Intensive Care Medicine

, Volume 31, Issue 8, pp 1079–1086 | Cite as

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

  • Thomas R. Ziegler
  • Lorraine G. Ogden
  • Kristen D. Singleton
  • Menghua Luo
  • Concepcion Fernandez-Estivariz
  • Daniel P. Griffith
  • John R. Galloway
  • Paul E. Wischmeyer
Original

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 proteins Critical Illness Glutamine Parenteral nutrition Outcome 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Thomas R. Ziegler
    • 1
    • 2
  • Lorraine G. Ogden
    • 3
  • Kristen D. Singleton
    • 4
  • Menghua Luo
    • 1
    • 2
  • Concepcion Fernandez-Estivariz
    • 1
    • 2
  • Daniel P. Griffith
    • 2
  • John R. Galloway
    • 2
    • 5
  • Paul E. Wischmeyer
    • 4
  1. 1.Department of Medicine/Center for Clinical and Molecular Nutrition, School of MedicineEmory UniversityAtlantaUSA
  2. 2.Nutrition and Metabolic Support ServiceEmory University HospitalAtlantaUSA
  3. 3.Department of Preventive Medicine and Biometrics, Health Sciences CenterUniversity of ColoradoDenverUSA
  4. 4.Department of Anesthesiology, Health Sciences CenterUniversity of ColoradoDenverUSA
  5. 5.Department of Surgery, School of MedicineEmory UniversityAtlantaUSA

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