Injury Severity Score (ISS) > 12 Points Were Included in the Study. Clinical Trial
Glutamine is the most abundant nonessential amino acid in the human body. Besides its role
as a constituent of proteins and its importance in amino acid transamination, glutamine may
modulate immune cells.
The innate immune system is the first line of host defence against pathogens and in most
cases sufficient to eliminate invading microbes. Mammalian Toll-like receptors (TLR)
comprise a family of germ line-encoded trans-membrane receptors which activation leads to
the induction of inflammatory responses, phagocytosis but also to the development of antigen
specific adapative immunity.
It has been postulated though not formally proven yet that glutamine beneficial effect could
be due to a positive effect on the innate immune system. Given the importance of TLRs and
TLRs-dependent signalling in host defence against infections we hypothesized that glutamine
may increase the expression and/or functionality of TLRs which in turn may have beneficial
effects to clear infections.
Objective: To evaluate whether glutamine supplementation alters the expression and
functionality of TLR2 and TLR4 in circulating monocytes of trauma patients admitted to the
ICU. Specifically the next variables were measured:
- Expression of TLR2 and TLR4 in peripheral blood monocytes was determined by flow
cytometry
- To study the functionality of TLR2 and TLR4, monocytes were stimulated with TLR
specific agonists and cytokines were measured in cell culture supernatants. We
determined the concentration of IL-1β, IL-6, TNFα and IL-10 in cell culture
supernatants using a bead array ELISA.
- To determine the phagocytic capability of monocytes, live Escherichia coli expressing
green fluorescent protein was added to 100 μL of whole blood collected in
K2-anticoagulation medium tubes. Bacteria were added at a ratio of 100 bacteria per
monocyte. The analyses were carried out in an Epics XL flow cytometer.
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Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Masking: Single Blind (Outcomes Assessor)