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Postoperative glycyl-glutamine infusion reduces immunosuppression: partial prevention of the surgery induced decrease
A Spittler1, T Sautner, A Gornikiewicz
1Surgical Research Laboratories, AKH, University of Vienna, Wachringer Guertel 19-20, 1090 Vienna, Austria.
Clinical Nutrition (Edinburgh, Scotland)
|February 13, 2001
Summary
Postoperative glycyl-glutamine (GLY-GLN) infusions preserved monocyte HLA-DR expression after surgery, unlike alanyl-glutamine. This finding suggests GLY-GLN may help prevent infections in surgical patients.
Area of Science:
- Immunology
- Surgical Metabolism
- Nutritional Support
Background:
- Surgery, trauma, and inflammation decrease monocyte HLA-DR expression, increasing infection risk.
- Postoperative plasma glutamine (GLN) levels decline, impacting monocyte function.
- In vitro studies show GLN concentration influences HLA-DR expression on monocytes.
Purpose of the Study:
- To investigate if postoperative infusions of glutamine dipeptides prevent decreased monocyte HLA-DR expression.
- To compare the effects of glycyl-glutamine (GLY-GLN) and alanyl-glutamine (ALA-GLN) on postoperative HLA-DR expression.
Main Methods:
- Thirty patients undergoing major abdominal surgery were studied.
- Patients received either a control infusion or GLY-GLN or ALA-GLN (35g GLN) over 48 hours postoperatively.
- Monocyte HLA-DR expression was measured by flow cytometry immediately and 48 hours after surgery.
Main Results:
- GLY-GLN significantly preserved monocyte HLA-DR expression at 48 hours compared to controls (65.0% vs 42.5%).
- ALA-GLN did not show a significant difference in preserving HLA-DR expression compared to controls.
- Patient groups were comparable in age, gender, and operation time.
Conclusions:
- This is the first study to compare GLY-GLN and ALA-GLN in the postoperative setting.
- GLY-GLN's ability to preserve monocyte HLA-DR expression may help prevent postoperative infectious complications.