title: Immunonutrition stimulates immune functions and antioxidant defense capacities of leukocytes in radiochemotherapy-treated head & neck and esophageal cancer patients: A double-blind randomized clinical trial.
abstract: BACKGROUND
  Immunonutrition has been reported to improve the immune status of perioperative cancer patients, thereby reducing complications and length of hospital stay.
  
  
  OBJECTIVE
  This study aimed to assess whether immunonutrition enriched in arginine, EPA & DHA and nucleotides could impact the immune cells responses in head & neck and esophageal cancer patients treated by radiochemotherapy (RCT).
  
  
  METHODS
  A double-blind clinical trial was carried out in 28 patients randomized into two groups, receiving either an immunomodulating enteral nutrition formula (IEN, n = 13, Impact(®), Nestlé) or an isoenergetic isonitrogenous standard enteral nutrition formula (SEN, n = 15) throughout RCT (5-7 weeks). After isolation from whole blood, immune cells metabolism and functions were assessed at the beginning (Db) and at the end (De) of RCT.
  
  
  RESULTS
  Immunonutrition maintained CD4(+)/CD8(+) T-lymphocyte counts ratio and CD3 membrane expression between Db and De. Polymorphonuclear cells CD62L and CD15 densities and ROS production were increased in IEN patients. Peripheral blood mononuclear cells (PBMC) production of pro-inflammatory prostaglandin-E2 was stable in IEN patients and lower than in SEN patients at De. Genes coding for immune receptors, antioxidant enzymes and NADPH oxidase subunits were overexpressed in the PBMC of IEN vs SEN patients at De.
  
  
  CONCLUSIONS
  Immunonutrition can enhance immune cell responses through the modulation of their phenotypes and functions. By modulating the gene expression of immune cells, immunonutrition could make it easier for the organism to adapt to the systemic inflammation and oxidative stress induced by RCT.
  
  
  BACKGROUND
  This clinical trial has been registered on ClinicalTrial.gov website: NCT00333099.
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Talvas
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: G
authors.initials: G
authors.lastname: Garrait
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: N
authors.initials: N
authors.lastname: Goncalves-Mendes
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Rouanet
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France.
authors.forename: J
authors.initials: J
authors.lastname: Vergnaud-Gauduchon
authors.affiliation: Centre Jean Perrin, Service de Statistiques, F-63000 Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Kwiatkowski
authors.affiliation: Centre Léon Bérard, Unité de Nutrition Clinique, F-69000 Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Bachmann
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service de Médecine Digestive et Hépatobiliaire, F-63003 Clermont-Ferrand, France.
authors.forename: C
authors.initials: C
authors.lastname: Bouteloup
authors.affiliation: CH Lyon Sud, Laboratoire d'Immunologie, F-69000 Lyon, France.
authors.forename: J
authors.initials: J
authors.lastname: Bienvenu
authors.affiliation: Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France; INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermont-Ferrand, France; Centre Jean Perrin, CHU Clermont-Ferrand, Unité de Nutrition, CLARA, F-63000 Clermont-Ferrand, France. Electronic address: m-paule.vasson@udamail.fr.
authors.forename: M-P
authors.initials: MP
authors.lastname: Vasson
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000494:pharmacology; D001120:Arginine / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D001772:Blood Cell Count; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D059248:Chemoradiotherapy; D015232:Dinoprostone / Q000378:metabolism; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage; D004750:Enteral Nutrition / Q000379:methods; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D015870:Gene Expression; D006801:Humans; D056747:Immunomodulation; D007902:Length of Stay; D007963:Leukocytes, Mononuclear / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011182:Postoperative Care; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D017382:Reactive Oxygen Species; D059467:Transcriptome
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D012333:RNA, Messenger; D017382:Reactive Oxygen Species; D004281:Docosahexaenoic Acids; D001120:Arginine; D015118:Eicosapentaenoic Acid; D015232:Dinoprostone
keywords: Cancer; Immunonutrition; Radiochemotherapy