title: Antioxidant-enriched enteral nutrition and immuno-inflammatory response after major gastrointestinal tract surgery.
abstract: Major surgery induces an immuno-inflammatory response accompanied by oxidative stress that may impair cellular function and delay recovery. The objective of the study was to investigate the effect of an enteral supplement, containing glutamine and antioxidants, on circulating levels of immuno-inflammatory markers after major gastrointestinal tract surgery. Patients (n 21) undergoing major gastrointestinal tract surgery were randomised in a single-centre, open-label study. The effects on circulating levels of immuno-inflammatory markers were determined on the day before surgery and on days 1, 3, 5 and 7 after surgery. Major gastrointestinal surgery increased IL-6, TNF receptor 55/60 (TNF-R55) and C-reactive protein (CRP). Surgery reduced human leucocyte antigen-DR (HLA-DR) expression on monocytes. CRP decrease was more pronounced in the first 7 d in the treatment group compared with the control group. In the treatment group, from the moment Module AOX was administered on day 1 after surgery, TNF receptor 75/80 (TNF-R75) level decreased until the third post-operative day and then stabilised, whereas in the control group the TNF-R75 level continued to increase. The results of the present pilot study suggest that enteral nutrition enriched with glutamine and antioxidants possibly moderates the immuno-inflammatory response (CRP, TNF-R75) after surgery.
authors.affiliation: Department of Surgery, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
authors.forename: Mireille F M
authors.initials: MF
authors.lastname: van Stijn
authors.forename: Petra G
authors.initials: PG
authors.lastname: Boelens
authors.forename: Milan C
authors.initials: MC
authors.lastname: Richir
authors.forename: Gerdien C
authors.initials: GC
authors.lastname: Ligthart-Melis
authors.forename: Jos W R
authors.initials: JW
authors.lastname: Twisk
authors.forename: Jeroen
authors.initials: J
authors.lastname: Diks
authors.forename: Alexander P J
authors.initials: AP
authors.lastname: Houdijk
authors.forename: Paul A M
authors.initials: PA
authors.lastname: van Leeuwen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023181:Antimicrobial Cationic Peptides / Q000097:blood; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D001798:Blood Proteins; D002097:C-Reactive Protein / Q000378:metabolism; D004750:Enteral Nutrition; D041981:Gastrointestinal Tract / Q000601:surgery*; D006684:HLA-DR Antigens / Q000235:genetics; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D018579:Patient Selection; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D017472:Receptors, Interleukin-1 / Q000097:blood; D055815:Young Adult
chemical_list: D023181:Antimicrobial Cationic Peptides; D000975:Antioxidants; D001798:Blood Proteins; D006684:HLA-DR Antigens; D015850:Interleukin-6; D016209:Interleukin-8; D017472:Receptors, Interleukin-1; C021623:bactericidal permeability increasing protein; D002097:C-Reactive Protein