title: [Arginine enhanced enteral nutrition, effect on blood inflammatory markers in head and neck cancer patients].
abstract: OBJECTIVE
  Although immune dysfunction in cancer patients could be multifactorial, the immune system may be modulated by specific nutritional substrates, such as arginine. The aim of our study was to evaluate the effect of enteral nutrition supplemented with a high dose of arginine on c-reactive protein (CRP), interleukin 6 (IL6) and tumoral necrosis factor (TNF alpha) in surgical head and neck cancer patients.
  
  
  METHODS
  At surgery, patients were randomly allocated to two groups: (a) enteral diet supplements with arginine (group I, n=18); (b) isocaloric, isonitrogenous enteral formula (group II, n=23). Perioperatively and on the postoperative day 6 the following parameters were evaluated: serum values of prealbumin, transferrin, lymphocytes, IL6, TNF alpha and CRP.
  
  
  RESULTS
  The mean age (standard deviation) was 60.9 (10.6) years. Prealbumin and transferrin improved in both groups, CRP decreased in both groups, (group I: 105.1 (62.8)mg/dl vs 53.2 (51)mg/dl: p<0.05 and group II: 103.3 (62)mg/dl vs 61.9 (57.4)mg/dl: p<0.05). IL6 improved in both groups (group I: 38.35 (14.2)pg/ml vs 15.6 (9.1)pg/ml: p<0.05 and group II: 32.8 (35)pg/ml vs 6.8 (4.9)pg/ml: p<0.05) TNF alpha and lymphocytes did not change.
  
  
  CONCLUSIONS
  Both formulas improved IL6 and CRP levels. A high dose of enteral arginine in these patients did not add biochemical advantages as compared to a standard enteral formula.
authors.affiliation: Instituto de Endocrinología y Nutrición, Facultad de Medicina y Hospital Río Hortega, Valladolid, España. dadluis@yahoo.es
authors.forename: Daniel Antonio
authors.initials: DA
authors.lastname: De Luis
authors.forename: Rocío
authors.initials: R
authors.lastname: Aller
authors.forename: Olatz
authors.initials: O
authors.lastname: Izaola
authors.forename: Luis
authors.initials: L
authors.lastname: Cuéllar
authors.forename: María
authors.initials: M
authors.lastname: Terroba
authors.forename: Tomás
authors.initials: T
authors.lastname: Martín
authors.forename: Manuel
authors.initials: M
authors.lastname: González Sagrado
authors.forename: Rosa
authors.initials: R
authors.lastname: Conde
mesh_terms: D001120:Arginine / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000032:analysis; D019587:Dietary Supplements; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000628:therapy; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D001120:Arginine