Modulation of Postoperative Immune and Inflammatory Response by Arginine-enhancing Enteral Diet in Gastric Cancer Patients

Objective: To evaluate the effect of the enteral diet supplemented with arginine on host immune and inflammatory responses in gastric cancer surgical patients.Methods: Ninety-six gastric cancer patients were randomized equally to receive either an arginine enriched enteral diet(Arg group),or an isocaloric standard enteral diet(control group).The patients received enteral nutrition by continuous pump infusion via a nasogastric tube.Jejunal infusion was started 48 hours after surgery and continued for seven days.All variables were measure before operation and on postoperative day 1 and 8.The level of protein,immune function,nitrogen balance,infection related complication,inflammatory responses and in-hospital days were compared between the two groups.Results: There were significant postoperative changes in inflammatory response and immunological variables in both groups.CD3,CD4,IgG,IgA and IgM levels in Arg group were higher(all P0.05) than in the standard group at 1 or 8 d after operation.CRP,IL-6,TNFα and PGE2 levels were lower (all P0.05),and in-hospital days were less in the Arg group compared with those in control group.The level of protein and nitrogen balance were not different between the two groups.Conclusion: Supplementation of enteral nutrition with arginine can ameliorate the host immunosuppressive and control inflammatory response.