Smith Tracey J, Wilson Marques, Whitney Claire, Fagnant Heather, Neumeier William H, Smith Carl, Heaton Kristin J, Cho Eunhan, Spielmann Guillaume, Walsh Neil P, Karl J Philip
Military Nutrition Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA.
Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick, MA, USA.
J Nutr. 2022 Jun 9;152(6):1560-1573. doi: 10.1093/jn/nxac064.
Physiologic and psychologic stress slow healing from experimental wounds by impairing immune function.
We aimed to determine whether supplemental protein and multinutrient supplementation improved wound healing markers after acute stress induced by acute sleep restriction.
In this single-blind, crossover study in generally healthy young adults (18 males/2 females; mean ± SD age: 19.7 ± 2.30 y), experimental wounds were created by removing the top layer of forearm blisters induced via suction after 48 h of 72-h sleep restriction (2-h nightly sleep), a protocol previously shown to delay wound healing. Skin barrier restoration (measured by transepidermal water loss) assessed wound healing ≤10 d postblistering, and local immune responses were evaluated by serial measurement of cytokine concentrations in fluid collected at wound sites for 48 h postblistering. Participants consumed controlled, isocaloric diets with either 0.900 g · kg-1 · d-1 protein plus placebo (PLA) or 1.50 g · kg-1 · d-1 protein plus multinutrient beverage [l-arginine: 20.0 g/d; l-glutamine: 30.0 g/d; omega-3 (n-3) fatty acids: 1.00 g/d; zinc sulfate: 24.0 mg/d; cholecalciferol: 800 IU/d; and vitamin C: 400 mg/d] (NUT) during sleep restriction and for 4 d afterwards.
Skin barrier restoration (primary outcome) was shorter for NUT (median: 3.98 d; IQR: 1.17 d) than for PLA (median: 5.25 d; IQR: 1.05 d) (P = 0.001). Cytokines from wound fluid (secondary outcome) increased over time (main effect of time P ≤ 0.001), except IL-13 (P = 0.07); however, no effects of treatment were observed.
Supplemental nutrition may promote wound healing after sleep restriction in healthy adults including military personnel, the latter of which also have a high incidence of wounds and infection.This trial was registered at clinicaltrials.gov as NCT03525184.
生理和心理压力会通过损害免疫功能延缓实验性伤口的愈合。
我们旨在确定补充蛋白质和多种营养素是否能改善急性睡眠限制诱导的急性应激后的伤口愈合指标。
在这项针对一般健康的年轻成年人(18名男性/2名女性;平均±标准差年龄:19.7±2.30岁)的单盲交叉研究中,通过在72小时睡眠限制(每晚睡眠2小时)48小时后去除前臂水疱的顶层来制造实验性伤口,此前的一项方案已证明该方案会延迟伤口愈合。皮肤屏障恢复(通过经表皮水分流失测量)在水疱形成后≤10天评估伤口愈合情况,局部免疫反应通过在水疱形成后48小时连续测量伤口部位收集的液体中的细胞因子浓度来评估。参与者在睡眠限制期间及其后4天食用对照的等热量饮食,饮食中含有0.900 g·kg-1·d-1蛋白质加安慰剂(PLA)或1.50 g·kg-1·d-1蛋白质加多种营养饮料[L-精氨酸:20.0 g/天;L-谷氨酰胺:30.0 g/天;ω-3(n-3)脂肪酸:1.00 g/天;硫酸锌:24.0 mg/天;胆钙化醇:800 IU/天;维生素C:400 mg/天](NUT)。
NUT组(中位数:3.98天;四分位间距:1.17天)的皮肤屏障恢复(主要结果)比PLA组(中位数:5.25天;四分位间距:1.05天)短(P = 0.001)。伤口液中的细胞因子(次要结果)随时间增加(时间的主要效应P≤0.001),白细胞介素-13除外(P = 0.07);然而,未观察到治疗效果。
补充营养可能促进包括军事人员在内的健康成年人在睡眠限制后的伤口愈合,军事人员伤口和感染的发生率也很高。本试验在clinicaltrials.gov注册,注册号为NCT03525184。