Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
1.
Curr Opin Clin Nutr Metab Care ; 26(5): 455-462, 2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37389472

RESUMO

PURPOSE OF REVIEW: This review aims to highlight the benefits of nutrition before and during graft-versus-host disease (GvHD) and the promising precision medicine approach that should be offered to prevent and mitigate GvHD. RECENT FINDINGS: The intestinal damage induced by preconditioning/conditioning chemotherapies is the main trigger of GvHD. Impaired nutritional status and decreased plasma citrulline level, which is the most sensitive biomarker of intestinal barrier health, predict the occurrence of acute GvHD after allogeneic hematopoietic cell transplantation (allo-HCT). Optimal oral and/or enteral nutrition and a lack of vitamin D deficiency limit this intestinal damage. As intestinal dysbiosis plays an important role in GvHD, probiotics and prebiotics supplementation could be a promising therapy. Diverting enterostomy combined with parenteral nutrition saves the lives of patients with severe steroid-refractory gastrointestinal GvHD. SUMMARY: Regardless of age, healthy nutritional status and a healthy gut barrier are protective factors against GvHD in patients undergoing allo-HCT, and above all, these are closely dependent on adequate oral and/or enteral intake. Therefore, maintaining gut barrier integrity through adequate oral nutrition before allo-SCT and early first-line enteral nutrition after allo-HCT are of critical importance, not forgetting vitamin D supplementation. In the future, probiotics and prebiotics are expected to play a growing role for replenishing the commensal microbiota given the impact of gut dysbiosis on GvHD. Parenteral nutrition remains the only nutritional support that can be used in the event of severe gastrointestinal GvHD.


Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Microbiota , Humanos , Prebióticos , Disbiose/terapia , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/prevenção & controle , Doença Enxerto-Hospedeiro/epidemiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos
2.
Bull Cancer ; 103(11S): S201-S206, 2016 Nov.
Artigo em Francês | MEDLINE | ID: mdl-27788917

RESUMO

Allogeneic haematopoietic stem-cell transplantation is usually applied with success for patients with diseases involving bone marrow and associated with frequent and severe malnutrition. Denutrition is an independent survival factor and contribute to transplant-related mortality. Due to the heaviness of the treatment, this event is frequent. Before allogeneic transplantation, the nutritional statute should be evaluated. The adult or pediatric patient's evaluation modalities and nutritional needs are detailed in this paper. The administration modalities (enteral or parenteral) with doses are specifically precise. We also explain why the enteral nutritional support may remain the best option comparing to parenteral option.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Desnutrição/terapia , Avaliação Nutricional , Apoio Nutricional/normas , Adulto , Fatores Etários , Criança , Nutrição Enteral/normas , França , Hospitalização , Humanos , Desnutrição/diagnóstico , Apoio Nutricional/métodos , Nutrição Parenteral/normas , Retratamento , Sociedades Médicas , Condicionamento Pré-Transplante , Transplante Homólogo
3.
Am J Clin Nutr ; 100(3): 850-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25080462

RESUMO

BACKGROUND: Benefits of recombinant human growth hormone (rhGH) alone or combined with glutamine in patients with intestinal failure because of short-bowel syndrome remain controversial. OBJECTIVE: We explored effects of rhGH on whole-body protein metabolism in patients with short-bowel syndrome with intestinal failure (SBS-IF) to gain insight into its mechanism of action. DESIGN: Eight stable hyperphagic patients with severe SBS-IF received, in a double-blind, randomized crossover study, low-dose rhGH (0.05 mg · kg⁻¹ · d⁻¹) and a placebo for two 3-wk periods. Leucine and glutamine kinetics under fasting and fed conditions, fat-free mass (FFM), and serum insulin were determined on the final day of each treatment. RESULTS: rhGH increased FFM and nonoxidative leucine disposal (NOLD; an index of protein synthesis) (P < 0.02), whereas FFM and NOLD were correlated in the fed state (r = 0.81, P = 0.015). With rhGH administration, leucine release from protein breakdown (an index of proteolysis) decreased in the fed compared with fasting states (P = 0.012), which was not observed with the placebo. However, the fast-to-fed difference in leucine release from protein breakdown was not significantly different between rhGH and placebo (P = 0.093). With rhGH, the intestinal absorption of leucine and glutamine increased (P = 0.036) and correlated with serum insulin (r = 0.91, P = 0.002). rhGH increased glutamine de novo synthesis (P < 0.02) and plasma concentrations (P < 0.03) in both fasting and fed states. CONCLUSIONS: In SBS-IF patients, feeding fails to decrease proteolysis in contrast to what is physiologically observed in healthy subjects. rhGH enhances FFM through the stimulation of protein synthesis and might decrease proteolysis in response to feeding. Improvements in de novo synthesis and intestinal absorption increase glutamine availability over the physiologic range, suggesting that beneficial effects of rhGH in hyperphagic patients might be achieved without glutamine supplementation.


Assuntos
Fármacos Gastrointestinais/uso terapêutico , Glutamina/biossíntese , Hormônio do Crescimento Humano/uso terapêutico , Absorção Intestinal/efeitos dos fármacos , Mucosa Intestinal/efeitos dos fármacos , Intestino Delgado/efeitos dos fármacos , Síndrome do Intestino Curto/tratamento farmacológico , Adulto , Composição Corporal/efeitos dos fármacos , Estudos de Coortes , Terapia Combinada , Estudos Cross-Over , Método Duplo-Cego , Feminino , Glutamina/sangue , Glutamina/metabolismo , Hormônio do Crescimento Humano/genética , Humanos , Hiperfagia/etiologia , Resistência à Insulina , Mucosa Intestinal/metabolismo , Mucosa Intestinal/fisiopatologia , Intestino Delgado/metabolismo , Intestino Delgado/fisiopatologia , Masculino , Pessoa de Meia-Idade , Nutrição Parenteral no Domicílio , Período Pós-Prandial , Biossíntese de Proteínas/efeitos dos fármacos , Proteólise/efeitos dos fármacos , Proteínas Recombinantes/uso terapêutico , Índice de Gravidade de Doença , Síndrome do Intestino Curto/metabolismo , Síndrome do Intestino Curto/fisiopatologia , Síndrome do Intestino Curto/terapia , Aumento de Peso/efeitos dos fármacos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA