title: "Immunonutrition" Has Failed to Improve Peritonitis-Induced Septic Shock in Rodents.
abstract: BACKGROUND
  Immunonutrition in sepsis, including n-3 poly-unsaturated fatty acids (PUFAs) or L-arginine supplementation, is a controversial issue that has yielded a great number of studies for the last thirty-five years, and the conclusions regarding the quantity and quality of this support in patients are deceiving. The aim of the present experimental study is to investigate the effects of a pretreatment with enteral nutrition enriched with n-3 PUFAs or L-arginine on vascular dysfunctions, inflammation and oxidative stress during septic shock in rats.
  
  
  METHODS
  Rats were fed with enteral Peptamen® HN (HN group), Peptamen® AF containing n-3 PUFAs (AF group) or Peptamen® AF enriched with L-arginine (AFA group). On day 4, peritonitis by cecal ligation and puncture (CLP) was performed. Rats were resuscitated (H18) once septic shock was established. After a 4-hour resuscitation, vessels and organs were harvested to assess inflammation, superoxide anion, nitric oxide and prostacyclin levels. Ex-vivo vascular reactivity was also performed.
  
  
  RESULTS
  Compared to CLP-AF or CLP-HN groups, 47.6% of CLP-AFA rats died before the beginning of hemodynamic measurements (vs. 8.0% and 20.0% respectively, p<0.05). AF and AFA rats required significantly increased norepinephrine infusion rates to reach the mean arterial pressure objective, compared to CLP-HN rats. Both CLP-AF and CLP-AFA reduced mesenteric resistance arterial contractility, decreased vascular oxidative stress, but increased NF-κB (0.40±0.15 in CLP-AF and 0.69±0.06 in CLP-AFA vs. 0.09±0.03 in SHAM rats and 0.30±0.06 in CLP-HN, ß-actin ratio, p<0.05) and pIκB expression (0.60±0.03 in CLP-AF and 0.94±0.15 in CLP-AFA vs. 0.04±0.01 in SHAM rats and 0.56±0.07 in CLP-HN, ß-actin ratio, p<0.05), nitric oxide and prostacyclin production in septic rats.
  
  
  CONCLUSIONS
  Although n-3 PUFAs or L-arginine supplementation exhibited an antioxidant effect, it worsened the septic shock-induced vascular dysfunction. Furthermore, mortality was higher after L-arginine supplementation.
authors.affiliation: EA 7293, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Université de Strasbourg, Strasbourg, France.|Service de Réanimation Médicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Boisramé-Helms
authors.affiliation: EA 4278, Université d'Avignon, F-84000, Avignon, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Meyer
authors.affiliation: Laboratoire de Biophotonique et Pharmacologie, UMR 7213 CNRS, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
authors.forename: Su Emmanuelle
authors.initials: SE
authors.lastname: Degirmenci
authors.affiliation: Laboratoire de Biophotonique et Pharmacologie, UMR 7213 CNRS, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Burban
authors.affiliation: Laboratoire de Biophotonique et Pharmacologie, UMR 7213 CNRS, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Schini-Kerth
authors.affiliation: Département de Chimie Clinique, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, AP-HP, Paris, France.|Laboratoire de Biologie de la Nutrition, EA 4466, Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Luc
authors.initials: L
authors.lastname: Cynober
authors.affiliation: Département de Chimie Clinique, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, AP-HP, Paris, France.|Laboratoire de Biologie de la Nutrition, EA 4466, Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: De Bandt
authors.affiliation: Service de Réanimation Médicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Hasselmann
authors.affiliation: EA 7293, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de médecine, Université de Strasbourg, Strasbourg, France.|Service de Réanimation Médicale, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Meziani
mesh_terms: D000818:Animals; D001120:Arginine / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D008297:Male; D010538:Peritonitis / Q000188:drug therapy* / Q000401:mortality; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000188:drug therapy / Q000401:mortality; D012772:Shock, Septic / Q000188:drug therapy* / Q000401:mortality
chemical_list: D015525:Fatty Acids, Omega-3; D001120:Arginine