L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty

PURPOSE: To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 g...

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Published in:Acta cirúrgica brasileira 2011, Vol.26 (suppl 1), p.72-76
Main Authors: Cunha Filho, José Ferreira da, Gonçalves, Isabelle Ivo, Guimarães, Sergio Botelho, Jamacaru, Francisco Vagnaldo Fechine, Garcia, José Huygens Parente, Vasconcelos, Paulo Roberto Leitão de
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creator Cunha Filho, José Ferreira da
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description PURPOSE: To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS: No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P
doi_str_mv 10.1590/S0102-86502011000700015
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METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS: No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P &lt;0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p &lt;0.01). CONCLUSION: Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control. OBJETIVO: Avaliar os efeitos do pré-tratamento com L-alanil-glutamina (L-Ala-Gln) sobre o estresse oxidativo, o controle glicêmico e a resposta inflamatória em crianças submetidas à palatoplastia. MÉTODOS: Trinta crianças do sexo masculino, agendadas para palatoplastia, faixa etária 2-10 anos, foram distribuídas aleatoriamente em dois grupos (n = 15): Grupo A (salina, controle) e Grupo B (L-Ala-Gln). O grupo A recebeu solução salina 0,9% 100 ml, administrado por via intravenosa utilizando uma bomba de infusão durante 3 horas anteriores ao procedimento cirúrgico. O grupo B foi tratado com L-Ala-Gln, solução a 20% (0,5 g/kg), acrescentando soro fisiológico até completar 100 ml. Amostras de sangue venoso periférico foram coletadas em cinco momentos diferentes: T1 (3 h antes do procedimento cirúrgico); T2 (no final da perfusão), T3 (no final do procedimento cirúrgico), no pós-operatório, após 6 h (T-4) e 12 h (T5). Os parâmetros analisados foram a glutationa (GSH), ácido tiobarbitúrico (TBARS), glicose, insulina, proteína C-reativa (PCR) e interleucina-6 (IL-6). RESULTADOS: Não houve diferença significante entre os grupos comparando as concentrações de glicose, insulina, TBARS, GSH e IL-6. No entanto, os níveis de glicose aumentaram em T4 e T5, comparado ao basal (T1) (P &lt;0,001) e a IL-6 aumentou em ambos os grupos durante o período pós-operatório, sinalizando o aumento da resposta inflamatória. O pré-tratamento com L-Ala-Gln não suprimiu o aumento de IL-6, mas reduziu o aumento pós-operatório de PCR (T5, p&lt;0,01). CONCLUSÃO: O pré-tratamento com L-Ala-Gln em crianças submetidas à palatoplastia atenua a resposta inflamatória no período pós-operatório imediato, promovendo um melhor controle glicêmico.</description><identifier>ISSN: 0102-8650</identifier><identifier>EISSN: 0102-8650</identifier><identifier>DOI: 10.1590/S0102-86502011000700015</identifier><language>eng</language><ispartof>Acta cirúrgica brasileira, 2011, Vol.26 (suppl 1), p.72-76</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2605-5e7c507097ced143987d55d2893bd643da4d5589138dd39f2fd7e04a283bc38b3</citedby><cites>FETCH-LOGICAL-c2605-5e7c507097ced143987d55d2893bd643da4d5589138dd39f2fd7e04a283bc38b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids></links><search><creatorcontrib>Cunha Filho, José Ferreira da</creatorcontrib><creatorcontrib>Gonçalves, Isabelle Ivo</creatorcontrib><creatorcontrib>Guimarães, Sergio Botelho</creatorcontrib><creatorcontrib>Jamacaru, Francisco Vagnaldo Fechine</creatorcontrib><creatorcontrib>Garcia, José Huygens Parente</creatorcontrib><creatorcontrib>Vasconcelos, Paulo Roberto Leitão de</creatorcontrib><title>L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty</title><title>Acta cirúrgica brasileira</title><description>PURPOSE: To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS: No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P &lt;0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p &lt;0.01). CONCLUSION: Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control. OBJETIVO: Avaliar os efeitos do pré-tratamento com L-alanil-glutamina (L-Ala-Gln) sobre o estresse oxidativo, o controle glicêmico e a resposta inflamatória em crianças submetidas à palatoplastia. MÉTODOS: Trinta crianças do sexo masculino, agendadas para palatoplastia, faixa etária 2-10 anos, foram distribuídas aleatoriamente em dois grupos (n = 15): Grupo A (salina, controle) e Grupo B (L-Ala-Gln). O grupo A recebeu solução salina 0,9% 100 ml, administrado por via intravenosa utilizando uma bomba de infusão durante 3 horas anteriores ao procedimento cirúrgico. O grupo B foi tratado com L-Ala-Gln, solução a 20% (0,5 g/kg), acrescentando soro fisiológico até completar 100 ml. Amostras de sangue venoso periférico foram coletadas em cinco momentos diferentes: T1 (3 h antes do procedimento cirúrgico); T2 (no final da perfusão), T3 (no final do procedimento cirúrgico), no pós-operatório, após 6 h (T-4) e 12 h (T5). Os parâmetros analisados foram a glutationa (GSH), ácido tiobarbitúrico (TBARS), glicose, insulina, proteína C-reativa (PCR) e interleucina-6 (IL-6). RESULTADOS: Não houve diferença significante entre os grupos comparando as concentrações de glicose, insulina, TBARS, GSH e IL-6. No entanto, os níveis de glicose aumentaram em T4 e T5, comparado ao basal (T1) (P &lt;0,001) e a IL-6 aumentou em ambos os grupos durante o período pós-operatório, sinalizando o aumento da resposta inflamatória. O pré-tratamento com L-Ala-Gln não suprimiu o aumento de IL-6, mas reduziu o aumento pós-operatório de PCR (T5, p&lt;0,01). CONCLUSÃO: O pré-tratamento com L-Ala-Gln em crianças submetidas à palatoplastia atenua a resposta inflamatória no período pós-operatório imediato, promovendo um melhor controle glicêmico.</description><issn>0102-8650</issn><issn>0102-8650</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNplkMtKxTAQhoMoeDz6DOYFqrk0bbqUgzc44EJdl2ky1UqaliRd9O3NURHBxTDX_4f5CLnk7Iqrhl0_M85EoSvFBOOcMVbn4OqIbH4Xx3_qU3IW40e-KCsuN8TtC3DgV1e8uSXBOHikc8AUENKIPlFICf0CCSMFsySkg-8djCOkKaw0YJwnHw9Tat4HZwN6GpduHLLM0jTROdunaXYQ03pOTnpwES9-8pa83t2-7B6K_dP94-5mXxhRMVUorI3KbzS1QctL2ejaKmWFbmRnq1JaKHOvGy61tbLpRW9rZCUILTsjdSe3pP72NWGKMWDfzmEYIawtZ-0BWvsFrf0HTX4CyFxiOQ</recordid><startdate>2011</startdate><enddate>2011</enddate><creator>Cunha Filho, José Ferreira da</creator><creator>Gonçalves, Isabelle Ivo</creator><creator>Guimarães, Sergio Botelho</creator><creator>Jamacaru, Francisco Vagnaldo Fechine</creator><creator>Garcia, José Huygens Parente</creator><creator>Vasconcelos, Paulo Roberto Leitão de</creator><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>2011</creationdate><title>L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty</title><author>Cunha Filho, José Ferreira da ; Gonçalves, Isabelle Ivo ; Guimarães, Sergio Botelho ; Jamacaru, Francisco Vagnaldo Fechine ; Garcia, José Huygens Parente ; Vasconcelos, Paulo Roberto Leitão de</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2605-5e7c507097ced143987d55d2893bd643da4d5589138dd39f2fd7e04a283bc38b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cunha Filho, José Ferreira da</creatorcontrib><creatorcontrib>Gonçalves, Isabelle Ivo</creatorcontrib><creatorcontrib>Guimarães, Sergio Botelho</creatorcontrib><creatorcontrib>Jamacaru, Francisco Vagnaldo Fechine</creatorcontrib><creatorcontrib>Garcia, José Huygens Parente</creatorcontrib><creatorcontrib>Vasconcelos, Paulo Roberto Leitão de</creatorcontrib><collection>CrossRef</collection><jtitle>Acta cirúrgica brasileira</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cunha Filho, José Ferreira da</au><au>Gonçalves, Isabelle Ivo</au><au>Guimarães, Sergio Botelho</au><au>Jamacaru, Francisco Vagnaldo Fechine</au><au>Garcia, José Huygens Parente</au><au>Vasconcelos, Paulo Roberto Leitão de</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty</atitle><jtitle>Acta cirúrgica brasileira</jtitle><date>2011</date><risdate>2011</risdate><volume>26</volume><issue>suppl 1</issue><spage>72</spage><epage>76</epage><pages>72-76</pages><issn>0102-8650</issn><eissn>0102-8650</eissn><abstract>PURPOSE: To evaluate the effects of L-alanyl-glutamine (L-Ala-Gln) pretreatment on oxidative stress, glycemic control and inflammatory response in children submitted to palatoplasty. METHODS: Thirty male children scheduled for routine palatoplasty, age range 2-10 years, were randomly assigned to 2 groups (n=15): Group A (saline, control) and Group B (L-Ala-Gln). Group A received normal saline 100 ml, delivered intravenously by infusion pump over 3 hours preceding surgical procedure. Group B was treated with L-Ala-Gln, 20% solution (0.5g/Kg), adding saline to complete 100ml. Peripheral venous blood samples were collected at 5 different time-points: T1- at the beginning of the study, 3 h prior to the surgical procedure; T2- at the end of the infusion (before the surgical procedure), T3- at the end of the surgical procedure, T4- 6 h postoperative and T5- 12 h postoperative. Parameters analyzed included glutathione (GSH), thiobarbituric acid reactive substances (TBARS), glucose, insulin, C-reactive protein (CRP) and interleukin-6 (IL-6). RESULTS: No statistically significant differences were found between groups comparing glucose, insulin, TBARS, GSH and IL-6 levels. However, glucose levels increased (P &lt;0.001) in T4 and T5 as compared to baseline (T1) in control group as opposed to L-Ala-Gln group. IL-6 increased in both groups during the postoperative period, indicating an increased inflammatory response. L-Ala-Gln pretreatment did not suppress the increase of IL-6, but reduced the increase of postoperative CRP levels (T5, p &lt;0.01). CONCLUSION: Pretreatment with L-Ala-Gln in children submitted to palatoplasty attenuates the inflammatory response in early post-operative period and promoted a better glycemic control. OBJETIVO: Avaliar os efeitos do pré-tratamento com L-alanil-glutamina (L-Ala-Gln) sobre o estresse oxidativo, o controle glicêmico e a resposta inflamatória em crianças submetidas à palatoplastia. MÉTODOS: Trinta crianças do sexo masculino, agendadas para palatoplastia, faixa etária 2-10 anos, foram distribuídas aleatoriamente em dois grupos (n = 15): Grupo A (salina, controle) e Grupo B (L-Ala-Gln). O grupo A recebeu solução salina 0,9% 100 ml, administrado por via intravenosa utilizando uma bomba de infusão durante 3 horas anteriores ao procedimento cirúrgico. O grupo B foi tratado com L-Ala-Gln, solução a 20% (0,5 g/kg), acrescentando soro fisiológico até completar 100 ml. Amostras de sangue venoso periférico foram coletadas em cinco momentos diferentes: T1 (3 h antes do procedimento cirúrgico); T2 (no final da perfusão), T3 (no final do procedimento cirúrgico), no pós-operatório, após 6 h (T-4) e 12 h (T5). Os parâmetros analisados foram a glutationa (GSH), ácido tiobarbitúrico (TBARS), glicose, insulina, proteína C-reativa (PCR) e interleucina-6 (IL-6). RESULTADOS: Não houve diferença significante entre os grupos comparando as concentrações de glicose, insulina, TBARS, GSH e IL-6. No entanto, os níveis de glicose aumentaram em T4 e T5, comparado ao basal (T1) (P &lt;0,001) e a IL-6 aumentou em ambos os grupos durante o período pós-operatório, sinalizando o aumento da resposta inflamatória. O pré-tratamento com L-Ala-Gln não suprimiu o aumento de IL-6, mas reduziu o aumento pós-operatório de PCR (T5, p&lt;0,01). CONCLUSÃO: O pré-tratamento com L-Ala-Gln em crianças submetidas à palatoplastia atenua a resposta inflamatória no período pós-operatório imediato, promovendo um melhor controle glicêmico.</abstract><doi>10.1590/S0102-86502011000700015</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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title L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty
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