[Effect of early enriched parenteral alanyl-glutamine on heat shock protein 70 (HSP70) expression in critical patients].
OBJECTIVE
To evaluate the effect of early parenteral glutamine (Gln) administration on heat shock protein (HSP70) expression and clinical outcome in critical patients.


METHODS
Forty-four Patients requiring parenteral nutrition (PN) for more than 7 days, admitted to emergency intensive care unit (EICU) and neurosurgical intensive care units (NICU) were randomly divided into two groups, one was the control group, the other was the Gln treatment group (each n=22). Patients in both group received PN and enteral nutrition (EN). In addition, glutamine 0.4 g/kg per day was given to patients of Gln treatment group for 7 days. Serum HSP70, Gln concentrations were measured at admission and 7 days after the nutritional supplementation. Observations of clinical outcome included the length of mechanical ventilation, the length of stay in intensive care unit (ICU), the incidence of liver and kidney dysfunction before and after treatment.


RESULTS
Serum HSP70 and Gln level showed no significant changes in control group and Gln treatment group before the treatment (both P>0.05), though they were mildly increased after conventional treatment compared with the control group, but without statistically significant difference. In Gln treatment group, between serum HSP70, Gln concentrations were significantly higher than those before treatment (both P<0.01), and they showed significant difference between control group and Gln group after treatment (both P<0.01). HSP70 level was significantly positively correlated with Gln level in critical patients (r=0.650 5, P=0.001). The ratios of liver dysfunction and the length of mechanical ventilation showed significant difference between Gln group and control group (both P<0.05). The ratios of kidney dysfunction and the length of stay in ICU showed no obvious changes between two groups (both P>0.05).


CONCLUSIONS
Early parenteral glutamine administration can improve clinical outcome, decrease the ratio of organ dysfunction possibly by the mechanism of increasing serum HSP70 in critical patients.
Zhang
Zheng
Z
Emergency Center, Nanjing First Hospital Affiliated Nanjing Medical University, Nanjing 210006, Jiangsu, China.
Qin
Hai-dong
HD
Ni
Hai-bin
HB
Xu
Ying
Y
Wu
Hai-rong
HR
Cheng
Hui
H
Wang
Shu-kui
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004151:Dipeptides / Q000627:therapeutic use*; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D018840:HSP70 Heat-Shock Proteins / Q000097:blood*; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011379:Prognosis; D055815:Young Adult
D004151:Dipeptides; D018840:HSP70 Heat-Shock Proteins; D005973:Glutamine; C054122:alanylglutamine