Arginine supplementation does not enhance serum nitric oxide levels in elderly nursing home residents with pressure ulcers

• Published in: Biological research for nursing Vol. 6; no. 4; p. 289
• Main Authors: Stechmiller, Joyce K, Langkamp-Henken, Bobbi, Childress, Beverly, Herrlinger-Garcia, Kelli A, Hudgens, Jan, Tian, Lili, Percival, Susan S, Steele, Ruby
• Format: Journal Article
• Language: English
• Published: United States 01.04.2005
• Subjects: Administration, Oral; Aged; Arginine - blood; Arginine - pharmacology; Arginine - therapeutic use; Citrulline - blood; Citrulline - drug effects; Dietary Supplements - utilization; Drug Monitoring; Female; Florida; Geriatric Assessment; Humans; Inflammation; Lymphocyte Activation - drug effects; Male; Mitogens; Neutrophil Activation - drug effects; Nitric Oxide - blood; Nursing Homes; Nutrition Assessment; Nutritional Status; Ornithine - blood; Ornithine - drug effects; Pressure Ulcer - blood; Pressure Ulcer - drug therapy; Pressure Ulcer - immunology; Respiratory Burst - drug effects; Time Factors; Florida
• ISSN: 1099-8004
• DOI: 10.1177/1099800405274732

The purpose of this study was to determine whether arginine supplementation enhances in vitro (neutrophil burst and mitogen-induced lymphocyte proliferation) and in vivo (delayed-type hypersensitivity [DTH] and serum nitric oxide) measures of immune function in nursing home elders with pressure ulcers. Twenty-six elders, 65 years of age or older, with one or more pressure ulcers, were randomized to receive 8.5 g of arginine or an isonitrogenous supplement for 4 weeks. Immune function studies and serum arginine, ornithine, citrulline, and nitric oxide were measured at baseline, 4 weeks postsupplementation (Week 4) and after a 6-week washout (Week 10). At Week 4, serum ornithine increased (p = .01) and arginine trended to increase (p = .055), but there was no increase in citrulline or nitric oxide with arginine supplementation. There were no differences in neutrophil burst or DTH responses between groups. Whole blood mitogen-induced proliferation decreased significantly at Week 10 in the isonitrogenous but not in the arginine-supplemented group. There is mounting concern that arginine supplementation during an inflammatory state could be detrimental due to overwhelming nitric oxide production. A key finding of this study is that arginine supplementation did not increase serum nitric oxide levels over that observed in elders with pressure ulcers given an isonitrogenous supplement.