García de Lorenzo A, Culebras J M
Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, España.
Nutr Hosp. 1995 Sep-Oct;10(5):297-305.
The manipulation of the inflammatory and hormonal responses may produce, on one hand, positive effects, and, on the other hand, potentially negative effects. The modification of the neuro-endocrine-humoral pattern may become more important and effective than the supply of nutrients. In this article we bring an up date of the role of insulin, anabolic steroids, blocking the catabolic hormones, phenobarbital, somatostatin, clenbuterol and metaprorenol, growth factors: GH and IGF-1, cytokines, and anti-cytokines sera. The use of GH, IGF-1, and of the epidermal and or colonic growth factors, along with a blocking of the cytokines, the manipulation of the lipidic mediators, and the supply of classical nutrients, specific to the aggression situation, may improve the protein synthesis and tissue repair. It may at the same time both decrease the loss of body proteins as well as promoting and acceleration of the recovery, shortening the hospital stay and reducing the convalescence time. The future seems to point towards molecular and cellular biotechnology and towards "nutritional" pharmacology, which contemplates the effects of growth factors, the recent advances in the field of cytokine modulation, and the manipulation of the binomer nutrient-medication.