ARGININE, GLUTAMINE, AND DEHYDROEPIANDROSTERONE REVERSE THE IMMUNOSUPPRESSIVE EFFECT OF PREDNISONE DURING GUT-DERIVED SEPSIS

Objective: Corticosteroids are used broadly in clinical practice but m ay profoundly impair resistance to infections, In contrast, arginine a nd glutamine are safe and effective immunonutrients that can improve r esistance to infection in both animals and humans, This study assessed whether arginine and/or glutamine, with or without dehydroepiandroste rone, a natural endogenous steroid, could reverse the susceptibility t o infection caused by prednisone in a burned animal model, Design: Pro spective, randomized study, Setting: A laboratory approved by the Amer ican Association for the Accreditation of Laboratory Animal Care at th e Shriners Burns Institute, Cincinnati Unit,Subjects: Adult female Bal b/c mice, weighing 18 to 22 g. Interventions: Animals were prefed an a rginine- and/or glutamine- or a glycine-supplemented diet for 14 days, Dehydroepiandrosterone (25 mg/kg/day) and/or prednisone (10 mg/kg/day ) were given on days -4 to 0 before animals were given a gavage of 10( 9) (111)indium-oxine-radiolabeled or -unlabeled Escherichia coli and 2 0% total body surface area burn injury, Survival rate and the extent o f translocation of E. coil were determined, Measurements and Main Resu lts: Feeding with diets supplemented with arginine, glutamine, and arg inine plus glutamine and treatment with dehydroepiandrosterone reverse d the susceptibil ity to infections caused by prednisone and burn inju ry. The beneficial effects were mediated by enhanced killing of transl ocated bacteria and/or by an improved gut barrier function. Conclusion s: Dietary supplementation can reverse the susceptibility to infection s caused by prednisone, Both arginine and glutamine as well as dehydro epiandrosterone may be useful therapeutic agents for preventing infect ions in steroid-treated patients.