Efecto de una fórmula enteral enriquecida en arginina sobre los marcadores inflamatorios en pacientes con tumores de cabeza y cuello

Abstract

Background and objective Although immune dysfunction in cancer patients could be multifactorial, the immune system may be modulated by specific nutritional substrates, such as arginine. The aim of our study was to evaluate the effect of enteral nutrition supplemented with a high dose of arginine on c-reactive protein (CRP), interleukin 6 (IL6) and tumoral necrosis factor (TNF α) in surgical head and neck cancer patients. Subjects and methods At surgery, patients were randomly allocated to two groups: (a) enteral diet supplements with arginine (group I, n=18); (b) isocaloric, isonitrogenous enteral formula (group II, n=23). Perioperatively and on the postoperative day 6 the following parameters were evaluated: serum values of prealbumin, transferrin, lymphocytes, IL6, TNF α and CRP. Results The mean age (standard deviation) was 60.9 (10.6) years. Prealbumin and transferrin improved in both groups, CRP decreased in both groups, (group I: 105.1 (62.8) mg/dl vs 53.2 (51) mg/dl: p<0.05 and group II: 103.3 (62) mg/dl vs 61.9 (57.4) mg/dl: p<0.05). IL6 improved in both groups (group I: 38.35 (14.2) pg/ml vs 15.6 (9.1) pg/ml: p<0.05 and group II: 32.8 (35) pg/ml vs 6.8 (4.9) pg/ml: p<0.05) TNFα and lymphocytes did not change. Conclusions Both formulas improved IL6 and CRP levels. A high dose of enteral arginine in these patients did not add biochemical advantages as compared to a standard enteral formula.