R. Gennari et Jw. Alexander, ARGININE, GLUTAMINE, AND DEHYDROEPIANDROSTERONE REVERSE THE IMMUNOSUPPRESSIVE EFFECT OF PREDNISONE DURING GUT-DERIVED SEPSIS, Critical care medicine, 25(7), 1997, pp. 1207-1214
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.