Effect of Immune-Enhancing Enteral Nutrition Enriched with or without Beta-Glucan on Immunomodulation in Critically Ill Patients.
We investigated whether high-protein enteral nutrition with immune-modulating nutrients (IMHP) enriched with β-glucan stimulates immune function in critically ill patients. In a randomized double-blind placebo-controlled study, 30 patients consumed one of three types of enteral nutrition: a control or IMHP with and without β-glucan. The IMHP with β-glucan group showed increases in natural killer (NK) cell activities relative to the baseline, and greater increases were observed in NK cell activities relative to the control group after adjusting for age and gender. The IMHP groups with and without β-glucan had greater increases in serum prealbumin and decreases in high-sensitivity C-reactive protein (hs-CRP) than the control group. The control group had a greater decrease in peripheral blood mononuclear cell (PBMC) interleukin (IL)-12 production than the IMHP with and without β-glucan groups. In all patients, the change (Δ) in hs-CRP was correlated with Δ prealbumin and Δ PBMC IL-12, which were correlated with ΔNK cell activity and Δ prealbumin. This study showed beneficial effects of a combination treatment of β-glucan and IMHP on NK cell activity. Additionally, strong correlations among changes in NK cell activity, PBMC IL-12, and hs-CRP suggested that β-glucan could be an attractive candidate for stimulating protective immunity without enhanced inflammation (ClinicalTrials.gov: NCT02569203).
Department of Surgery, Yonsei University College of Medicine, Seoul 03722, Korea. jakii@yuhs.ac.
Jae Gil
JG
Lee
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea. ysamkim@yuhs.ac.
Young Sam
YS
Kim
National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul 03722, Korea. juny9558@naver.com.|Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. juny9558@naver.com.
Young Ju
YJ
Lee
Research Center for Silver Science, Institute of Symbiotic Life-TECH, Yonsei University, Seoul 03722, Korea. vitaminahy@naver.com.
Hyeon Yeong
HY
Ahn
Research Center for Silver Science, Institute of Symbiotic Life-TECH, Yonsei University, Seoul 03722, Korea. minjookim@yonsei.ac.kr.
Minjoo
M
Kim
National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul 03722, Korea. mkkim0106@yonsei.ac.kr.|Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. mkkim0106@yonsei.ac.kr.
Minkyung
M
Kim
National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul 03722, Korea. wm5156@hanmail.net.|Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. wm5156@hanmail.net.
Min Jung
MJ
Cho
Department of Nutrition, Yonsei University Health System, Seoul 03722, Korea. yscho@yuhs.ac.
Younsoo
Y
Cho
National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul 03722, Korea. jhleeb@yonsei.ac.kr.|Department of Food and Nutrition, Brain Korea 21 PLUS Project, College of Human Ecology, Yonsei University, Seoul 03722, Korea. jhleeb@yonsei.ac.kr.|Research Center for Silver Science, Institute of Symbiotic Life-TECH, Yonsei University, Seoul 03722, Korea. jhleeb@yonsei.ac.kr.
Jong Ho
JH
Lee
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016638:Critical Illness; D016207:Cytokines / Q000378:metabolism; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D056747:Immunomodulation / Q000187:drug effects*; D007694:Killer Cells, Natural / Q000187:drug effects; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D047071:beta-Glucans / Q000494:pharmacology*
D016207:Cytokines; D047071:beta-Glucans; D002097:C-Reactive Protein
ICU; NK cell; beta-glucan; enteral nutrition; immune system; inflammation