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  • Title: [Effects of different doses of L-arginine on the serum levels of helper T lymphocyte 1 (Th1)/Th2 cytokines in severely burned patients].
    Author: Yan H, Peng X, Wang P, Huang YS, Wang SL.
    Journal: Zhonghua Shao Shang Za Zhi; 2009 Oct; 25(5):331-4. PubMed ID: 19951554.
    Abstract:
    OBJECTIVE: To investigate the effects of L-arginine in different doses on the serum levels of helper T lymphocyte1 (Th1)/Th2 cytokines in severely burned patients. METHODS: Twenty-nine severely burned patients, with total burn surface area from 50% to 80%TBSA, hospitalized within 20 hours after burn, were randomly divided into control group (10 cases, fed with 5% glucose saline 500 mL), L-arginine 200 mg group (10 cases, fed with 5% glucose saline 500 mL + 200 mg/kg L-arginine), L-arginine 400 mg group (9 cases, fed with 5% glucose saline 500 mL + 400 mg/kg L-arginine). All patients received enteral feeding through nasointestinal tube, started within 22 hours after burn. Fasting venous blood of all patients was harvested on post burn day (PBD) 1 (before enteral feeding), 3, 5, and 7 to determine serum contents of TNF-alpha, IL-1beta, TGF-beta(1) and IL-4 by radio-immunity method and enzyme-linked immunosorbent assay. RESULTS: Serum contents of TNF-alpha and IL-1beta of patients in all groups increased rapidly after burn, and although contents of TNF-alpha (318 +/- 57) ng/mL and IL-1beta (218 +/- 47) pg/mL of patients in L-arginine 200 mg group peaked on PBD 5, they were still significantly lower than those of patients in control group [(389 +/- 34) ng/mL, (272 +/- 40) pg/mL, P < 0.05], but they decreased on PBD 7. Serum contents of TNF-alpha and IL-1beta in L-arginine 400 mg group were close to those of control group (P > 0.05). Serum contents of TGF-beta(1) and IL-4 of patients in each group increased slowly after burn, and content of TGF-beta(1) (110 +/- 16) pg/mL of patients in L-arginine 200 mg group was significantly higher than that of patients in control group [(83 +/- 20) pg/mL, P < 0.05] on PBD 5. There was no statistical significant difference between L-arginine 400 mg group and control group in respect of serum content of TGF-beta(1) (P > 0.05). CONCLUSIONS: Compared with the dosage of 400 mg/kg L-arginine, the 200 mg/kg dose is more effective in reducing the release of Th1 cytokines and increasing Th2 cytokines production, hence maintaining Th1/Th2 cytokine ratio to produce better immune opsonization during the infection phase of severe burn.
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