[Arginine enhanced enteral nutrition, effect on blood inflammatory markers in head and neck cancer patients].
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.
De Luis
Daniel Antonio
DA
Instituto de Endocrinología y Nutrición, Facultad de Medicina y Hospital Río Hortega, Valladolid, España. dadluis@yahoo.es
Aller
Rocío
R
Izaola
Olatz
O
Cuéllar
Luis
L
Terroba
María
M
Martín
Tomás
T
González Sagrado
Manuel
M
Conde
Rosa
R
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
D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D001120:Arginine