The influence of immunomodulatory diets on transplant success and complications.
The influence of immunomodulatory diets on transplant success and complications.
复制标题
免疫调节饮食对移植成功和并发症的影响。
DOI：
10.1097/01.tp.0000148802.04879.27
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发表时间：
2005
期刊：
影响因子：
6.2
通讯作者：
Woodle,ESteve
中科院分区：
文献类型：
--
作者：
Alexander,JWesley;Metze,TimothyJ;McIntosh,MatthewJ;Goodman,HopeR;First,MRoy;Munda,Rino;Cardi,MichaelA;Austin,JoeN;Goel,Sharad;Safdar,Shahzad;Greenberg,Norman;Chen,Xiaowu;Woodle,ESteve
背景：动物研究表明，在接受短期低剂量环孢素治疗的动物中，饮食中补充精氨酸和含有ω-3和ω-9脂肪酸的脂质可延长同种异体移植物的存活。他们还减少心血管并发症和infections in human.Methods.成人肾移植患者接受标准的免疫抑制剂分层根据性别，糖尿病状态，供体来源（LD或CD），第一次与重复移植，并随机接受或不接受补充精氨酸和菜籽油（含ω-3和ω-9脂肪酸），每天两次。结果：76名患者被随机分配到补充组（S）和71名患者到对照组（C）。意向治疗分析显示，与C组（23.7%）（P= 0.01）相比，S组患者30天后首次排斥反应事件较少（5.4%），30天后钙调磷酸酶抑制剂（CNI）药物毒性事件较少（9.2% vs. 35.3%，P= 0.003）。S组患者3年内新发糖尿病（NODM）的发生率降低（2.3% vs. 14.5%，P= 0.04），心脏事件较少（5.0% vs. 17.1%，P= 0.05），脓毒症发作较少（6.5%vs.18.7%，P= 0.05）.结论：饮食中补充L-精氨酸和菜籽油是一种安全、廉价和独特的治疗方法，这与肾移植患者第一个月后排斥率和CNI毒性的降低有关。由于NODM和心脏事件的减少，患者生存的长期益处可能特别重要。
Background.Animal studies have shown that dietary supplementation with arginine and lipids containing the ω-3 and ω-9 fatty acids prolong allograft survival in animals receiving a short course of low-dose cyclosporine. They also reduce cardiovascular complications and infections in humans.Methods.Adult renal transplant patients receiving standard immunosuppression were stratified according to gender, diabetic state, donor source (LD or CD), and first versus repeat transplant, and randomized to receive or not receive supplemental arginine and canola oil (containing both ω-3 and ω-9 fatty acids) twice daily. Patients were followed for a minimum of 3 years.Results.Seventy-six patients were randomized to the supplement group (S) and 71 patients to the control group (C). Intent-to-treat analysis revealed that S patients had fewer post-30 day first rejection episodes (5.4%) when compared with the C group (23.7%)(P= 0.01) and fewer post-30 day episodes of calcineurin inhibitor (CNI) drug toxicity (9.2% vs. 35.3%, P= 0.003). S patients developed new onset diabetes mellitus (NODM) less frequently by 3 years (2.3% vs. 14.5%, P= 0.04), had fewer cardiac events (5.0% vs. 17.1%, P= 0.05), and fewer episodes of sepsis (6.5% vs. 18.7%, P= 0.05).Conclusions.Dietary supplementation with L-arginine and canola oil is a safe, inexpensive, and unique treatment, which is associated with decreased rejection rates and CNI toxicity after the first month in renal transplant patients. Due to reductions in NODM and cardiac events, long-term benefits for patient survival may be particularly important.