Effect of L-arginine on immune function: a meta-analysis.

L-arginine plays an important role in immune regulation by affecting the immune response and inflammation. This meta-analysis was performed to assess whether L-arginine supplementation could improve the outcomes of immune function, and to evaluate the safety of L-arginine supplementation. Four databases (PubMed, EMBASE, Web of Science, the Cochrane Library) for all randomized controlled trials investigating the effects of supplementation with L-arginine published from 1966 to September 2013 were searched. The quality of controlled trials was assessed with the Jadad method. Meta-analyses were performed with fixed- or random-effects models according to heterogeneity of studies. Data from 11 trials involving 321 patients were enrolled. Meta-analysis showed that the L-arginine supplement group had a significantly greater CD4⁺ T-cell proliferation response (MD 5.03; 95% CI 1.11, 8.95; p<0.05), and that the incidence of infectious complications was lower (OR 0.40; 95% CI 0.17, 0.95; p<0.05) than control.

[Meta-analysis of branched chain amino acid-enriched nutrition to improve hepatic function in patients undergoing hepatic operation].

OBJECTIVE: To perform a meta-analysis of randomized controlled trials (RCTs) assessing the benefit of providing branched chain amino acid (BCAA)-enriched nutrition to improve hepatic function in patients undergoing hepatic operation. METHODS: The electronic databases of PubMed, Springerlink, the Chinese Biomedical Database (CBM), the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) were searched for relevant RCTs using the following search terms: nutritional support, enteral nutrition, parenteral nutrition, hepatic/liver surgery, liver cirrhosis, cancer, hepatectomy, and liver transplantation. The quality of the retrieved RCTs was assessed according to the scale developed by the Cochrane Collaboration. The meta-analysis was conducted using RevMan software, version 5.2. RESULTS: A total of 11 relevant RCTs, representing 510 patients, were included in the meta-analysis. Compared to patients in the control (normal nutrition) group, the patients in the BCAA group experienced an effective improvement in hepatic function, as evidenced by significant decreases in total bilirubin (by 0.07 mumol/L; 95% confidence interval (CI): -0.18 to 0.05, P more than 0.05]. In addition, the BCAA group showed improvements in plasma levels of albumin (weighted mean difference (WMD) = 0.07; 95% CI: 0.06, 0.24, P less than 0.05) and alanine aminotransferase (WMD = +5.61; 95% CI: -8.63 to 19.86, P more than 0.05] but neither of the changes reached the threshold of a statistically significant improvement. The BCAA group did however show significantly lower complication rate after operation (65%, 95% CI: 0.48, 0.87, P less than 0.01] and mean duration of hospital stay (4.61 days; 95% CI: -6.61, -2.61, P less than 0.01]. CONCLUSION: BCAA-enriched nutrition improves hepatic function in patients undergoing hepatic operation, thereby helping to reduce the complication risk, duration of hospital stay, and financial burden. BCAA-enriched nutrition is a safe and effective therapy and further clinical application may be beneficial.