Glutamine and Arginine Combination for Sepsis Patients: Is It A Choice?

Abstract

Sepsis is a life-threatening condition associated with a dysregulated host response to infection. It has indicated the serious stage of patient condition. Sepsis definition not only as a process of immune disorder or response of systemic inflammation, but also includes the alteration of multiple organs function, hence the existence of sepsis means the prolonged stays in the hospital or even the intensive care unit (ICU). Prevalence of hospital deaths caused by sepsis has been increasing as 90% since last 20 years. Sepsis and inflammation cause multiple organ dysfunction syndrome (MODS) which is usually the cause for death in intensive care units. To maintain the condition of those patients, an adequate nutrition supplementation is a must to be given. Several micro and macro nutrients have considered as immuno-nutrient, which can stimulate the immune condition of the patients. The roles of immune-nutrient are to repair barrier and immune function, improve wound healing, and decrease hyper inflammation. Glutamine and arginine are two nutrients which are suggested to treat the patient with sepsis. Decreasing or inhibiting stress response with substrates like glutamine and arginine may help preventing from MODS thus mortality in critically ill patients. Glutamine and Arginine independently have role on growth, tissue recovery, regeneration cell and reduce bacteria translocation in sepsis patient. However, the recent studies showed that glutamine and arginine combination (GAC) supplementation significantly decreased pro-inflammatory cytokine such as CRP, TNF-α, IL-1β, and IL-6, tissue repair, cell renewal and collagen synthesis. Several studies found that supplementation of glutamine and arginine combination has advantage effects on preventing sepsis, but the specific benefits remain unknown. This paper aims to provide an overview of the benefits of using glutamine and arginine as supplementation therapy in sepsis patients.