Effects of long-term continuous use of immune-enhancing enteral formula on nutritional and immunologic status in non-surgical patients

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2006-07, Vol.22 (7), p.713-721
• Main Authors: Sakurai, Yoichi, Oh-oka, Yuriko, Kato, Shiho, Suzuki, Sadamu, Hayakawa, Mariko, Masui, Toshihiko, Yoshida, Ikuo, Tonomura, Shuhei, Mitsutaka, Shoji, Nakamura, Yasuko, Uyama, Ichiro, Komori, Yoshiyuki, Ochiai, Masahiro
• Format: Article
• Language: English
• Subjects: 8,11,14-Eicosatrienoic Acid - blood; Access routes; amino acid metabolism; arginine; Arginine - blood; B-Lymphocytes; Biological and medical sciences; blood lipids; blood serum; Blood Urea Nitrogen; CD4-CD8 Ratio; CD4-positive T-lymphocytes; Clinical trials; cytotoxic T-lymphocytes; Diet; docosahexaenoic acid; Docosahexaenoic Acids - blood; eicosapentaenoic acid; Eicosapentaenoic Acid - blood; Enteral nutrition; Enteral Nutrition - adverse effects; Enteral Nutrition - methods; Feeding. Feeding behavior; Food, Formulated; free amino acids; Fundamental and applied biological sciences. Psychology; Gastrostomy; Humans; immune response; Immunity; Immunologic variables; Immunonutrition; immunostimulants; insulin-like growth factor I; Insulin-Like Growth Factor I - analysis; Interleukin-10 - blood; Killer Cells, Natural - immunology; long term effects; Long-term enteral feeding; Lymphocyte Count; Lymphocytes; Nutrition; nutritional intervention; Nutritional Status; ornithine; Ornithine - blood; patients; Prospective Studies; Protein metabolism; Proteins; surgery; T-Lymphocytes; Total enteral nutrition; tube feeding; Urea; Uric Acid - blood; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2006.03.014

Although the perioperative use of immune-enhancing enteral formula (IEEF) effectively reduces the rate of infectious complications, whether chronic use of IEEF is beneficial is unknown. A prospective randomized clinical trial was performed to examine the safety and effectiveness of long-term IEEF on nutritional and immunologic status in non-surgical patients receiving total enteral nutrition through the gastrostomy access route. A total of 30 patients were randomly assigned to two groups in which they received total enteral nutrition, an IEEF (n = 15) or a regular polymeric enteral formula (control group; n = 15) for 12 wk. Nutritional and immunologic variables were periodically examined. Serum concentrations of insulin-like growth factor-I increased significantly for the IEEF group throughout the study. Although serum concentrations of dihomo-γ-linoleic acid decreased significantly in the IEEF group, serum concentrations of eicosapentaenoic acid and docosahexaenoic acid increased significantly, as did concentrations of serum arginine and ornithine. The CD4/CD8 ratio and natural killer cell activity also increased for the IEEF group, but the differences were not significant. The B-cell fraction increased and the T-cell fraction of peripheral lymphocytes decreased for the IEEF group. Neither infectious nor non-infectious complications occurred during the study period in either group, except for a significant increase in serum urea nitrogen and uric acid concentrations for the IEEF group. Long-term use of IEEF is safe in non-surgical patients and results in a significant increase in serum insulin-like growth factor-I concentrations in association with increased humoral immunity.