title: L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty.
abstract: OBJECTIVE
  To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty.
  
  
  METHODS
  Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6).
  
  
  RESULTS
  No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P <0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p <0.01).
  
  
  CONCLUSIONS
  Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control.
authors.affiliation: Federal University of Ceara, Fortaleza-CE, Brazil.
authors.forename: José Ferreira da
authors.initials: JF
authors.lastname: Cunha Filho
authors.forename: Isabelle Ivo
authors.initials: II
authors.lastname: Gonçalves
authors.forename: Sergio Botelho
authors.initials: SB
authors.lastname: Guimarães
authors.forename: Francisco Vagnaldo Fechine
authors.initials: FV
authors.lastname: Jamacaru
authors.forename: José Huygens Parente
authors.initials: JH
authors.lastname: Garcia
authors.forename: Paulo Roberto Leitão de
authors.initials: PR
authors.lastname: Vasconcelos
mesh_terms: D000704:Analysis of Variance; D001786:Blood Glucose / Q000187:drug effects; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000378:metabolism / Q000601:surgery*; D002972:Cleft Palate / Q000378:metabolism / Q000601:surgery*; D004151:Dipeptides / Q000494:pharmacology*; D005978:Glutathione / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000378:metabolism / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects; D011184:Postoperative Period; D011446:Prospective Studies; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000517:prevention & control; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D004151:Dipeptides; D015850:Interleukin-6; D017392:Thiobarbituric Acid Reactive Substances; D002097:C-Reactive Protein; D005978:Glutathione; C054122:alanylglutamine