Effect of Immune-Enhancing Enteral Nutrition Enriched with or without Beta-Glucan on Immunomodulation in Critically Ill Patients

Jae Gil Lee, Young Sam Kim, Young Ju Lee, Hyeon Yeong Ahn, Minjoo Kim, Minkyung Kim, Min Jung Cho, Younsoo Cho, Jong Ho Lee, Jae Gil Lee, Young Sam Kim, Young Ju Lee, Hyeon Yeong Ahn, Minjoo Kim, Minkyung Kim, Min Jung Cho, Younsoo Cho, Jong Ho Lee

Abstract

We investigated whether high-protein enteral nutrition with immune-modulating nutrients (IMHP) enriched with β-glucan stimulates immune function in critically ill patients. In a randomized double-blind placebo-controlled study, 30 patients consumed one of three types of enteral nutrition: a control or IMHP with and without β-glucan. The IMHP with β-glucan group showed increases in natural killer (NK) cell activities relative to the baseline, and greater increases were observed in NK cell activities relative to the control group after adjusting for age and gender. The IMHP groups with and without β-glucan had greater increases in serum prealbumin and decreases in high-sensitivity C-reactive protein (hs-CRP) than the control group. The control group had a greater decrease in peripheral blood mononuclear cell (PBMC) interleukin (IL)-12 production than the IMHP with and without β-glucan groups. In all patients, the change (Δ) in hs-CRP was correlated with Δ prealbumin and Δ PBMC IL-12, which were correlated with ΔNK cell activity and Δ prealbumin. This study showed beneficial effects of a combination treatment of β-glucan and IMHP on NK cell activity. Additionally, strong correlations among changes in NK cell activity, PBMC IL-12, and hs-CRP suggested that β-glucan could be an attractive candidate for stimulating protective immunity without enhanced inflammation (ClinicalTrials.gov: NCT02569203).

Keywords: ICU; NK cell; beta-glucan; enteral nutrition; immune system; inflammation.

Figures

Figure 1
Figure 1
Matrix of correlations among changes in BMI, serum albumin, pre-albumin, cytokines, PBMC cytokine production, and NK cell activity. Correlations were obtained by deriving Spearman’s correlation coefficient. Red is a positive correlation and blue is a negative correlation.
Figure 2
Figure 2
Correlations among changes in NK cell activity E:T = 5:1, PBMC IL-12, serum hs-CRP, and serum pre-albumin in all subjects. Tested by Spearman’s correlation analysis, r: correlation coefficients.

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