripheral lymphocytes decreased for the IEEF group. Neither infectious nor non-infectious complications occurred during the study period in either group, except for a significant increase in serum urea nitrogen and uric acid concentrations for the IEEF group.


CONCLUSIONS
Long-term use of IEEF is safe in non-surgical patients and results in a significant increase in serum insulin-like growth factor-I concentrations in association with increased humoral immunity.
Sakurai
Yoichi
Y
Department of Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; Okazaki Mita Hospital, Ozaki, Aichi, Japan. ysakurai@fujita-hu.ac.jp
Oh-Oka
Yuriko
Y
Kato
Shiho
S
Suzuki
Sadamu
S
Hayakawa
Mariko
M
Masui
Toshihiko
T
Yoshida
Ikuo
I
Tonomura
Shuhei
S
Mitsutaka
Shoji
S
Nakamura
Yasuko
Y
Uyama
Ichiro
I
Komori
Yoshiyuki
Y
Ochiai
Masahiro
M
D015126:8,11,14-Eicosatrienoic Acid / Q000097:blood; D001120:Arginine / Q000097:blood; D001402:B-Lymphocytes; D001806:Blood Urea Nitrogen; D016516:CD4-CD8 Ratio; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D005526:Food, Formulated; D005774:Gastrostomy; D006801:Humans; D007109:Immunity; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D016753:Interleukin-10 / Q000097:blood; D007694:Killer Cells, Natural / Q000276:immunology; D018655:Lymphocyte Count; D009752:Nutritional Status; D009952:Ornithine / Q000097:blood; D011446:Prospective Studies; D013601:T-Lymphocytes; D014527:Uric Acid / Q000097:blood
D016753:Interleukin-10; D004281:Docosahexaenoic Acids; D014527:Uric Acid; D007334:Insulin-Like Growth Factor I; D001120:Arginine; D015118:Eicosapentaenoic Acid; D009952:Ornithine; D015126:8,11,14-Eicosatrienoic Acid