Glutamine effects on heat shock protein 70 and interleukines 6 and 10: Randomized trial of glutamine supplementation versus standard parenteral nutrition in critically ill children

Iolanda Jordan, Mònica Balaguer, M. Esther Esteban, Francisco José Cambra, Aida Felipe, Lluïsa Hernández, Laia Alsina, Marta Molero, Miquel Villaronga, Elisabeth Esteban

Research output: Indexed journal article Articlepeer-review

26 Citations (Scopus)

Abstract

Background and aims: To determine whether glutamine (Gln) supplementation would have a role modifying both the oxidative stress and the inflammatory response of critically ill children. Methods: Prospective, randomized, double-blind, interventional clinical trial. Selection criteria were children requiring parenteral nutrition for at least 5 days diagnosed with severe sepsis or post major surgery. Patients were randomly assigned to standard parenteral nutrition (SPN, 49 subjects) or standard parenteral nutrition with glutamine supplementation (SPN + Gln, 49 subjects). Results: Glutamine levels failed to show statistical differences between groups. At day 5, patients in the SPN + Gln group had significantly higher levels of HSP-70 (heat shock protein 70) as compared with the SPN group (68.6 vs 5.4, p = 0.014). In both groups, IL-6 (interleukine 6) levels showed a remarkable descent from baseline and day 2 (SPN: 42.24 vs 9.39, p < 0.001; SPN + Gln: 35.20 vs 13.80, p < 0.001) but only the treatment group showed a statistically significant decrease between day 2 and day 5 (13.80 vs 10.55, p = 0.013). Levels of IL-10 (interleukine 10) did not vary among visits except in the SPN between baseline and day 2 (9.55 vs 5.356, p < 0.001). At the end of the study, no significant differences between groups for PICU and hospital stay were observed. No adverse events were detected in any group. Conclusions: Glutamine supplementation in critically-ill children contributed to maintain high HSP-70 levels for longer. Glutamine supplementation had no influence on IL-10 and failed to show a significant reduction of IL-6 levels.

Original languageEnglish
Pages (from-to)34-40
Number of pages7
JournalClinical Nutrition
Volume35
Issue number1
DOIs
Publication statusPublished - 1 Feb 2016
Externally publishedYes

Keywords

  • Glutamine
  • HSP-70
  • Inflammatory mediators
  • Parenteral nutrition
  • Pediatric intensive care unit

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