Abstract
Background:
Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.
Aim and Objectives:
The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.
Materials and methods:
From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59%, range: 50%-90%) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios (%), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.
Results:
There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72% and 71.27±10.94%, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96% and 19.93±12.08%, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99% and 43.96±3.21%, P=0.01).
Conclusion:
Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.
Glutamine is an important energy source for immune cells. Several clinical trials have supported that glutamine supplementation in severely burned patients can maintain the immunologic function and improve the outcome.
Aim and Objectives:
The aim of this clinical study was to observe the effects of glutamine supplementation on immunologic modulation in extensive burn injury patients from the alternations of T cell and B cell lymphocytes counts and their differentiated ratios.
Materials and methods:
From July 2006 to September 2007, seven patients with extensive burn (total burn surface area 65.57±13.59%, range: 50%-90%) were enrolled in this prospective clinical trial. Patients received parenteral glutamine in doses of 20 g/day for 7 days. Alterations in immunologic function indices including T cell, B cell, CD4+ cell counts (μL^(-1)), differentiated count ratios (%), and the changes of CD4/CD8 ratio were determined on the 1st day and the 8th day from the initiation of glutamine treatment. The pre-treatment data on the 1st day was then compared with the post-treatment data on the 8th day.
Results:
There were no significant changes between the T cell (721±571 and 361±124 μL^(-1), P=0.149) and B cells counts (311±210 and 190±155 μL^(-1), P=0.267) after glutamine therapy. The T cell differentiated count ratio after glutamine supplementation was significantly higher than before treatment (59.77±16.72% and 71.27±10.94%, P=0.009). We especially observed a greater increase in patients with lower initial T cell differentiated count ratio. However, there was a decrease in B cell differentiated count ratios (29.24±12.96% and 19.93±12.08%, P=0.154). Although the CD4+ cell counts did not increase significantly after parenteral glutamine supplementation, (357±275 and 252±110 μL^(-1), P=0.437), we found the CD4+ differentiated count ratio increased significantly after glutamine therapy (30.93±7.99% and 43.96±3.21%, P=0.01).
Conclusion:
Parenteral glutamine supplementation in extensive burn patients increases the Tlymphocyte and CD4+ cell differentiated count ratios, as well as modulate the cellular immunologic function rather than the humoral response. The possible process is first to stimulate the helper T (CD4+) cells, which play the most important role in initiation of immunologic function and regulation.
| Translated title of the contribution | 靜脈給予Glutamine對嚴重燒燙傷病患免疫機能調控之影響 |
|---|---|
| Original language | English |
| Pages (from-to) | 27-34 |
| Number of pages | 8 |
| Journal | 中華民國整形外科醫學會雜誌 |
| Volume | 18 |
| Issue number | 1 |
| Publication status | Published - 2009 |
| Externally published | Yes |
Keywords
- glutamine
- extensive burns
- immunologic modulation