Rc. Dewitt et al., Glutamine-enriched total parenteral nutrition preserves respiratory immunity and improves survival to a Pseudomonas pneumonia, J SURG RES, 84(1), 1999, pp. 13-18
Background Addition of 2% glutamine (GLN), a specific lymphocyte fuel, prev
ents deleterious effects of TPN on gut-associated lymphoid tissue and IgA w
hile preserving IgA-mediated upper respiratory immunity to influenza virus.
We examined whether a 2% GLN-enhanced TPN solution preserves respiratory i
mmunity to a lethal and clinically relevant pneumonia challenge.
Materials and methods. Male ICR mice were randomized to chow (n = 20), TPN
(n = 20), or an isonitrogenous, isocaloric TPN-2% GLN solution (n = 17). Al
l groups were immunized 10 days before surgery with Pseudomonas polysacchar
ide-containing liposomes (LIP) to confer immunity except for a nonimmune ch
ow-fed LIP control group (n = 21) which received LIP without Pseudomonas. M
ice received 5 days of diet and then were given an LD90 dose of 1.2 x 10(8)
intratracheal Pseudomonas bacteria, and mortality was recorded,
Results. Immunization reduced mortality compared with LIP alone. TPN impair
ed immunity and reduced survival while GLN maintained immunization effectiv
eness,
[GRAPHICS]
*P < 0.01 vs TPN. dagger P < 0.01 vs LIP.
Conclusions. Pseudomonas immunization reduces mortality to Pseudomonas pneu
monia, but this immunity is lost with TPN. Addition of 2% GLN to TPN preser
ves immunity in the respiratory tract and reduces mortality to a lethal bac
terial challenge compared with standard TPN. (C) 1999 Academic Press.