Abstract
We investigated whether high-protein enteral nutrition with immune-modulating nutrients (IMHP) enriched with β-glucan stimulates immune function in critically ill patients. In a randomized double-blind placebo-controlled study, 30 patients consumed one of three types of enteral nutrition: a control or IMHP with and without β-glucan. The IMHP with β-glucan group showed increases in natural killer (NK) cell activities relative to the baseline, and greater increases were observed in NK cell activities relative to the control group after adjusting for age and gender. The IMHP groups with and without β-glucan had greater increases in serum prealbumin and decreases in high-sensitivity C-reactive protein (hs-CRP) than the control group. The control group had a greater decrease in peripheral blood mononuclear cell (PBMC) interleukin (IL)-12 production than the IMHP with and without β-glucan groups. In all patients, the change (Δ) in hs-CRP was correlated with Δ prealbumin and Δ PBMC IL-12, which were correlated with ΔNK cell activity and Δ prealbumin. This study showed beneficial effects of a combination treatment of β-glucan and IMHP on NK cell activity. Additionally, strong correlations among changes in NK cell activity, PBMC IL-12, and hs-CRP suggested that β-glucan could be an attractive candidate for stimulating protective immunity without enhanced inflammation (ClinicalTrials.gov: NCT02569203).
Highlights
IntroductionEnteral nutrition with immune-modulating nutrients, such as ω-3 fatty acids, selenium, and antioxidants, may modulate pathophysiological processes in critical illness, such as inflammatory and oxidative stress responses and impaired immune function [3,4]
Ill patients are at risk of nutritional deficiency; supportive nutrition is required for most intensive care unit (ICU) patients, with enteral nutrition preferred over parenteral nutrition [1,2]
The immunomodulatory effect of the Lentinula edodes mushroom has been conducted in previous studies and there are various biological active compounds in mushrooms. β-glucan, which is derived from mushrooms, is known
Summary
Enteral nutrition with immune-modulating nutrients, such as ω-3 fatty acids, selenium, and antioxidants, may modulate pathophysiological processes in critical illness, such as inflammatory and oxidative stress responses and impaired immune function [3,4]. The immunomodulatory effect of the Lentinula edodes (shiitake) mushroom has been conducted in previous studies and there are various biological active compounds in mushrooms. Nutrients 2016, 8, 336 as one of the biological active compounds in mushrooms [5,6,7,8]. Previous clinical studies conducted the immunomodulatory effects of β-glucan in patients with cancer, allergies, or respiratory tract infection [9,10,11]. Richter et al reported that short-term oral application of β-glucan significantly stimulated mucosal immunity of children with chronic respiratory problems in a series of clinical trials [12,13]. Richter et al reported that short-term oral application of β-glucan significantly stimulated mucosal immunity of children with chronic respiratory problems in a series of clinical trials [12,13]. β-glucan is thought to mediate its stimulatory effects through the activation of various immune system components, including macrophages, neutrophils, natural killer (NK) cells, and lymphocytes [14,15,16,17]
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