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Immunonutrition

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Usefulness of immunonutrition

Immunonutrition can contribute to the significant reduction of risks related to complications of acute post-operative inflammation. Surgical intervention (in oncology, traumatology, etc.) often determines a HYPERmetabolic – CATABOLIC response responsible for:

  • Weight loss
  • Reduction in muscle mass and tone
  • Impairment of the immune system
  • Slowing of the healing processes
  • Difficulty in weaning from mechanical respiration (when applied)
  • Increased risk of infections
  • In the worst case scenario, multiorgan failure and increased risk of mortality.

In such cases, only the MINIMUM administration of nutrients via the ENTERAL route is able to prevent the atrophy of the intestinal villi and the atrophy of the mucosa, to increase the intestinal immune barrier and to reduce bacterial translocation. However, let us remember that ADEQUATE (and not minimal) nutritional support is able to prevent both malnutrition and the various repercussions on the immune system.

Immunonutrition was born on the basis of these assumptions and aims to optimize the body's own resources.

Immunonutrition molecules – immunonutrients

In immunonutrition the most useful and used molecules are:

Arginine has a stimulating action on the secretion of some hormones, including la somatotropina [GH] and this is particularly valid (and demonstrated) precisely for defedated and/or poly-traumatized subjects. It is also a precursor of nitric oxide (NO) and helps to enhance the activation of T lymphocytes and macrophages (white blood cells).

Glutamine, among its numerous functions, constitutes 60-70% of the energy used by enterocytes (cells of the intestinal mucosa) and has a primary action on lymphocyte and macrophage activation. Its administration proves useful in healing wounds and reducing hospital stays.
Taurine is a derived amino acid that contributes to the regulation of osmotic balance, intracellular calcium homeostasis, the composition and stabilization of cell membranes, antioxidant protection, blood sugar regulation, etc. Its administration allows you to maintain normal concentrations of platelets, erythrocytes (red blood cells), granulocytes (white blood cells) and lymphocytes.
ω3 fatty acids are typically anti-inflammatory; they also act on lipid metabolism by promoting the increase in HDL and the reduction of LDL and triglycerides. They also act positively on the reduction of blood pressure and on the immune response and have no side effects.
FOS promote the selection of the correct intestinal bacterial flora, reduce the transit time of food, modulate the absorption of glucose and reduce that of cholesterol; last but not least, they help maintain the integrity of the intestinal mucosa.

Immunonutrition: yes or no?

In conclusion, although the therapeutic effects of immunonutrition are now established, there is still little use of this nutritional practice among doctors and within clinical inpatient facilities. Obviously, immunonutrition also has very specific limits:

  • It is possible to derive a significant benefit as long as basic nutritional needs are met first
  • It is not advisable to administer immunonutrients indiscriminately and each case should provide a separate formulation.

These are secondary aspects and can be easily managed through the intervention of a specialized professional, the latter being an indispensable figure in clinical nutrition and an integral part of medical therapy.

Bibliography:

  • Journal of the national association of dietitians (ANDID) – 21st year, sixth issue, bimonthly period VIth bimonthly 2011 – page 25:28.

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