Yan Hong, Peng Xi, Wang Pei, Huang Yue-sheng, Wang Shi-liang
Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, the Third Military Medical University, Chongqing 400038, China.
Zhonghua Shao Shang Za Zhi. 2009 Oct;25(5):331-4.
To investigate the effects of L-arginine in different doses on the serum levels of helper T lymphocyte1 (Th1)/Th2 cytokines in severely burned patients.
Twenty-nine severely burned patients, with total burn surface area from 50% to 80%TBSA, hospitalized within 20 hours after burn, were randomly divided into control group (10 cases, fed with 5% glucose saline 500 mL), L-arginine 200 mg group (10 cases, fed with 5% glucose saline 500 mL + 200 mg/kg L-arginine), L-arginine 400 mg group (9 cases, fed with 5% glucose saline 500 mL + 400 mg/kg L-arginine). All patients received enteral feeding through nasointestinal tube, started within 22 hours after burn. Fasting venous blood of all patients was harvested on post burn day (PBD) 1 (before enteral feeding), 3, 5, and 7 to determine serum contents of TNF-alpha, IL-1beta, TGF-beta(1) and IL-4 by radio-immunity method and enzyme-linked immunosorbent assay.
Serum contents of TNF-alpha and IL-1beta of patients in all groups increased rapidly after burn, and although contents of TNF-alpha (318 +/- 57) ng/mL and IL-1beta (218 +/- 47) pg/mL of patients in L-arginine 200 mg group peaked on PBD 5, they were still significantly lower than those of patients in control group [(389 +/- 34) ng/mL, (272 +/- 40) pg/mL, P < 0.05], but they decreased on PBD 7. Serum contents of TNF-alpha and IL-1beta in L-arginine 400 mg group were close to those of control group (P > 0.05). Serum contents of TGF-beta(1) and IL-4 of patients in each group increased slowly after burn, and content of TGF-beta(1) (110 +/- 16) pg/mL of patients in L-arginine 200 mg group was significantly higher than that of patients in control group [(83 +/- 20) pg/mL, P < 0.05] on PBD 5. There was no statistical significant difference between L-arginine 400 mg group and control group in respect of serum content of TGF-beta(1) (P > 0.05).
Compared with the dosage of 400 mg/kg L-arginine, the 200 mg/kg dose is more effective in reducing the release of Th1 cytokines and increasing Th2 cytokines production, hence maintaining Th1/Th2 cytokine ratio to produce better immune opsonization during the infection phase of severe burn.
探讨不同剂量L-精氨酸对严重烧伤患者辅助性T淋巴细胞1（Th1）/Th2细胞因子血清水平的影响。
29例烧伤总面积为50%至80%TBSA的严重烧伤患者，于烧伤后20小时内入院，随机分为对照组（10例，给予5%葡萄糖盐水500 mL）、L-精氨酸200 mg组（10例，给予5%葡萄糖盐水500 mL + 200 mg/kg L-精氨酸）、L-精氨酸400 mg组（9例，给予5%葡萄糖盐水500 mL + 400 mg/kg L-精氨酸）。所有患者均于烧伤后22小时内开始经鼻肠管进行肠内营养。于烧伤后第1天（肠内营养前）、3、5、7天采集所有患者的空腹静脉血，采用放射免疫法和酶联免疫吸附测定法测定血清中TNF-α、IL-1β、TGF-β(1)和IL-4的含量。
各组患者烧伤后血清TNF-α和IL-1β含量迅速升高，L-精氨酸200 mg组患者的TNF-α（318±57）ng/mL和IL-1β（218±47）pg/mL含量虽在烧伤后第5天达到峰值，但仍显著低于对照组患者[（389±34）ng/mL，（272±40）pg/mL，P<0.05]，但在烧伤后第7天下降。L-精氨酸400 mg组患者的TNF-α和IL-1β血清含量与对照组接近（P>0.05）。各组患者烧伤后血清TGF-β(1)和IL-4含量缓慢升高，L-精氨酸200 mg组患者在烧伤后第5天的TGF-β(1)（110±16）pg/mL含量显著高于对照组患者[（83±20）pg/mL，P<0.05]。L-精氨酸400 mg组与对照组在TGF-β(1)血清含量方面无统计学差异（P>0.05）。
与400 mg/kg L-精氨酸剂量相比，200 mg/kg剂量在减少Th1细胞因子释放和增加Th2细胞因子产生方面更有效，从而在严重烧伤感染期维持Th1/Th2细胞因子比值以产生更好的免疫调理作用。
