Cytokine Responses in Very Low Birth Weight Infants Receiving Glutamine‐enriched Enteral Nutrition

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 48; no. 1; pp. 94 - 101
• Main Authors: Berg, Anemone, Elburg, Ruurd M, Vermeij, Linda, Zwol, Annelies, Brink, Gijs R, Twisk, Jos WR, Nieuwenhuis, Edward ES, Fetter, Willem PF
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01.01.2009; Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Birth Weight; CD28 Antigens - immunology; CD3 Complex - immunology; Cytokines; Cytokines - blood; Cytokines - immunology; Diseases of mother, fetus and pregnancy; Double-Blind Method; Enteral Nutrition; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Gestational Age; Glutamine; Glutamine - administration & dosage; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Very Low Birth Weight - blood; Infant, Very Low Birth Weight - immunology; Intensive Care, Neonatal; Interferon-gamma - blood; Interleukins - blood; Lipopolysaccharides - pharmacology; Male; Medical sciences; Placebos; Pregnancy. Fetus. Placenta; Randomized controlled trial; Th1/Th2 cell; Tumor Necrosis Factor-alpha - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Very low birth weight infants; Human; Premature; Obesity; Pregnancy disorders; Nutrition; Cytokines; Enteral nutrition; Nutrition disorder; Cytokine; Metabolic diseases; Infant; Randomized controlled trial; Enteral administration; Very low birthweight; Newborn diseases; Prematurity; Very low birth weight infants; Aminoacid; Thl/Th2 cell; Gastroenterology; Th2 lymphocyte; Nutritional status; Glutamine
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/MPG.0b013e3181805116

ABSTRACT Objective: Very low birth weight (VLBW) infants receiving glutamine‐enriched enteral nutrition may present with a lower infection rate, which may result from enhanced antimicrobial innate or Th1 cytokine responses. We investigated whether glutamine‐enriched enteral nutrition in VLBW infants increased these cytokine responses following in vitro stimulation of whole blood cells. Methods: In a double‐blind, placebo‐controlled, randomized controlled trial, VLBW infants (gestational age <32 weeks and/or birth weight <1500 g) received enteral glutamine supplementation (0.3 g · kg−1 · day−1) or isonitrogenous placebo supplementation (alanine) between days 3 and 30 of life. Cytokine responses following in vitro whole blood cell stimulation with anti‐(α)CD3/αCD28 or lipopolysaccharide were analyzed by cytometric bead array at 3 time points: before the start of the study, at day 7 of life, and at day 14 of life. Results: Baseline patient and nutritional characteristics were not different between groups. At least 2 blood samples were analyzed in 25 of 52 (48%) and 38 of 50 (76%) infants in the glutamine‐supplemented and control groups, respectively. Glutamine‐enriched enteral nutrition was not associated with significant alterations in cytokine responses (interferon‐γ, tumor necrosis factor‐α, interleukin [IL]‐2, IL‐4, IL‐5, and IL‐10) of peripheral blood cells upon stimulation with either anti‐αCD3/αCD28 or lipopolysaccharide. Conclusions: We hypothesize that glutamine‐enriched enteral nutrition decreases the infection rate in VLBW infants by influencing the mucosal and not the systemic immune system.