有症状的HIV感染患者接受强化营养支持后体重增加，且肿瘤坏死因子受体蛋白浓度升高。

Weight gain and increased concentrations of receptor proteins for tumor necrosis factor after patients with symptomatic HIV infection received fortified nutrition support.

作者信息

Süttmann U, Ockenga J, Schneider H, Selberg O, Schlesinger A, Gallati H, Wolfram G, Deicher H, Müller M J

机构信息

Zentrum Innere Medizin und Dermatologie, Abteilung Klinische Immunologie, Lehrte, Germany.

出版信息

J Am Diet Assoc. 1996 Jun;96(6):565-9. doi: 10.1016/S0002-8223(96)00156-3.

DOI:10.1016/S0002-8223(96)00156-3

PMID:8655902

Abstract

OBJECTIVE

To determine whether certain nutrients and dietary factors act as modulators of the immune system and improve the nutritional status of immunocompromised patients.

DESIGN

Controlled, double-blind, crossover phase trials of the effects of a fortified formula in patients infected with the human immunodeficiency virus (HIV). Patients consumed a control formula for 4 months and a study formula for 4 months.

SUBJECTS

Ten men with symptomatic HIV infection who were following stable medication regimens and had no malignancies, mycobacteriosis, or additional virus infection requiring systemic treatment.

INTERVENTION

Formula fortified with alpha-linolenic acid (1.8 g/day), arginine (7.8 g/day), and RNA (0.75 g/day) and a standard formula.

MAIN OUTCOME MEASURES

Nutritional status determined by anthropometric, bioelectrical, biochemical, and dietary assessment; energy expenditure determined by indirect calorimetry; disease progression; CD4 lymphocyte counts; HIV p24 antigen plasma concentrations; tumor necrosis factor (TNF) receptor proteins; and compliance control parameters.

STATISTICAL ANALYSES PERFORMED

Student's t tests for paired and unpaired data.

RESULTS

Fortified nutrition resulted in a weight gain (+ 2.9 kg/4 months vs -0.5 kg/4 months with the control formula, P < .05), an incorporation of eicosaenoic acid into erythrocyte cell membranes (+ 47% of baseline values, P < .05), and increased plasma arginine concentrations (96.8 +/- 45.1 vs 51.8 +/- 20.9 mumol/L, P < .01). The serum concentrations of the soluble tumor necrosis factor receptor (sTNFR) proteins increased during the study period (sTNFR 55 = + 0.23 vs -0.40 ng/mL, P < .001; sTNFR 75 = + 0.90 vs -0.36 ng/mL, P < .01), whereas no changes in CD4+ lymphocyte counts were observed.

CONCLUSION

Increasing dietary intakes of n-3 polyunsaturated fatty acids, L-arginine, and RNA increased body weight, possibly by modulating the negative effects of TNF.

摘要

目的

确定某些营养素和饮食因素是否作为免疫系统的调节剂，并改善免疫功能低下患者的营养状况。

设计

对感染人类免疫缺陷病毒（HIV）的患者进行强化配方效果的对照、双盲、交叉阶段试验。患者食用对照配方4个月，研究配方4个月。

受试者

10名有症状的HIV感染男性，他们遵循稳定的药物治疗方案，且没有需要全身治疗的恶性肿瘤、分枝杆菌病或其他病毒感染。

干预措施

强化了α-亚麻酸（1.8克/天）、精氨酸（7.8克/天）和RNA（0.75克/天）的配方以及标准配方。

主要观察指标

通过人体测量、生物电、生化和饮食评估确定营养状况；通过间接测热法确定能量消耗；疾病进展；CD4淋巴细胞计数；HIV p24抗原血浆浓度；肿瘤坏死因子（TNF）受体蛋白；以及依从性控制参数。

进行的统计分析

对配对和非配对数据进行学生t检验。

结果

强化营养导致体重增加（4个月增加2.9千克，对照配方4个月减少0.5千克，P < 0.05），二十碳五烯酸掺入红细胞膜（+47%基线值，P < 0.05），血浆精氨酸浓度增加（96.8±45.1对51.8±20.9微摩尔/升，P < 0.01）。在研究期间，可溶性肿瘤坏死因子受体（sTNFR）蛋白的血清浓度增加（sTNFR 55 = +0.23对 -0.40纳克/毫升，P < 0.001；sTNFR 75 = +0.90对 -0.36纳克/毫升，P < 0.01），而CD4 +淋巴细胞计数未观察到变化。