Intensive Care Medicine

, Volume 31, Issue 8, pp 1079–1086

Parenteral glutamine increases serum heat shock protein 70 in critically ill patients

Authors

  • Thomas R. Ziegler
    • Department of Medicine/Center for Clinical and Molecular Nutrition, School of MedicineEmory University
    • Nutrition and Metabolic Support ServiceEmory University Hospital
  • Lorraine G. Ogden
    • Department of Preventive Medicine and Biometrics, Health Sciences CenterUniversity of Colorado
  • Kristen D. Singleton
    • Department of Anesthesiology, Health Sciences CenterUniversity of Colorado
  • Menghua Luo
    • Department of Medicine/Center for Clinical and Molecular Nutrition, School of MedicineEmory University
    • Nutrition and Metabolic Support ServiceEmory University Hospital
  • Concepcion Fernandez-Estivariz
    • Department of Medicine/Center for Clinical and Molecular Nutrition, School of MedicineEmory University
    • Nutrition and Metabolic Support ServiceEmory University Hospital
  • Daniel P. Griffith
    • Nutrition and Metabolic Support ServiceEmory University Hospital
  • John R. Galloway
    • Nutrition and Metabolic Support ServiceEmory University Hospital
    • Department of Surgery, School of MedicineEmory University
    • Department of Anesthesiology, Health Sciences CenterUniversity of Colorado
Original

DOI: 10.1007/s00134-005-2690-5

Cite this article as:
Ziegler, T.R., Ogden, L.G., Singleton, K.D. et al. Intensive Care Med (2005) 31: 1079. doi:10.1007/s00134-005-2690-5

Abstract

Objective

Heat shock protein 70 (HSP-70) is protective against cellular and tissue injury. Increased serum HSP-70 levels are associated with decreased mortality in trauma patients. Glutamine (Gln) administration increases serum and tissue HSP-70 expression in experimental models of sepsis. Gln has been safely administered to critically ill patients and can improve clinical outcomes, but the effect of Gln administration on HSP-70 expression in humans is unknown. We examined whether Gln-supplemented parenteral nutrition (PN) increases serum HSP-70 levels in critically ill patients.

Design and setting

Randomized, controlled, double-blind study in surgical intensive care units (SICU) in a university hospital.

Patients

29 patients admitted to the SICU and requiring PN for more than 7 days.

Interventions

Patients received either Gln-PN (containing alanyl-glutamine dipeptide; 0.5 g/kg per day; n=15) or standard Gln-free PN (control-PN) that was iso-nitrogenous to Gln-PN (n=14). Serum HSP-70 concentrations were measured at enrollment and at 7 days. Clinical outcome measures were also determined.

Results

HSP-70 concentrations were unchanged in control-PN subjects from baseline to day 7. In marked contrast, Gln-PN subjects demonstrated significantly higher (3.7-fold) serum HSP-70 concentrations than control subjects. In Gln-PN patients there was a significant correlation between increases in HSP-70 levels over baseline and decrease in ICU length of stay.

Conclusions

Gln-PN significantly increases serum HSP-70 in critically ill patients. The magnitude of HSP-70 enhancement in Gln-treated patients was correlated with improved clinical outcomes. These data indicate the need for larger, randomized trials of the Gln effect on serum and tissue HSP-70 expression in critical illness and relationship to clinical outcomes.

Keywords

Heat shock proteinsCritical IllnessGlutamineParenteral nutritionOutcome

Copyright information

© Springer-Verlag 2005