Immunosupression and infection after major surgery: a nutritional deficiency

Critical Care Clinics
Xinmei ZhuJuan B Ochoa

Abstract

T cell dysfunction significantly increases susceptibility to infections and organ failure after trauma or surgery (physical injury). This coincides with a persistent drop in arginine availability, a necessary amino acid for normal T cell function. Recent data led to the identification of a novel mechanism of T cell suppression caused by the depletion of arginine through the induction of arginase 1 (ARG1) in a specialized group of immature myeloid cells, now named myeloid-derived suppressor cells (MDSC). In addition to T cell dysfunction, arginine depletion leads to the decrease in nitric oxide (NO) production. Dietary therapy containing arginine at supraphysiologic concentrations along with other components such as omega-3 fat acids, antioxidants, nucleotides, and vitamin A is associated with improvement in T cell function, NO production, and a significant decrease in infection rates. The authors propose that a pathologic decrease in arginine availability is an identifiable nutrition deficiency syndrome that worsens outcomes if left untreated.

References

Nov 1, 1991·Annals of Surgery·J B OchoaA B Peitzman
Sep 1, 1980·The Journal of Surgical Research·A BarbulG Efron
Oct 1, 1993·The Journal of Trauma·T D JacobA B Peitzman
Jan 11, 2000·Critical Care Medicine·R J BealeD J Bihari
Apr 25, 2000·Surgery·A C BernardJ B Ochoa
Feb 24, 2001·JPEN. Journal of Parenteral and Enteral Nutrition·J B OchoaE Fitzpatrick
Apr 11, 2001·Annals of Plastic Surgery·J E LovettJ Ochoa
Aug 31, 2001·JAMA : the Journal of the American Medical Association·D K HeylandU Suchner
Sep 11, 2001·Journal of the American College of Surgeons·J A MannickJ A Lederer
Jan 5, 2002·Journal of Immunotherapy·V BronteP Zanovello
Feb 18, 2003·Current Opinion in Clinical Nutrition and Metabolic Care·Vishal Bansal, Juan B Ochoa
Jun 18, 2003·Trends in Immunology·Vincenzo BrontePaola Zanovello
Jul 23, 2003·The Journal of Immunology : Official Journal of the American Association of Immunologists·Paulo C RodriguezAugusto C Ochoa
May 1, 2004·Surgery·Andrew R BarksdaleJuan B Ochoa
Jan 18, 2005·The Journal of Surgical Research·Betty J TsueiPaul A Kearney
Feb 16, 2005·JPEN. Journal of Parenteral and Enteral Nutrition·Vishal BansalJuan B Ochoa
Sep 28, 2005·The Journal of Experimental Medicine·Paulo C RodriguezAugusto C Ochoa
Oct 11, 2005·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Juan B OchoaVishal Bansal
Dec 13, 2005·Critical Care Medicine·Juan B Ochoa, Valeriya Makarenkova
Feb 4, 2006·The Journal of Immunology : Official Journal of the American Association of Immunologists·Valeriya P MakarenkovaJuan B Ochoa
Feb 14, 2006·The American Journal of Clinical Nutrition·Sidney M Morris
Jan 11, 2007·Cancer Research·Dmitry I GabrilovichHans Schreiber
Jan 27, 2007·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Augusto C OchoaPaulo C Rodriguez
Dec 26, 2007·Critical Care Medicine·Juan B Ochoa
Feb 7, 2009·Nature Reviews. Immunology·Dmitry I Gabrilovich, Srinivas Nagaraj

❮ Previous
Next ❯

Citations

Nov 1, 2011·Molecular and Cellular Biochemistry·Kechen BanRosemary A Kozar
Feb 16, 2013·The Proceedings of the Nutrition Society·Nikki BuijsPaul A M van Leeuwen
Nov 1, 2011·Current Opinion in Clinical Nutrition and Metabolic Care·Sidney M Morris
May 28, 2014·Journal of Cancer Research and Clinical Oncology·Aleksander Galas, Jan Kulig
Jul 10, 2012·World Journal of Surgical Oncology·Josephine A MauskopfJuan B Ochoa
Feb 26, 2011·Neuroscience and Biobehavioral Reviews·Canteros Maria Griselda
Jul 30, 2014·Current Opinion in Immunology·Hagit ShapiroEran Elinav
Jan 28, 2015·Journal of Translational Medicine·Yu GuMin Wang
May 7, 2015·Current Problems in Surgery·Martin D RosenthalFrederick A Moore
Sep 28, 2014·Journal of the American College of Surgeons·Refaat A HegaziDavid C Evans
Apr 16, 2016·Gastroenterology Report·Shishira BharadwajEzra Steiger
Apr 19, 2015·JPEN. Journal of Parenteral and Enteral Nutrition·Juan B Ochoa Gautier
Jan 9, 2014·Innate Immunity·Markus AlbertsmeierMartin K Angele
Dec 8, 2016·Diseases of the Colon and Rectum·Lucas W ThornbladeDavid R Flum
Dec 19, 2013·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·David C EvansChristopher M Jones
Aug 18, 2017·International Journal of Molecular Sciences·Leonard AngkaRebecca C Auer
Mar 30, 2018·Clinical Spine Surgery : a Spine Publication·Rabia QureshiHamid Hassanzadeh
Aug 11, 2017·The Journal of Immunology : Official Journal of the American Association of Immunologists·Nima AghaeepourBrice L Gaudilliere
Nov 25, 2018·Scandinavian Journal of Immunology·Eleonora Alexandrovna StarikovaIrina Solomonovna Freidlin
Jul 16, 2011·Current Opinion in Clinical Nutrition and Metabolic Care·Ulf O Gustafsson, Olle Ljungqvist
Sep 15, 2012·The Journal of Trauma and Acute Care Surgery·Paul E Marik, Mark Flemmer
Feb 25, 2014·Current Opinion in Critical Care·Jan Wernerman
Jun 9, 2016·Annals of Surgery·William AlazawiSatyajit Bhattacharya
Jul 8, 2014·Current Opinion in Critical Care·Cécile Chambrier, Didier Barnoud
Jul 8, 2011·Current Opinion in Anaesthesiology·Paul Wischmeyer
Dec 18, 2010·Expert Review of Clinical Immunology·Barry A Mizock, Krishnan Sriram
Dec 10, 2016·The Journal of Nutrition·Martin D RosenthalRobert G Martindale
Aug 16, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·K Slater, A A Ajjikuttira
Sep 22, 2021·Current Opinion in Critical Care·Franck VerdonkBrice Gaudilliere
Jul 8, 2011·Current Opinion in Anaesthesiology

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.