L-alanil-glutamina e seus efeitos sobre o estresse oxidativo : o controle glicêmico e a resposta inflamatória em crianças submetidas à palatoplastia

Abstract

The palatoplasty is the surgical procedure aimed at closing the communication of the nasal and oral cavities, not resulting from the processes palatins embryonic closing at the time of formation of the face. The objective of this study was to evaluate the effect of L-alanyl-glutamine on the oxidative stress, the glycemic control and inflammatory response in cleft palate and lip patients, submitted to palatoplasty. The study was prospective, single blind, randomized, placebo-controlled, and is comprised of 30 (thirty) male children in the age group between 02 and 10 years of age, divided into 02 groups: Group A-Control, n = 15 , which were administered to each child 100ml of saline solution to 0.9% and Group B- L-alanyl-glutamine, n = 15, which were administered to each child a solution of 100ml with L-alanyl-glutamine to 20 %, 0.5 g / kg / dose (Dipeptiven ®) and saline solution to 0.9%. The Research Project was submitted to the Committee of Ethics in Research of Hospital Infantil Albert Sabin being approved under the registry No 51/06 of May 29, 2006. It was picked peripheral venous blood, at 05 times different: T1- 03 hours prior to the surgical procedure; T2- after administration of the solution (before the surgical procedure), T3- after the surgical procedure, T4- 06 hours post-operative and T5- 12 hours post-operative. The concentrations were determined of: glutathione, Tiobarbituric Acid of Reactivates substances (TBARS), glucose, insulin, C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10) . Comparisons between groups Control and L-alanyl-glutamine were made using the t test for not paired variables ( parametric data) or the U test of Mann-Whitney ( not parametric data), and is regarded as statistically significant P value < 0.05. For the parameters evaluated in weight and age, no statistically significant differences were found between groups. In all the times studied, there were no statistically significant differences in glucose, insulin, TBARS, glutathione, IL-6 and IL-10, there was an increase in T4 [(Grupo A - 20,472 [11,637-27,780] versus T1 0,0 [0,0-2,226] p<0,05; T2 0,0 [0,0-2,140] p<0.01 e T3 0,625 [0,0-2,153] p<0.01) (Grupo B – 19,317 [11,670-24,048] versus T1 1,888 [0,559-5,295] p<0,05; T2 0,0 [0,0-1,316] p<0,001 e T3 0,0 [0,0-2,757] p<0,05)] and T5[(Grupo A – 22,129 [9,721-33,225] versus T1 0,0 [0,0-2,226]p<0,01; T2 0,0 [0,0-2,140] p<0,001; T3 0,625 [0,0-2,153]p<0,001) (Grupo B – 22,177 [11,157-33,407] versus T1 1,888 [0,559-5,295]p<0,01; T2 0,0 [0,0-1,316]p<0,001; T3 0,0 [0,0-2,757]p<0,01), of the IL-6, regarding times T1, T2 and T3, for the two groups. In assessing the CRP, children of the L-alanyi-glutamine group, compared to patients in the group Control showed a significant reduction, in T5 (3,6 [3,160-5,05] versus 8,4 [4,1-11,9]) (p=0.0037). In conclusion, significant reduction in the dosage of CRP, 12 hours after the surgical procedure in children who received L-alanyl - glutamine, reflects lower inflammatory response.