Effects of Standard and/or Glutamine Dipeptide and/or Omega-3 Fatty Ascid-Supplemented Parenteral Nutrition on Neutrophil Functions, Interleukin-8 Level and Length of Stay-A Double Blind,Controlled, Randomised Study

Abstract

Background and Aims: Protein calorie malnutrition for cancer patients is  related with altered cellular and humoral immunity. Standard TPN and glutamine and lipid emulsion with omega 3 fatty acids were given to  colorectal cancer patients and the effects of these to neutrophil functions and IL-8 levels are compared.

Methods: Consecutive 36 patients with colorectal cancer diagnosed with endoscopic biopsy and with malnutrition determined by subjective global assessment were enrolled to study. The patients are randomly divided into four groups. Standard TPN to control group, TPN with glutamine solution to S-D group, TPN with omega 3 fatty acid solution to S-O group and TPN with omega 3 fatty acids solution and glutamine to S-D-O group were given for seven days after the operation. At the preoperative, postoperative first day and 7th day, neutrophil phagocytosis index, neutrophil adhesivity index and IL-8 levels were determined.

Results: In all groups compared to control group neutrophil phagocytosis index were increased significantly (p<0.05). The most increasing was in group 3. There wasn’t significant difference between groups about  postoperative first day neutrophil adhesiveness index (p>0.05). At the 7th day the neutrophil adhesivity index for study groups were increased  compared with control group, but there was no significant differences  between groups. There was no significant difference between groups for
IL-8 levels.

Conclusions: As a result of the study, altered cellular immunity in colorectal cancer patients with malnutrition can be corrected with omega 3 fatty acid emulsions and glutamine added to TPN so the ratio of morbidity and  mortality can be decreased