Alanyl‐Glutamine Enriched Total Parenteral Nutrition Improves Local, Systemic, and Remote Organ Responses to Intraperitoneal Bacterial Challenge

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Abstract
Background: Standard total parenteral nutrition (STD‐TPN) may diminish host defense against infection. Glutamine (Gln) is suggested to enhance host immunity. This study investigated the effects of antecedent alanyl‐glutamine enriched TPN (Ala‐Gln‐TPN) on host responses to intraperitoneal bacterial challenge compared with STD‐TPN. Methods: Rats were divided into STD‐TPN and Ala‐Gln‐TPN groups. They received isocaloric and isonitrogenous nutrition for 7 days and were challenged intraperitoneally with E. coli. Rats were killed before (0 hour) challenge and at 2 and 6 hours after challenge. Bacterial numbers in peritoneal lavage fluid (PLF), liver, spleen, and blood were determined. Tumor necrosis factor‐α (TNF), interleukin (IL)‐8, and interferon‐γ (IFN) in plasma and PLF were measured. Hepatic TNF, splenic TNF, and splenic IFN levels were determined. Results: The numbers of E. coli in systemic blood at 2 hours after intraperitoneal bacterial challenge were significantly lower in the Ala‐Gln‐TPN than in STD‐TPN group. E. coli numbers in blood significantly correlated with those in the liver. The Ala‐Gln‐TPN also resulted in significantly higher PLF and hepatic TNF levels, higher splenic IFN levels, and lower plasma IL‐8 levels at 6 hours after challenge compared with the STD‐TPN. Conclusions: Antecedent Ala‐Gln enriched TPN enhance local, systemic, and remote organ immune responses to intraperitoneal bacterial challenge. Ala‐Gln‐TPN may enhance host defense and be more beneficial than standard TPN in sepsis. (journal of Parenteral and Enteral Nutrition 25:346–351, 2001)