Special feeds for the immunocompromised: feeding the critically ill
Keywords: Glutamine, Arginine, Nucleotides, Polyunsaturated fatty acids
AbstractImmunonutrients, such as omega-3 fatty acids, glutamine, sulphur-containing amino acids, antioxidants, arginine and nucleotides, affect the immune system. Mixtures of these nutrients reduce length of hospital stay and infection severity, improve gastrointestinal trophism, and reduce postoperative infections, wound complications, days on the ventilator, and treatment costs. This article summarises immunonutrition, and the roles these compounds play in the immune system. Nutrients with anti-inflammatory effects may enhance T lymphocyte function, as they act at various cellular areas, affect cytokine production, and change the response of target tissues to cytokines. Fatty acids change membrane phospholipid fatty acid composition, and antioxidants change cytokine production, by modulating the extent of activation of transcription factors by oxidant molecules. However, information on this topic is controversial, and more research is required to determine the exact mechanisms of these nutrients on the immune system.
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