Arginine-supplemented enteral nutrition in critically ill diabetic and obese rats: A dose-ranging study evaluating nutritional status and macrophage function
Arginine-supplemented enteral nutrition in critically ill diabetic and obese rats: A dose-ranging study evaluating nutritional status and macrophage function
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DOI：
10.1016/j.nut.2012.07.005
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发表时间：
2013-01-01
期刊：
影响因子：
4.4
通讯作者：
Darquy, Sylviane
中科院分区：
文献类型：
--
作者：
Bonhomme, Sandra;Belabed, Linda;Darquy, Sylviane
目的：危重糖尿病和肥胖患者是并发症的高危人群。精氨酸的可用性在糖尿病和应激情况下降低，但精氨酸是免疫反应所必需的，主要是通过一氧化氮（NO）发挥作用。这些事实为危重患者提供了补充精氨酸的饮食。然而，研究已经引起了人们对这种饮食在重症监护患者中可能产生的不良影响的担忧。因此，我们分析了代谢和免疫学的影响，富含精氨酸的饮食在强调糖尿病肥胖rates.Methods：Zucker糖尿病肥胖大鼠（FA/FA）内毒素血症的腹腔注射脂多糖，然后喂食4-d肠内营养富含精氨酸（ARG组）或非必需氨基酸的混合物（NEAA组）。这两组又分为三个亚组：ARG亚组每天接受0.5 g（ARG0.5）、2 g（ARG 2）和5 g（ARG 5）精氨酸/kg，NEAA组与相应的ARG亚组（NEAA0.5、NEAA 2和NEAA 5）等氮。测量血浆和尿液生物标志物。细胞因子和NO的生产水平和诱导型NO合成酶和蛋白水平测定从腹腔macrophage.Results：在ARG 5和NEAA 5亚组的生存率低于所有其他亚组。ARG 5组的氮平衡高于NEAA 5组。ARG 2组的血浆三酰甘油水平低于NEAA 2组。白细胞介素-6，肿瘤坏死因子-α，和NO的生产在巨噬细胞减少和ARG-treated rats.Conclusions：在这个模型中，死亡率增加的氮负荷，而不是精氨酸本身。精氨酸改善氮平衡，并通过调节NO的产生对巨噬细胞有抗炎作用，可能是通过抑制酶-1的表达。(C)2013 Elsevier Inc. All rights reserved.
Objective: Critically ill diabetic and obese patients are at high risk of complications. Arginine availability is lowered in diabetes and in stress situations, yet arginine is necessary for immune response, mainly by its action through nitric oxide (NO). These facts argue for arginine-supplemented diets in critically ill patients. However, studies have raised concerns about possible adverse effects of such diets in intensive-care patients. We therefore analyzed the metabolic and immunologic effects of an arginine-enriched diet in stressed diabetic-obese rats.Methods: Zucker Diabetic Fatty rats (fa/fa) were made endotoxemic by an intraperitoneal injection of lipopolysaccharide and then fed 4-d enteral nutrition enriched with arginine (ARG group) or a non-essential amino acid mix (NEAA group). The two groups each were subdivided into three subgroups: the ARG subgroups received 0.5 g (ARG0.5), 2 g (ARG2), and 5 g (ARG5) of arginine per kilogram daily, and the NEAA groups were made isonitrogenous with the corresponding ARG subgroups (NEAA0.5, NEAA2, and NEAA5). Plasma and urinary biomarkers were measured. Cytokine and NO production levels and inducible NO synthase and arginase protein levels were determined from peritoneal macrophages.Results: The survival rate was lower in the ARG5 and NEAA5 subgroups than in all the other subgroups. The nitrogen balance was higher in the ARG5 group than in the NEAA5 group. Plasma triacylglycerol levels were lower in the ARG2 group than in the NEAA2 group. Interleukin-6, tumor necrosis factor-alpha, and NO production in the macrophages decreased and arginase-1 was upregulated in the ARG-treated rats.Conclusions: In this model, mortality was increased by the nitrogen burden rather than by arginine per se. Arginine improved nitrogen balance and had an anti-inflammatory action on macrophages by regulating NO production, probably through arginase-1 expression. (C) 2013 Elsevier Inc. All rights reserved.