Parenteral glutamine increases serum heat shock protein 70 in critically ill patients.

Published

Journal Article

OBJECTIVE: Heat shock protein 70 (HSP-70) is protective against cellular and tissue injury. Increased serum HSP-70 levels are associated with decreased mortality in trauma patients. Glutamine (Gln) administration increases serum and tissue HSP-70 expression in experimental models of sepsis. Gln has been safely administered to critically ill patients and can improve clinical outcomes, but the effect of Gln administration on HSP-70 expression in humans is unknown. We examined whether Gln-supplemented parenteral nutrition (PN) increases serum HSP-70 levels in critically ill patients. DESIGN AND SETTING: Randomized, controlled, double-blind study in surgical intensive care units (SICU) in a university hospital. PATIENTS: 29 patients admitted to the SICU and requiring PN for more than 7 days. INTERVENTIONS: Patients received either Gln-PN (containing alanyl-glutamine dipeptide; 0.5 g/kg per day; n=15) or standard Gln-free PN (control-PN) that was iso-nitrogenous to Gln-PN (n=14). Serum HSP-70 concentrations were measured at enrollment and at 7 days. Clinical outcome measures were also determined. RESULTS: HSP-70 concentrations were unchanged in control-PN subjects from baseline to day 7. In marked contrast, Gln-PN subjects demonstrated significantly higher (3.7-fold) serum HSP-70 concentrations than control subjects. In Gln-PN patients there was a significant correlation between increases in HSP-70 levels over baseline and decrease in ICU length of stay. CONCLUSIONS: Gln-PN significantly increases serum HSP-70 in critically ill patients. The magnitude of HSP-70 enhancement in Gln-treated patients was correlated with improved clinical outcomes. These data indicate the need for larger, randomized trials of the Gln effect on serum and tissue HSP-70 expression in critical illness and relationship to clinical outcomes.

Full Text

Duke Authors

Cited Authors

  • Ziegler, TR; Ogden, LG; Singleton, KD; Luo, M; Fernandez-Estivariz, C; Griffith, DP; Galloway, JR; Wischmeyer, PE

Published Date

  • August 2005

Published In

Volume / Issue

  • 31 / 8

Start / End Page

  • 1079 - 1086

PubMed ID

  • 15973519

Pubmed Central ID

  • 15973519

International Standard Serial Number (ISSN)

  • 0342-4642

Digital Object Identifier (DOI)

  • 10.1007/s00134-005-2690-5

Language

  • eng

Conference Location

  • United States