title: Perioperative oral administration of cystine and theanine enhances recovery after distal gastrectomy: a prospective randomized trial.
abstract: BACKGROUND
  It has been reported that cystine and theanine, amino acids related to glutathione synthesis, have immunomodulatory effects, such as suppressing inflammation after strenuous exercise. In this study, we examined the effects of oral administration of cystine and theanine during the perioperative period as a pilot study.
  
  
  METHODS
  Forty-three cases of distal gastrectomy for cancer conducted in our department were assigned to the cystine and theanine group (CT group) or to the placebo control group (P group), and a randomized, single-blind, parallel-group study was then performed. Cystine (700 mg) and theanine (280 mg) or a placebo was administered to participants for 10 continuous days (4 days before to 5 days after surgery). Changes in pre- and postoperative interleukin (IL)-6, C-reactive protein (CRP), albumin, white blood cell (WBC) count, neutrophil count, total lymphocyte count, resting energy expenditure (REE), and body temperature were compared and examined.
  
  
  RESULTS
  Ten patients were excluded, leaving 33 patients in the study. The CT group had significantly lower IL-6 values (postoperative day [POD] 4), CRP levels (POD 7), neutrophil counts (POD 4), and body temperatures (POD 5) than the P group (P < .05). In addition, REE in the P group peaked on day 1 (1.14 ± 0.16 [pre- and postoperative ratio]), whereas the CT group did not show any increase on POD 1 (0.99 ± 0.21, P < .05 vs P group).
  
  
  CONCLUSIONS
  This study suggests that oral administration of cystine and theanine during the perioperative period may alleviate postgastrectomy inflammation and promote recovery after surgery.
authors.affiliation: Department of Surgery, Sendai City Medical Center, Sendai, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Miyachi
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Oyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuchiya
authors.forename: Naomi
authors.initials: N
authors.lastname: Abe
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sato
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Chiba
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Kurihara
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shibakusa
authors.forename: Takashi
authors.initials: T
authors.lastname: Mikami
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003553:Cystine / Q000008:administration & dosage*; D005260:Female; D005763:Gastroenterostomy; D005971:Glutamates / Q000008:administration & dosage*; D005978:Glutathione / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D010865:Pilot Projects; D011184:Postoperative Period; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D016037:Single-Blind Method
chemical_list: D005971:Glutamates; D015850:Interleukin-6; D012709:Serum Albumin; D003553:Cystine; C026166:theanine; D002097:C-Reactive Protein; D005978:Glutathione