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Metabolic and Immune Effects of Dietary Arginine Supplementation After Burn

Metabolic and Immune Effects of Dietary Arginine Supplementation After Burn Abstract • The effect of supplemental dietary arginine on metabolism and immunity was studied in 36 burned guinea pigs (30% of total body surface area) with previously placed catheter gastrostomies. The animals were randomized into four groups. After an initial three-day adaptation period, all groups received continuous isonitrogenous, isocaloric (175 kcal [735 kJ]/kg/d), and isovolemic intragastric tube feedings until postburn day (PBD) 14. Groups A, B, C, and D received 0%, 1%, 2%, and 4%, respectively, of total energy intake as arginine given in the form of crystalline arginine hydrochloride with 22%, 21%, 20%, and 18%, respectively, of total energy as whey protein. The average body weight after burn decreased equally in all groups. Resting metabolic expenditure on PBD 6 was higher in groups B (151%±6% of preburn) and C (156%±7%) than in groups A (131%±4%) and D (136%±3%). Ear-thickness response to dinitrofluorobenzene challenge on PBD 12 showed the best response in group C. The mortality rates of groups A, B, C, and D were 56%, 29%, 22%, and 56%, respectively. This study suggests that oral dietary arginine supplementation up to 2% of energy intake may be beneficial after burn injury. (Arch Surg 1987;122:784-789) References 1. Alexander JW, MacMillan BG, Stinnett JD, et al: Beneficial effect of aggressive protein feeding in severely burned children . Ann Surg 1980;192: 505-517.Crossref 2. Richards JR: Current concepts in the metabolic response to injury, infection and starvation . Proc Nutr Soc 1980;39:113-123.Crossref 3. Barbul A, Wasserkrug HL, Yoshimura NN, et al: High arginine levels in intravenous hyperalimentation abrogate post-traumatic immune suppression . J Surg Res 1984;36:620-624.Crossref 4. Seitfer E, Rettura G, Barbul A, et al: Arginine: An essential amino acid for injured rats . Surgery 1978;84:224-230. 5. Sitren HS, Fisher H: Nitrogen retention in rats fed on diets enriched with arginine and glycine: I. Improved N retention after trauma . Br J Nutr 1977;37:195-208.Crossref 6. Dominioni L, Stinnett JD, Fang CH, et al: Gastrostomy feeding in normal and hypermetabolic burned guinea pigs: A model for the study of enteral diets . J Burn Care Rehabil 1984;5:100-105.Crossref 7. Mochizuki H, Trocki O, Dominioni L, et al: Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding . Ann Surg 1984;200:297-310.Crossref 8. Hansbrough J, Peterson V, Zapata-Sirvent R, et al: Postburn immunosuppression in an animal model: II. Restoration of cell mediated immunity by immunomodulating drugs . Surgery 1984;95:290-295. 9. Phanuphak P, Moorhead JW, Claman HN: Tolerance and contact sensitivity to DNFB in mice: I. In vivo detection by ear swelling and correlation with in vitro cell stimulation . J Immunol 1974;112:115-123. 10. Kinney JM: Surgical diagnosis, patterns of energy, weight and tissue change , in Wilkinson SW, Cuthbertson D (eds): Metabolism and the Response to Injury . Chicago, Year Book Medical Publishers Inc, 1976, pp 121-133. 11. Kien CL, Rohrbaugh DK, Burke JF, et al: Whole body protein synthesis in relation to basal energy expenditure in healthy children and in children recovering from burn injury . Pediatr Res 1978;12:211-217.Crossref 12. Barbul A, Sisto DA, Wasserkrug HL, et al: Metabolic and immune effects of arginine in post-injury hyperalimentation . J Trauma 1981;21: 970-974.Crossref 13. Chyun J, Griminger P: Improvement of nitrogen retention by arginine and glycine supplementation and its relation to collagen synthesis in traumatized mature and aged rats . J Nutr 1984;114:1697-1704. 14. Minuskin ML, Lavine ME, Ulman EA, et al: Nitrogen retention, muscle creatinine and orotic acid excretion in traumatized rats fed arginine and glycine enriched diets . J Nutr 1981;111:1265-1274. 15. O'Dell BL, Regan WO: Effect of lysine and glycine upon arginine requirement of guinea pigs . Proc Soc Exp Biol Med 1963;112:336-337.Crossref 16. Barbul A, Wasserkrug HL, Penberthy LT, et al: Optimal levels of arginine in maintenance intravenous hyperalimentation . JPEN 1984;8: 281-284.Crossref 17. Kari FW, Ulman EA, Mulloy AL, et al: Arginine requirement of mature protein-malnourished rats for maximal rate of repletion . J Nutr 1981;111:1489-1493. 18. Barbul A, Sisto DA, Wasserkrug HL, et al: Arginine stimulates lymphocyte immune response in healthy human beings . Surgery 1981;90: 244-251. 19. Baker C, Miller CL, Trunkey DD: Predicting fatal sepsis in burned patients . J Trauma 1979;19:641-648.Crossref 20. Munster AW, Winchurch RA, Birmingham WJ, et al: Longitudinal assay of lymphocyte responsiveness in patients with major burns . Ann Surg 1980;192:772-775.Crossref 21. Barbul A, Rettura G, Levenson MS, et al: Wound healing and thymotropic effects of arginine: A pituitary mechanism of action . Am J Clin Nutr 1983;37:786-794. 22. Mulloy AL, Kari FW, Visek WJ: Dietary arginine, insulin secretion, glucose tolerance and liver lipids during repletion of protein-depleted rats . Horm Metab Res 1982;14:471-475.Crossref 23. Woolfson AMJ, Heatley RV, Allison SP: Insulin to inhibit protein catabolism after injury . N Engl J Med 1979;300:14-17.Crossref 24. Barbul A, Sisto DA, Wasserkrug HL, et al: Nitrogen-sparing and immune mechanisms of arginine: Differential dose-dependent responses during post-injury intravenous hyperalimentation . Curr Surg 1983;40: 114-116. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Metabolic and Immune Effects of Dietary Arginine Supplementation After Burn

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1987.01400190050010
Publisher site
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Abstract

Abstract • The effect of supplemental dietary arginine on metabolism and immunity was studied in 36 burned guinea pigs (30% of total body surface area) with previously placed catheter gastrostomies. The animals were randomized into four groups. After an initial three-day adaptation period, all groups received continuous isonitrogenous, isocaloric (175 kcal [735 kJ]/kg/d), and isovolemic intragastric tube feedings until postburn day (PBD) 14. Groups A, B, C, and D received 0%, 1%, 2%, and 4%, respectively, of total energy intake as arginine given in the form of crystalline arginine hydrochloride with 22%, 21%, 20%, and 18%, respectively, of total energy as whey protein. The average body weight after burn decreased equally in all groups. Resting metabolic expenditure on PBD 6 was higher in groups B (151%±6% of preburn) and C (156%±7%) than in groups A (131%±4%) and D (136%±3%). Ear-thickness response to dinitrofluorobenzene challenge on PBD 12 showed the best response in group C. The mortality rates of groups A, B, C, and D were 56%, 29%, 22%, and 56%, respectively. This study suggests that oral dietary arginine supplementation up to 2% of energy intake may be beneficial after burn injury. (Arch Surg 1987;122:784-789) References 1. Alexander JW, MacMillan BG, Stinnett JD, et al: Beneficial effect of aggressive protein feeding in severely burned children . Ann Surg 1980;192: 505-517.Crossref 2. Richards JR: Current concepts in the metabolic response to injury, infection and starvation . Proc Nutr Soc 1980;39:113-123.Crossref 3. Barbul A, Wasserkrug HL, Yoshimura NN, et al: High arginine levels in intravenous hyperalimentation abrogate post-traumatic immune suppression . J Surg Res 1984;36:620-624.Crossref 4. Seitfer E, Rettura G, Barbul A, et al: Arginine: An essential amino acid for injured rats . Surgery 1978;84:224-230. 5. Sitren HS, Fisher H: Nitrogen retention in rats fed on diets enriched with arginine and glycine: I. Improved N retention after trauma . Br J Nutr 1977;37:195-208.Crossref 6. Dominioni L, Stinnett JD, Fang CH, et al: Gastrostomy feeding in normal and hypermetabolic burned guinea pigs: A model for the study of enteral diets . J Burn Care Rehabil 1984;5:100-105.Crossref 7. Mochizuki H, Trocki O, Dominioni L, et al: Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding . Ann Surg 1984;200:297-310.Crossref 8. Hansbrough J, Peterson V, Zapata-Sirvent R, et al: Postburn immunosuppression in an animal model: II. Restoration of cell mediated immunity by immunomodulating drugs . Surgery 1984;95:290-295. 9. Phanuphak P, Moorhead JW, Claman HN: Tolerance and contact sensitivity to DNFB in mice: I. In vivo detection by ear swelling and correlation with in vitro cell stimulation . J Immunol 1974;112:115-123. 10. Kinney JM: Surgical diagnosis, patterns of energy, weight and tissue change , in Wilkinson SW, Cuthbertson D (eds): Metabolism and the Response to Injury . Chicago, Year Book Medical Publishers Inc, 1976, pp 121-133. 11. Kien CL, Rohrbaugh DK, Burke JF, et al: Whole body protein synthesis in relation to basal energy expenditure in healthy children and in children recovering from burn injury . Pediatr Res 1978;12:211-217.Crossref 12. Barbul A, Sisto DA, Wasserkrug HL, et al: Metabolic and immune effects of arginine in post-injury hyperalimentation . J Trauma 1981;21: 970-974.Crossref 13. Chyun J, Griminger P: Improvement of nitrogen retention by arginine and glycine supplementation and its relation to collagen synthesis in traumatized mature and aged rats . J Nutr 1984;114:1697-1704. 14. Minuskin ML, Lavine ME, Ulman EA, et al: Nitrogen retention, muscle creatinine and orotic acid excretion in traumatized rats fed arginine and glycine enriched diets . J Nutr 1981;111:1265-1274. 15. O'Dell BL, Regan WO: Effect of lysine and glycine upon arginine requirement of guinea pigs . Proc Soc Exp Biol Med 1963;112:336-337.Crossref 16. Barbul A, Wasserkrug HL, Penberthy LT, et al: Optimal levels of arginine in maintenance intravenous hyperalimentation . JPEN 1984;8: 281-284.Crossref 17. Kari FW, Ulman EA, Mulloy AL, et al: Arginine requirement of mature protein-malnourished rats for maximal rate of repletion . J Nutr 1981;111:1489-1493. 18. Barbul A, Sisto DA, Wasserkrug HL, et al: Arginine stimulates lymphocyte immune response in healthy human beings . Surgery 1981;90: 244-251. 19. Baker C, Miller CL, Trunkey DD: Predicting fatal sepsis in burned patients . J Trauma 1979;19:641-648.Crossref 20. Munster AW, Winchurch RA, Birmingham WJ, et al: Longitudinal assay of lymphocyte responsiveness in patients with major burns . Ann Surg 1980;192:772-775.Crossref 21. Barbul A, Rettura G, Levenson MS, et al: Wound healing and thymotropic effects of arginine: A pituitary mechanism of action . Am J Clin Nutr 1983;37:786-794. 22. Mulloy AL, Kari FW, Visek WJ: Dietary arginine, insulin secretion, glucose tolerance and liver lipids during repletion of protein-depleted rats . Horm Metab Res 1982;14:471-475.Crossref 23. Woolfson AMJ, Heatley RV, Allison SP: Insulin to inhibit protein catabolism after injury . N Engl J Med 1979;300:14-17.Crossref 24. Barbul A, Sisto DA, Wasserkrug HL, et al: Nitrogen-sparing and immune mechanisms of arginine: Differential dose-dependent responses during post-injury intravenous hyperalimentation . Curr Surg 1983;40: 114-116.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1987

References