08Aug 2018

EFFECT OF SUPPLEMENTATION WITH GLUTAMINE AND HYDROXYMETHYLBUTIRATE OVER THE CELLS INVOLVED IN WOUND HEALING.

  • Hospital General de M?xico/ Instituto Polit?cnico Nacional.
  • Instituto Polit?cnico Nacional, Escuela Superior de Medicina.
  • Hospital General de M?xico.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Introduction: The healing process demands energy-protein needs higher than the normal requirement. Nutritional support in bloody areas is essential since it restores the capacity of the immune response facilitating healing, promotes angiogenesis and cell proliferation. Objective: To evaluate the effect of glutamine and hydroxymethylbutyrate supplementation on the cells involved in the healing of bloody areas. Methodology: Clinical, experimental, longitudinal, prospective, comparative, randomized trial in patients with diagnosis of bloody areas. Divided into control group and treatment group wich received supplementation with glutamine (14g) and hydroxymethylbutyrate (3g) during 15 days. Tissue samples were taken for histopathologic evaluation. Differences between groups (Student\'s t) and effect size (Cohen\'s d) were analyzed. Results: Significant differences were reported in fibroblasts and angiogenesis (p <0.005) with a large effect size (d> 0.8); lymphocytes and granulocytes without significant differences (p <0.005) but with medium effect size. No side effects were reported. Conclusions: The mixture of glutamine and Hydroxymethylbutyrate has a positive effect in the cells involved in the inflammatory and proliferative phase of healing.


  1. Quain A, Khardori M. Nutrition in Wound Care Management: A comprehensive Overview. Wounds. 2015; 27(12):327-35.
  2. Dryden S, Shoemaker W, Kim J. Wound Management and Nutrition for Optimal Wound Healing. Atlas Oral Maxillofacial SurgClin N Am. 2013; 21(1):37-47.
  3. Montoya-Montoya N, Munera-Garc?a. Efecto de la intervenci?n nutricional temprana en el resultado cl?nico de pacientes con riesgo nutricional. Nutr Hosp. 2014; 29(1) 427-36.
  4. Stechmiller J. Understanding the Role of Nutrition and Wound Healing. Nutrition in ClinicalPractice. Nutr Clin Pract. 2010; 25(1):61-8.
  5. Vesga A, Ganboa E. Riesgo de malnutrici?n asociado a baja ingesta alimentaria, estancia hospitalaria prolongada y reingreso en un hospital de alto nivel de complejidad en Colombia. Nutr Hosp. 2015; 32(3):1308-1314.
  6. Rodr?guez B, Laquaniti N, Merkel M, Villagra A. Pol?ticaNutricionalactiva en la implementaci?n del soporte nutricional hospitalario; resultados de un estudio observacional. Nutr Hosp. 2014; 30(2):447-452.
  7. Harris C, Bates-Jensen B, Parslow N, Raizman R, Singh M. The Bates-Jensen Wound Assessment Tool (BWAT): Development of a Pictorial Guide for Training Nurses. Wound Care Canada. 2009 Julio; 7(2): 253-9.
  8. Baker L, Gout B, Crowe T. Hospital Malnutrition; prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health 2011; (8): 514-527.
  9. Lizaka S, Okuwa M, Sugama J, Sanada H. The impact of malnutrition and nutrition-related factors on the development and severity of pressure ulcers in older patients receiving home care. ClinNutr 2010; (29):47-53
  10. Chow O, Barbul A. Inmunonutrition: Role in Wound Healing and Tissue Regeneration. WHS. 2012; 3(1): 46?53.
  11. Uscategui H. Inmunonutrici?n: Enfoque en el paciente quir?rgico. Rev ChilCirc 2010; 62 (1): 87-92.
  12. Durkalec K, Jeszka J, Podgorski T. The effect of a 12-week beta-hydroxy-beta-methylbutirate (HMB) Supplementation on Highly-Trained Combat Sports Athletes: A randomized, double-blind, placebo-controlled crossover study. Nutrients, 2017; (9): 1-21.
  13. Jones M, Rivera M, Puccinelli C, Wang M, Williams S, A B. Targeted Amino Acid Supplementation in Diabetic Foot Wounds: Pilot Data and a Review of the Literature. Surgical Infections. 2014; 15(6): 708-12.
  14. Cruz-Jentoff A. Beta-hydroxy-beta-methyl butyrate (HMB): From experimental data to clinical evidence in sarcopenia. Curr Protein Pept Sci. 2017; (28): 668-672.
  15. Wing A, Chow A, Wang A, Ong L, Zhang S, Young S. The use of a specialized amino acid mixture for pressure ulcers: A placebo-controlled trial. Journal of Wound Care. 2014; 23(5): 259-60, 262-4, 266-9.
  16. Armstrong D, Hanft J, Driver V, Smith P, Lazaro J, Reyzelman A, et al. Effect of oral nutritional supplementation on wound healing in diabetic foot ulcers: a prospective randomized controlled trail. Diabet Med. 2014; 31.
  17. Sipahi S, Gungor O, Gunduz M, Cilci M, Cahit M, Tamaer A. Te effect of oral supplementation with a combination of beta-hydroxy-beta-methylbutirate, arginine, and glutamine on wound healing: a retrospective analysis of diabetic haemodialysis patients. BMC Nephrol 2013; 14(8): 1-6. .
  18. Wandrag L, Brett S, Frost G, Hickson M. Impact of supplementation with amino acids or their metabolites on muscle wasting in patients with critical illness or other muscle wasting illness: a systematic review. J Hum Nutr Diet.?2015; 28 (4):313-30.
  19. Haldun R, Temel H, Osman B, Ersoy E, Yazgan A, Yildirim Z. The mixture of Arginine, Glutamine, and B-hydroxy-b-methyl Butyrate Enhances the Healing of Ischemic Wounds in Rats. JPEN J Parenter Enteral Nutr.?2017; 41(6):1045-1050.
  20. Yavas C, Yavas G, Acar H, Toy H, Yuce D, Akyurek S, et al. Amelioration of radiation-induced acute inflammation and mucosal atrophy by beta-hydroxy-beta-methylbutyrate, L-glutamıne, and L-argınıne: results of an experimental study. Support Care Cancer 2013; (21):883?888
  21. Wu H, Xia Y, Jiang J, Du, Guo X, Liu X, et al. Effect of beta-hydroxy-beta-methylbutirate supplementation on muscle loss in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr.?2015; 61 (2):168-75.
  22. Sipahi S, Gungor O, Gunduz M, Cilci M, Cahit M, Tamer A. The effect of oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine on wound healing: a retrospective analysis of diabetic haemodialysis patients. BMC Nephrol. 2013; (14)8: 1-6.
  23. May P, Barber A, D?Olimpio J, Hourihane A, Abumrad N. Reversal of cancer-related wasting using oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine, and glutamine. Am J Surg. 2002; (182): 471?479.
  24. Clark R, Feleke G, Din M, Yasmin T, Singh G, Khan F, et al. Nutritional Treatment for Acquired Immunodeficiency Virus- Associated Wasting Using β-Hydroxy β-Methylbutyrate, Glutamine, and Arginine: A Randomized, Double-Blind, Placebo-Controlled Study. Eur J Clin Nutr. 2016; 70(2): 269?273.
  25. Osman B, Riza H, Eren E, cols y. A Pilot experimental study on the effect of arginine, glutamine, and b-hydroxy-b-methylbutyrate on secondary wound healing JPEN J Parenter Enteral Nutr.?2017 Aug;41(6):1045-1050.
  26. Ratchmater J, Nissen S, Panton L, Clark R, May P, Barber A, et al. Supplementation with a combination of beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine is safe and could improve hematological parameters. JPEN J Parenter Enteral Nutr.?2004; 28(2):65-75.
  27. Witte M, Barbul A. General principles of wound healing. Surg Clin North Am.?1997; 77(3):509-28.
  28. Achamrah N, De?chelotte P, Coe?ffier M. Glutamine and the regulation of intestinal permeability: from bench to bedside. Curr Opin Clin Nutr Metab Care.?2017; 20(1):86-91.
  29. Bardhan P. Improving the ORS: Does Glutamine have a Role? J Health Popul Nutr. 2007; 25(3): 263?266.

[M en C Alejandra Patricia Salas Gonzalez, Sevilla Gonzalez Maria de la Luz and Fuchs Tarlovsky Vanessa. (2018); EFFECT OF SUPPLEMENTATION WITH GLUTAMINE AND HYDROXYMETHYLBUTIRATE OVER THE CELLS INVOLVED IN WOUND HEALING. Int. J. of Adv. Res. 6 (8). 100-106] (ISSN 2320-5407). www.journalijar.com


Salas González Alejandra Patricia
INSTITUTO POLITÉCNICO NACIONAL/ HOSPITAL GENERAL DE MEXICO

DOI:


Article DOI: 10.21474/IJAR01/7495       DOI URL: http://dx.doi.org/10.21474/IJAR01/7495


Share this article