title: Evaluation of a new concept of immune-enhancing diet in a model of head-injured rat with infectious complications: A proof of concept study.
abstract: Immune-enhancing diet (IED) utilization in critically ill septic patients is still debated. A new concept of IED has been proposed combining extra glutamine sequentially with either antioxidants or other amino acids, in order to match patient requirements according to their response to injury. We evaluated whether this new IED elicits a more favorable response to stress when compared with two existing IEDs both enriched in arginine but with different levels of anti-oxidants, in a validated rat model combining head injury (HI) and infectious complications. Forty-eight HI rats were randomized into four groups (n = 11-13 per group) to receive, for 4 days, standard enteral nutrition (S), one of the two existing IEDs (IED1, IED2), or the new IED (IED3; providing glutamine and antioxidants for two days and glutamine and specific amino acids for two days). Two days after HI, the rats received an enteral bolus of luminescent Escherichia coli Xen14 to induce infection, and bacterial dissemination was evaluated. Body weight (BW) was recorded daily. Four days after HI, animals were euthanized; blood was sampled; organs were weighed; cumulated nitrogen balance (CNB) and nitrogen efficiency were determined. IED3 was more efficient than IED1 and IED2 in improving BW recovery from D3 (D3 vs. D1, p < 0.05) after HI. It significantly improved CNB and net protein utilization (IED3 vs. S, IED1, IED2, p < 0.05). An IED with sequential administration of anti-oxidants and glutamine may be better suited to meeting nutritional requirements in severe catabolic states.
authors.affiliation: Laboratoire de Pharmacie Galénique, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Charrueau
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Moinard
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Saskia
authors.initials: S
authors.lastname: Brinkmann
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Choisy
authors.affiliation: Laboratoire de Microbiologie, EA 4065, Risk in Pregnancy Department, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Butel
authors.affiliation: Unité de Technologies Chimiques et Biologiques pour la Santé (UTCBS) CNRS UMR 8258-INSERM U1022, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Michel-Francis
authors.initials: MF
authors.lastname: Bureau
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Servane
authors.initials: S
authors.lastname: Le Plénier
authors.affiliation: Laboratoire de Toxicologie, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Brignole-Baudouin
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France; Service de Biochimie, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, APHP, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Neveux
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France; Service de Biochimie, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, APHP, Paris, France. Electronic address: luc.cynober@parisdescartes.fr.
authors.forename: Luc
authors.initials: L
authors.lastname: Cynober
authors.affiliation: Laboratoire de Biologie de la Nutrition, EA4466, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75270 Paris Cedex 06, France; Service de Biochimie, Hôpital Cochin, Hôpitaux Universitaires Paris Centre, APHP, Paris, France.
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: De Bandt
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage; D000818:Animals; D000975:Antioxidants / Q000008:administration & dosage; D006259:Craniocerebral Trauma / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D004035:Diet Therapy / Q000379:methods*; D004195:Disease Models, Animal; D004750:Enteral Nutrition; D004927:Escherichia coli Infections / Q000150:complications / Q000517:prevention & control; D005973:Glutamine / Q000008:administration & dosage; D006801:Humans; D007109:Immunity / Q000502:physiology*; D017053:Infection Control / Q000379:methods; D007239:Infections / Q000150:complications*; D009751:Nutritional Requirements; D000075082:Proof of Concept Study; D051381:Rats
chemical_list: D000596:Amino Acids; D000975:Antioxidants; D005973:Glutamine
keywords: Arginine; Enteral nutrition; Glutamine; Sepsis; Trauma