Molecular Mechanisms of Pharmaconutrients
Nutritional supplementation has become the standard of care for management of critically ill patients. Traditionally, nutritional support in this patient population was intended to replete substrate deficiencies secondary to stress-induced catabolism. Recognition of the influence of certain nutrient...
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Veröffentlicht in: | The Journal of surgical research 2010-06, Vol.161 (2), p.288-294 |
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creator | Santora, Rachel, M.D Kozar, Rosemary A., M.D., Ph.D |
description | Nutritional supplementation has become the standard of care for management of critically ill patients. Traditionally, nutritional support in this patient population was intended to replete substrate deficiencies secondary to stress-induced catabolism. Recognition of the influence of certain nutrients on the immune and inflammatory response of the critically ill has led to the evolution of more sophisticated nutritional strategies and concepts. Administration of immune-enhancing formulas supplemented with a combination of glutamine, arginine, omega-3 fatty acids (ω-3 FA), and nucleotides have been shown in most studies to reduce infectious outcomes. More recently, the separation of nutritional support from the provision of key nutrients has led to a further appreciation of the immunomodulatory and anti-inflammatory benefits of isolated nutrients, such as glutamine and antioxidants. The purpose of this article is to review the molecular mechanisms that are unique to each class of frequently utilized nutrients. A better understanding of the specific molecular targets of immunonutrients will facilitate application of more refined nutritional therapies in critically ill patients. |
doi_str_mv | 10.1016/j.jss.2009.06.024 |
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Traditionally, nutritional support in this patient population was intended to replete substrate deficiencies secondary to stress-induced catabolism. Recognition of the influence of certain nutrients on the immune and inflammatory response of the critically ill has led to the evolution of more sophisticated nutritional strategies and concepts. Administration of immune-enhancing formulas supplemented with a combination of glutamine, arginine, omega-3 fatty acids (ω-3 FA), and nucleotides have been shown in most studies to reduce infectious outcomes. More recently, the separation of nutritional support from the provision of key nutrients has led to a further appreciation of the immunomodulatory and anti-inflammatory benefits of isolated nutrients, such as glutamine and antioxidants. The purpose of this article is to review the molecular mechanisms that are unique to each class of frequently utilized nutrients. A better understanding of the specific molecular targets of immunonutrients will facilitate application of more refined nutritional therapies in critically ill patients.</description><identifier>ISSN: 0022-4804</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2009.06.024</identifier><identifier>PMID: 20080249</identifier><identifier>CODEN: JSGRA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Amino Acids - metabolism ; Animals ; antioxidants ; Antioxidants - metabolism ; arginine ; Arginine - metabolism ; Biological and medical sciences ; Critical Illness ; Enteral Nutrition - methods ; Fatty Acids, Omega-3 - metabolism ; General aspects ; glutamine ; Glutamine - metabolism ; Humans ; immune-enhancing formulas ; Medical sciences ; Nucleotides - metabolism ; Nutritional Support ; omega-3-fatty acids ; pharmaconutrients ; PPAR gamma - metabolism ; Retinoid X Receptors - metabolism ; Surgery</subject><ispartof>The Journal of surgical research, 2010-06, Vol.161 (2), p.288-294</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright 2010 Elsevier Inc. 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Traditionally, nutritional support in this patient population was intended to replete substrate deficiencies secondary to stress-induced catabolism. Recognition of the influence of certain nutrients on the immune and inflammatory response of the critically ill has led to the evolution of more sophisticated nutritional strategies and concepts. Administration of immune-enhancing formulas supplemented with a combination of glutamine, arginine, omega-3 fatty acids (ω-3 FA), and nucleotides have been shown in most studies to reduce infectious outcomes. More recently, the separation of nutritional support from the provision of key nutrients has led to a further appreciation of the immunomodulatory and anti-inflammatory benefits of isolated nutrients, such as glutamine and antioxidants. The purpose of this article is to review the molecular mechanisms that are unique to each class of frequently utilized nutrients. A better understanding of the specific molecular targets of immunonutrients will facilitate application of more refined nutritional therapies in critically ill patients.</description><subject>Amino Acids - metabolism</subject><subject>Animals</subject><subject>antioxidants</subject><subject>Antioxidants - metabolism</subject><subject>arginine</subject><subject>Arginine - metabolism</subject><subject>Biological and medical sciences</subject><subject>Critical Illness</subject><subject>Enteral Nutrition - methods</subject><subject>Fatty Acids, Omega-3 - metabolism</subject><subject>General aspects</subject><subject>glutamine</subject><subject>Glutamine - metabolism</subject><subject>Humans</subject><subject>immune-enhancing formulas</subject><subject>Medical sciences</subject><subject>Nucleotides - metabolism</subject><subject>Nutritional Support</subject><subject>omega-3-fatty acids</subject><subject>pharmaconutrients</subject><subject>PPAR gamma - metabolism</subject><subject>Retinoid X Receptors - metabolism</subject><subject>Surgery</subject><issn>0022-4804</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kl1rFTEQhoMo9lj9Ad7IuRHxYreTZLMfCAUpfkGLgno9ZJNZT9bdTZvsFvrvzXKObfWiVyHkeWeGJ8PYSw45B16e9HkfYy4AmhzKHETxiG04NCqry0o-ZhsAIbKihuKIPYuxh3RvKvmUHaVInfBmw95e-IHMMuiwvSCz05OLY9z6bvttp8OojZ-WOTia5vicPen0EOnF4TxmPz9--HH2OTv_-unL2fvzzCip5oxkqdIIttBWdUpSVynOG9tRaduGlNCt4pZL3VUt1MLyloOxVUNAxqRDyWN2uq97ubQjWZN6Bz3gZXCjDjfotcN_Xya3w1_-GkVdSaiKVODNoUDwVwvFGUcXDQ2DnsgvESspuVRVyRPJ96QJPsZA3W0XDrgaxh6TYVwNI5SYlKXMq_vj3Sb-Kk3A6wOgo9FDF_RkXLzjRC0LKFfu3Z6jJPPaUcBokmhD1gUyM1rvHhzj9L-0GdzkUsPfdEOx90uY0i8hxygQ8Pu6CusmQAMgFUj5Byeirpo</recordid><startdate>20100615</startdate><enddate>20100615</enddate><creator>Santora, Rachel, M.D</creator><creator>Kozar, Rosemary A., M.D., Ph.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20100615</creationdate><title>Molecular Mechanisms of Pharmaconutrients</title><author>Santora, Rachel, M.D ; Kozar, Rosemary A., M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c535t-e365095d4ad5f53ef75119dfe6db9e52ab51d13af7b082d1b10cd79e0ecc79e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Amino Acids - metabolism</topic><topic>Animals</topic><topic>antioxidants</topic><topic>Antioxidants - metabolism</topic><topic>arginine</topic><topic>Arginine - metabolism</topic><topic>Biological and medical sciences</topic><topic>Critical Illness</topic><topic>Enteral Nutrition - methods</topic><topic>Fatty Acids, Omega-3 - metabolism</topic><topic>General aspects</topic><topic>glutamine</topic><topic>Glutamine - metabolism</topic><topic>Humans</topic><topic>immune-enhancing formulas</topic><topic>Medical sciences</topic><topic>Nucleotides - metabolism</topic><topic>Nutritional Support</topic><topic>omega-3-fatty acids</topic><topic>pharmaconutrients</topic><topic>PPAR gamma - metabolism</topic><topic>Retinoid X Receptors - metabolism</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Santora, Rachel, M.D</creatorcontrib><creatorcontrib>Kozar, Rosemary A., M.D., Ph.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Santora, Rachel, M.D</au><au>Kozar, Rosemary A., M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Molecular Mechanisms of Pharmaconutrients</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2010-06-15</date><risdate>2010</risdate><volume>161</volume><issue>2</issue><spage>288</spage><epage>294</epage><pages>288-294</pages><issn>0022-4804</issn><eissn>1095-8673</eissn><coden>JSGRA2</coden><abstract>Nutritional supplementation has become the standard of care for management of critically ill patients. 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subjects | Amino Acids - metabolism Animals antioxidants Antioxidants - metabolism arginine Arginine - metabolism Biological and medical sciences Critical Illness Enteral Nutrition - methods Fatty Acids, Omega-3 - metabolism General aspects glutamine Glutamine - metabolism Humans immune-enhancing formulas Medical sciences Nucleotides - metabolism Nutritional Support omega-3-fatty acids pharmaconutrients PPAR gamma - metabolism Retinoid X Receptors - metabolism Surgery |
title | Molecular Mechanisms of Pharmaconutrients |
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