School of Science, Medway Campus, University of Greenwich, Central Ave, Gillingham, Chatham Maritime, Kent ME4 4TB, UK.
School of Health Sciences, Avery Hill Campus, University of Greenwich, Avery Hill Road, London SE9 2UG, UK.
Nutrients. 2021 Jul 22;13(8):2498. doi: 10.3390/nu13082498.
Under stress conditions, the metabolic demand for nutrients increases, which, if not met, may slow down or indeed stop the wound from healing, thus, becoming chronic wounds. This study aims to perform a systematic review and meta-analysis of the effect of arginine and glutamine supplementation on wound healing. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for the systematic review and ten electronic databases were used. Five and 39 human studies met the inclusion criteria for arginine and glutamine, respectively. The overall meta-analysis demonstrated a significant effect of arginine supplementation on hydroxyproline content (MD: 4.49, 95% CI: 3.54, 4.45, < 0.00001). Regarding glutamine supplementation, there was significant effect on nitrogen balance levels (MD: 0.39, 95% CI: 0.21, 0.58, < 0.0001), IL-6 levels (MD: -5.78, 95% CI: -8.71, -2.86, = 0.0001), TNFα levels (MD: -8.15, 95% CI: -9.34, -6.96, < 0.00001), lactulose/mannitol (L/M) ratio (MD: -0.01, 95% CI: -0.02, -0.01, < 0.00001), patient mortality (OR: 0.48, 95% CI: 0.32, 0.72, = 0.0004), C-reactive protein (CRP) levels (MD: -1.10, 95% CI: -1.26, -0.93, < 0.00001) and length of hospital stay (LOS) (MD: -2.65, 95% CI: -3.10, -2.21, < 0.00001). Regarding T-cell lymphocytes, a slight decrease was observed, although it failed to reach significance (MD: -0.16, 95% CI: -0.33, 0.01, = 0.07). Conclusion: The wound healing might be enhanced in one or at various stages by nutritional supplementation in the right dose.
在应激条件下，营养物质的代谢需求增加，如果得不到满足，可能会减缓甚至停止伤口愈合，从而导致慢性伤口。本研究旨在对精氨酸和谷氨酰胺补充剂对伤口愈合的影响进行系统评价和荟萃分析。本系统评价遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南，使用了 10 个电子数据库。分别有 5 项和 39 项人类研究符合纳入精氨酸和谷氨酰胺的标准。总体荟萃分析表明，精氨酸补充对羟脯氨酸含量有显著影响（MD：4.49，95%CI：3.54，4.45，<0.00001）。关于谷氨酰胺补充，对氮平衡水平（MD：0.39，95%CI：0.21，0.58，<0.0001）、IL-6 水平（MD：-5.78，95%CI：-8.71，-2.86，=0.0001）、TNFα 水平（MD：-8.15，95%CI：-9.34，-6.96，<0.00001）、乳果糖/甘露醇（L/M）比值（MD：-0.01，95%CI：-0.02，-0.01，<0.00001）、患者死亡率（OR：0.48，95%CI：0.32，0.72，=0.0004）、C 反应蛋白（CRP）水平（MD：-1.10，95%CI：-1.26，-0.93，<0.00001）和住院时间（LOS）（MD：-2.65，95%CI：-3.10，-2.21，<0.00001）有显著影响。关于 T 细胞淋巴细胞，虽然观察到略有下降，但未达到显著水平（MD：-0.16，95%CI：-0.33，0.01，=0.07）。结论：在适当剂量下，营养补充可能会在一个或多个阶段增强伤口愈合。
