Effect of parenteral glutamine in patients with gastrointestinal cancer undergoing surgery.

INTRODUCTION: Background and objective: malnutrition during cancer treatment is common in patients; therefore, nutritional intervention has an important role in cancer prognosis. Total parenteral nutrition is indicated for patients subjected to a major surgery with gastrointestinal complications. Nutritional support could be improved with glutamine (Gln). Therefore, in this work, the effect of parenteral glutamine in patients with gastrointestinal cancer undergoing surgery was studied. Material and methods: patients were classifi ed into two groups: non-supplemented and supplemented (Gln; 0.4 g/kg/day). Both groups received parenteral nutrition. One and seven days after surgery the nutritional status was evaluated. Hematic cytometry, protein metabolism and biochemical data were analyzed. A questionnaire was also applied to assess gastrointestinal function. Results: after the intervention, the nutritional status in both groups improved. However, the nutritional condition improved signifi cantly better (p = 0.008) in the supplemented group. According to the gastrointestinal function evaluation, the supplemented group changed from severe to mild dysfunction (p = 0.0001). The non-supplemented group progressed from moderate to severe dysfunction, but no changes in blood cell markers were observed. The supplemented group improved its concentration of lymphocytes (p = 0.014). The plasma albumin concentration did not change in groups, but prealbumin improved signifi cantly (p = 0.012) in the group that was supplemented with Gln. Conclusions: intravenous nutritional support supplemented with glutamine can improve gastrointestinal function, improving the absorption of nutrients, which leads to a better state of nutrition. It also has positive effects on plasma concentration of lymphocytes, monocytes and prealbumin.

INTRODUCCIÓN: Introducción y objetivo: los pacientes con cáncer desarrollan desnutrición durante el tratamiento antineoplásico, es por ello que el soporte nutricio tiene un rol importante. La nutrición parenteral es el soporte indicado para pacientes que fueron sometidos a cirugía con complicaciones gastrointestinales; este soporte puede ser suplementado con glutamina. Evaluamos el efecto de la glutamina parenteral en pacientes con cáncer gastrointestinal sometidos a cirugía. Material y métodos: se aleatorizaron los pacientes en dos grupos. Ambos grupos recibieron nutrición parenteral, en un grupo no suplementada y en otro grupo suplementada con glutamina (0,4 g/kg/día). Las medidas se tomaron el día uno y el día siete posteriores a la cirugía; en ambas mediciones se evaluó el estado nutricional, se tomó una muestra sanguínea para analizar parámetros bioquímicos y se aplicó un cuestionario de función gastrointestinal. Resultados: después de la intervención, el estado nutricional mejoró en ambos grupos, sin embargo, en el grupo suplementado mejoró significativamente (p = 0,008). De acuerdo a la función gastrointestinal, el grupo suplementado progresó de disfunción severa a leve (p = 0,0001), mientras que el grupo no suplementado progresó de disfunción moderada a severa. En cuanto a los parámetros bioquímicos, no hubo cambios en el grupo no suplementado. En ambos grupos no hubo cambios en las concentraciones plasmáticas de albúmina. En el grupo suplementado mejoraron de manera signifi cativa las concentraciones de linfocitos (p = 0,014) y prealbúmina (p = 0,012). Conclusión: el apoyo nutricio endovenoso suplementado con glutamina puede mejorar la función gastrointestinal, mejorando la absorción de nutrimentos, lo que conlleva a un mejor estado de nutrición. Asimismo, tiene efectos positivos en las concentraciones plasmáticas de linfocitos y monocitos y prealbúmina.

Expression of AdipoR1 and AdipoR2 Receptors as Leptin-Breast Cancer Regulation Mechanisms.

The development of breast cancer is influenced by the adipose tissue through the proteins leptin and adiponectin. However, there is little research concerning AdipoR1 and AdipoR2 receptors and the influence of leptin over them. The objective of this work was to analyze the expression of AdipoR1 and AdipoR2, modulated by differential concentrations of leptin in an obesity model (10 ng/mL, 100 ng/mL, and 1000 ng/mL) associated with breast cancer in MCF-7 and HCC1937 cell lines. Each cell line was characterized through immunohistochemistry, and the expression of AdipoR1 and AdipoR2 was analyzed by PCR in real time using TaqMan® probes. Leptin induced an increase in cell population of MCF-7 (23.8%, 10 ng/mL, 48 h) and HCC1937 (17.24%, 1000 ng/mL, 72 h). In MCF-7, the expression of AdipoR1 decreased (3.81%, 1000 ng/mL) and the expression of AdipoR2 increased by 13.74 times (10 ng/mL) with regard to the control. In HCC1937, the expression of AdipoR1 decreased by 86.28% (10 ng/mL), as well as the expression of AdipoR2 (50.3%, 100 ng/mL). In regard to the results obtained, it could be concluded that leptin has an effect over the expression of AdipoR1 and AdipoR2 mRNA.