Pré-condicionamento com solução nutricional oral sobre a imunomodulação e o estresse oxidativo em pacientes submetidas à abdominoplastia total

Abstract

The host’s protective mechanisms are mediated by the ability of immunonutrients in defense mechanisms, such as the inflammatory response and antioxidant capacity. Among the most investigated are glutamine, arginine and polyunsaturated fatty acids derived from fish oil, anti-inflammatory agents which act on the synthesis of eicosanoids and regulate the immune response. This study is clinical, prospective, randomized, controlled, double-blind, aimed to identify whether there is any effect arising from nutraceutical preconditioning with use of a supplement containing L-alanyl-glutamine, and arginine mixture of oils containing fatty acids ω3 (EPA, DHA and ALA) on the oxidative stress and immunomodulation in surgical trauma. The supplement was administered in one dose of 200ml/day during the preoperative period (7 days before surgery) in patients undergoing abdominoplastia. Laboratory evaluations were performed before administration of the supplement (7 days before surgery – T0), before the anesthetic induction (T1), in the 1nd postoperative day (T2) and in the 3nd postoperative day (T3). The sample (25 patients) was divided into 2 groups: SNO1 - skim milk (0% fat) and SNO2 – suplement group: Supplement with ω6: ω3 ratio of 1,4:1 and ω9: ω6 ratio of 3,2:1, Arginine (10g/day), L-alanyl-glutamine (15g/day). Values of lymphocytes, leukocytes, TBARS, glutathione peroxidase activity and concentration of total antioxidants in the three times of both groups were analyzed. There was no statistically significant difference between the control and study groups for variables lymphocytes, leukocytes, TBARS, glutathione peroxidase activity. There was a statistically significant difference between the control group and related to the concentration of total antioxidant study. Therefore, oral nutritional supplements containing L-alanyl-glutamine, arginine and oil mixture with a high ratio ω9: ω6 and low ratio ω6:ω3 containing ω3 acids (ALA, DHA and EPA) has nutraceutical effect of preconditioning the values of total antioxidants in surgical trauma in patients undergoing total abdominoplasty.