WO2012138224A1 - Food composition for intra-operative tube feeding - Google Patents
Food composition for intra-operative tube feeding Download PDFInfo
- Publication number
- WO2012138224A1 WO2012138224A1 PCT/NL2012/050234 NL2012050234W WO2012138224A1 WO 2012138224 A1 WO2012138224 A1 WO 2012138224A1 NL 2012050234 W NL2012050234 W NL 2012050234W WO 2012138224 A1 WO2012138224 A1 WO 2012138224A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- composition
- fat
- surgery
- proteinaceous matter
- use according
- Prior art date
Links
- 239000000203 mixture Substances 0.000 title claims abstract description 156
- 235000013305 food Nutrition 0.000 title description 7
- 235000016709 nutrition Nutrition 0.000 claims abstract description 163
- 239000007788 liquid Substances 0.000 claims abstract description 80
- 238000001356 surgical procedure Methods 0.000 claims abstract description 53
- 230000010398 acute inflammatory response Effects 0.000 claims abstract description 15
- 230000000116 mitigating effect Effects 0.000 claims abstract description 10
- 235000018102 proteins Nutrition 0.000 claims description 56
- 102000004169 proteins and genes Human genes 0.000 claims description 56
- 108090000623 proteins and genes Proteins 0.000 claims description 56
- 150000001720 carbohydrates Chemical class 0.000 claims description 36
- 235000014633 carbohydrates Nutrition 0.000 claims description 36
- ZDXPYRJPNDTMRX-VKHMYHEASA-N L-glutamine Chemical compound OC(=O)[C@@H](N)CCC(N)=O ZDXPYRJPNDTMRX-VKHMYHEASA-N 0.000 claims description 30
- 229930182816 L-glutamine Natural products 0.000 claims description 22
- 241000209140 Triticum Species 0.000 claims description 13
- 235000021307 Triticum Nutrition 0.000 claims description 13
- HVYWMOMLDIMFJA-DPAQBDIFSA-N cholesterol Chemical compound C1C=C2C[C@@H](O)CC[C@]2(C)[C@@H]2[C@@H]1[C@@H]1CC[C@H]([C@H](C)CCCC(C)C)[C@@]1(C)CC2 HVYWMOMLDIMFJA-DPAQBDIFSA-N 0.000 claims description 12
- 239000005018 casein Substances 0.000 claims description 11
- 235000021240 caseins Nutrition 0.000 claims description 11
- BECPQYXYKAMYBN-UHFFFAOYSA-N casein, tech. Chemical compound NCCCCC(C(O)=O)N=C(O)C(CC(O)=O)N=C(O)C(CCC(O)=N)N=C(O)C(CC(C)C)N=C(O)C(CCC(O)=O)N=C(O)C(CC(O)=O)N=C(O)C(CCC(O)=O)N=C(O)C(C(C)O)N=C(O)C(CCC(O)=N)N=C(O)C(CCC(O)=N)N=C(O)C(CCC(O)=N)N=C(O)C(CCC(O)=O)N=C(O)C(CCC(O)=O)N=C(O)C(COP(O)(O)=O)N=C(O)C(CCC(O)=N)N=C(O)C(N)CC1=CC=CC=C1 BECPQYXYKAMYBN-UHFFFAOYSA-N 0.000 claims description 10
- 108010046377 Whey Proteins Proteins 0.000 claims description 8
- 229940057917 medium chain triglycerides Drugs 0.000 claims description 8
- 102000007544 Whey Proteins Human genes 0.000 claims description 7
- 150000003904 phospholipids Chemical class 0.000 claims description 7
- 208000028399 Critical Illness Diseases 0.000 claims description 6
- 239000005862 Whey Substances 0.000 claims description 6
- 235000012000 cholesterol Nutrition 0.000 claims description 6
- 235000013365 dairy product Nutrition 0.000 claims description 6
- 235000013311 vegetables Nutrition 0.000 claims description 4
- 239000005905 Hydrolysed protein Substances 0.000 claims description 3
- 238000002360 preparation method Methods 0.000 claims description 3
- 239000000413 hydrolysate Substances 0.000 claims description 2
- 238000004519 manufacturing process Methods 0.000 claims description 2
- 230000035764 nutrition Effects 0.000 description 73
- 239000003925 fat Substances 0.000 description 50
- 235000019197 fats Nutrition 0.000 description 50
- 101800001982 Cholecystokinin Proteins 0.000 description 33
- 102100025841 Cholecystokinin Human genes 0.000 description 33
- 229940107137 cholecystokinin Drugs 0.000 description 33
- IZTQOLKUZKXIRV-YRVFCXMDSA-N sincalide Chemical compound C([C@@H](C(=O)N[C@@H](CCSC)C(=O)NCC(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CCSC)C(=O)N[C@@H](CC(O)=O)C(=O)N[C@@H](CC=1C=CC=CC=1)C(N)=O)NC(=O)[C@@H](N)CC(O)=O)C1=CC=C(OS(O)(=O)=O)C=C1 IZTQOLKUZKXIRV-YRVFCXMDSA-N 0.000 description 33
- 239000002158 endotoxin Substances 0.000 description 31
- 229920006008 lipopolysaccharide Polymers 0.000 description 22
- 150000002632 lipids Chemical class 0.000 description 17
- 230000036470 plasma concentration Effects 0.000 description 16
- 241000282414 Homo sapiens Species 0.000 description 15
- 108060008682 Tumor Necrosis Factor Proteins 0.000 description 14
- 102100040247 Tumor necrosis factor Human genes 0.000 description 14
- 208000037487 Endotoxemia Diseases 0.000 description 13
- 102000030914 Fatty Acid-Binding Human genes 0.000 description 11
- 206010061218 Inflammation Diseases 0.000 description 11
- 102000003814 Interleukin-10 Human genes 0.000 description 11
- 102000004889 Interleukin-6 Human genes 0.000 description 11
- 108091022862 fatty acid binding Proteins 0.000 description 11
- 230000004054 inflammatory process Effects 0.000 description 11
- 238000011282 treatment Methods 0.000 description 11
- 108090000174 Interleukin-10 Proteins 0.000 description 10
- 108090001005 Interleukin-6 Proteins 0.000 description 10
- 206010040047 Sepsis Diseases 0.000 description 9
- 230000003110 anti-inflammatory effect Effects 0.000 description 9
- 230000009286 beneficial effect Effects 0.000 description 9
- 230000006378 damage Effects 0.000 description 9
- 229940024606 amino acid Drugs 0.000 description 8
- 235000001014 amino acid Nutrition 0.000 description 8
- 150000001413 amino acids Chemical class 0.000 description 8
- ZDXPYRJPNDTMRX-UHFFFAOYSA-N glutamine Natural products OC(=O)C(N)CCC(N)=O ZDXPYRJPNDTMRX-UHFFFAOYSA-N 0.000 description 8
- 208000014674 injury Diseases 0.000 description 8
- 210000001519 tissue Anatomy 0.000 description 8
- 108010016626 Dipeptides Proteins 0.000 description 7
- 235000021196 dietary intervention Nutrition 0.000 description 7
- 230000000694 effects Effects 0.000 description 7
- 230000028709 inflammatory response Effects 0.000 description 7
- 238000001990 intravenous administration Methods 0.000 description 7
- 108090000765 processed proteins & peptides Proteins 0.000 description 7
- 230000004044 response Effects 0.000 description 7
- WHUUTDBJXJRKMK-VKHMYHEASA-N L-glutamic acid Chemical compound OC(=O)[C@@H](N)CCC(O)=O WHUUTDBJXJRKMK-VKHMYHEASA-N 0.000 description 6
- JAZBEHYOTPTENJ-JLNKQSITSA-N all-cis-5,8,11,14,17-icosapentaenoic acid Chemical compound CC\C=C/C\C=C/C\C=C/C\C=C/C\C=C/CCCC(O)=O JAZBEHYOTPTENJ-JLNKQSITSA-N 0.000 description 6
- 235000020673 eicosapentaenoic acid Nutrition 0.000 description 6
- 229960005135 eicosapentaenoic acid Drugs 0.000 description 6
- JAZBEHYOTPTENJ-UHFFFAOYSA-N eicosapentaenoic acid Natural products CCC=CCC=CCC=CCC=CCC=CCCCC(O)=O JAZBEHYOTPTENJ-UHFFFAOYSA-N 0.000 description 6
- 238000002474 experimental method Methods 0.000 description 6
- 208000015181 infectious disease Diseases 0.000 description 6
- 238000001802 infusion Methods 0.000 description 6
- 230000000968 intestinal effect Effects 0.000 description 6
- 230000001404 mediated effect Effects 0.000 description 6
- 238000000034 method Methods 0.000 description 6
- 235000015097 nutrients Nutrition 0.000 description 6
- 230000002829 reductive effect Effects 0.000 description 6
- 102000004127 Cytokines Human genes 0.000 description 5
- 108090000695 Cytokines Proteins 0.000 description 5
- 230000002757 inflammatory effect Effects 0.000 description 5
- 206010025482 malaise Diseases 0.000 description 5
- 230000009885 systemic effect Effects 0.000 description 5
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Chemical compound OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 4
- 235000010469 Glycine max Nutrition 0.000 description 4
- 208000027418 Wounds and injury Diseases 0.000 description 4
- 230000003247 decreasing effect Effects 0.000 description 4
- 238000011161 development Methods 0.000 description 4
- 230000002519 immonomodulatory effect Effects 0.000 description 4
- 230000008816 organ damage Effects 0.000 description 4
- 235000020777 polyunsaturated fatty acids Nutrition 0.000 description 4
- 230000002980 postoperative effect Effects 0.000 description 4
- 239000000843 powder Substances 0.000 description 4
- 102000004196 processed proteins & peptides Human genes 0.000 description 4
- 230000000770 proinflammatory effect Effects 0.000 description 4
- 230000001954 sterilising effect Effects 0.000 description 4
- 238000004659 sterilization and disinfection Methods 0.000 description 4
- 230000008733 trauma Effects 0.000 description 4
- 150000003626 triacylglycerols Chemical class 0.000 description 4
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 4
- 102000000589 Interleukin-1 Human genes 0.000 description 3
- 108010002352 Interleukin-1 Proteins 0.000 description 3
- 240000004713 Pisum sativum Species 0.000 description 3
- 241000283984 Rodentia Species 0.000 description 3
- 240000008042 Zea mays Species 0.000 description 3
- 235000002017 Zea mays subsp mays Nutrition 0.000 description 3
- 230000004913 activation Effects 0.000 description 3
- 229960002648 alanylglutamine Drugs 0.000 description 3
- 230000002238 attenuated effect Effects 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 239000008280 blood Substances 0.000 description 3
- 150000001875 compounds Chemical class 0.000 description 3
- 235000015872 dietary supplement Nutrition 0.000 description 3
- 235000020669 docosahexaenoic acid Nutrition 0.000 description 3
- 239000008103 glucose Substances 0.000 description 3
- 229960002989 glutamic acid Drugs 0.000 description 3
- 230000028993 immune response Effects 0.000 description 3
- 210000000265 leukocyte Anatomy 0.000 description 3
- 230000007246 mechanism Effects 0.000 description 3
- 230000004060 metabolic process Effects 0.000 description 3
- 230000031990 negative regulation of inflammatory response Effects 0.000 description 3
- 239000003921 oil Substances 0.000 description 3
- 235000019198 oils Nutrition 0.000 description 3
- 210000000056 organ Anatomy 0.000 description 3
- 230000037361 pathway Effects 0.000 description 3
- 230000002265 prevention Effects 0.000 description 3
- 230000007112 pro inflammatory response Effects 0.000 description 3
- 229940044551 receptor antagonist Drugs 0.000 description 3
- 239000002464 receptor antagonist Substances 0.000 description 3
- 238000011084 recovery Methods 0.000 description 3
- 230000011514 reflex Effects 0.000 description 3
- 230000008718 systemic inflammatory response Effects 0.000 description 3
- DVSZKTAMJJTWFG-SKCDLICFSA-N (2e,4e,6e,8e,10e,12e)-docosa-2,4,6,8,10,12-hexaenoic acid Chemical compound CCCCCCCCC\C=C\C=C\C=C\C=C\C=C\C=C\C(O)=O DVSZKTAMJJTWFG-SKCDLICFSA-N 0.000 description 2
- UCTWMZQNUQWSLP-VIFPVBQESA-N (R)-adrenaline Chemical compound CNC[C@H](O)C1=CC=C(O)C(O)=C1 UCTWMZQNUQWSLP-VIFPVBQESA-N 0.000 description 2
- 229930182837 (R)-adrenaline Natural products 0.000 description 2
- GZJLLYHBALOKEX-UHFFFAOYSA-N 6-Ketone, O18-Me-Ussuriedine Natural products CC=CCC=CCC=CCC=CCC=CCC=CCCCC(O)=O GZJLLYHBALOKEX-UHFFFAOYSA-N 0.000 description 2
- 102000011767 Acute-Phase Proteins Human genes 0.000 description 2
- 108010062271 Acute-Phase Proteins Proteins 0.000 description 2
- HJCMDXDYPOUFDY-WHFBIAKZSA-N Ala-Gln Chemical compound C[C@H](N)C(=O)N[C@H](C(O)=O)CCC(N)=O HJCMDXDYPOUFDY-WHFBIAKZSA-N 0.000 description 2
- 241000894006 Bacteria Species 0.000 description 2
- 241000588724 Escherichia coli Species 0.000 description 2
- 241000282412 Homo Species 0.000 description 2
- 206010058558 Hypoperfusion Diseases 0.000 description 2
- 240000006240 Linum usitatissimum Species 0.000 description 2
- 235000004431 Linum usitatissimum Nutrition 0.000 description 2
- 241000124008 Mammalia Species 0.000 description 2
- 241001465754 Metazoa Species 0.000 description 2
- 235000010582 Pisum sativum Nutrition 0.000 description 2
- 235000019484 Rapeseed oil Nutrition 0.000 description 2
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 2
- 108010073771 Soybean Proteins Proteins 0.000 description 2
- 235000019486 Sunflower oil Nutrition 0.000 description 2
- 206010047700 Vomiting Diseases 0.000 description 2
- 235000005824 Zea mays ssp. parviglumis Nutrition 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- MBMBGCFOFBJSGT-KUBAVDMBSA-N all-cis-docosa-4,7,10,13,16,19-hexaenoic acid Chemical compound CC\C=C/C\C=C/C\C=C/C\C=C/C\C=C/C\C=C/CCC(O)=O MBMBGCFOFBJSGT-KUBAVDMBSA-N 0.000 description 2
- 150000001408 amides Chemical class 0.000 description 2
- 238000004458 analytical method Methods 0.000 description 2
- 230000004872 arterial blood pressure Effects 0.000 description 2
- 238000004820 blood count Methods 0.000 description 2
- 230000037396 body weight Effects 0.000 description 2
- 125000004432 carbon atom Chemical group C* 0.000 description 2
- 238000007675 cardiac surgery Methods 0.000 description 2
- 210000004027 cell Anatomy 0.000 description 2
- 238000006243 chemical reaction Methods 0.000 description 2
- 238000002512 chemotherapy Methods 0.000 description 2
- 230000001447 compensatory effect Effects 0.000 description 2
- 235000005822 corn Nutrition 0.000 description 2
- 230000007423 decrease Effects 0.000 description 2
- 230000006735 deficit Effects 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 235000014113 dietary fatty acids Nutrition 0.000 description 2
- KAUVQQXNCKESLC-UHFFFAOYSA-N docosahexaenoic acid (DHA) Natural products COC(=O)C(C)NOCC1=CC=CC=C1 KAUVQQXNCKESLC-UHFFFAOYSA-N 0.000 description 2
- 210000001842 enterocyte Anatomy 0.000 description 2
- 229960005139 epinephrine Drugs 0.000 description 2
- 229930195729 fatty acid Natural products 0.000 description 2
- 239000000194 fatty acid Substances 0.000 description 2
- 150000004665 fatty acids Chemical class 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 2
- 239000003862 glucocorticoid Substances 0.000 description 2
- RWSXRVCMGQZWBV-WDSKDSINSA-N glutathione Chemical compound OC(=O)[C@@H](N)CCC(=O)N[C@@H](CS)C(=O)NCC(O)=O RWSXRVCMGQZWBV-WDSKDSINSA-N 0.000 description 2
- 125000005456 glyceride group Chemical group 0.000 description 2
- 230000002489 hematologic effect Effects 0.000 description 2
- 230000000004 hemodynamic effect Effects 0.000 description 2
- 230000002458 infectious effect Effects 0.000 description 2
- 230000004968 inflammatory condition Effects 0.000 description 2
- 230000005764 inhibitory process Effects 0.000 description 2
- 208000028867 ischemia Diseases 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 150000004667 medium chain fatty acids Chemical class 0.000 description 2
- 244000005700 microbiome Species 0.000 description 2
- 239000001788 mono and diglycerides of fatty acids Substances 0.000 description 2
- 235000006180 nutrition needs Nutrition 0.000 description 2
- 230000002035 prolonged effect Effects 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 230000008439 repair process Effects 0.000 description 2
- 230000010410 reperfusion Effects 0.000 description 2
- 150000004671 saturated fatty acids Chemical class 0.000 description 2
- 235000003441 saturated fatty acids Nutrition 0.000 description 2
- 230000035939 shock Effects 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 229940001941 soy protein Drugs 0.000 description 2
- 239000002600 sunflower oil Substances 0.000 description 2
- 239000013589 supplement Substances 0.000 description 2
- 208000024891 symptom Diseases 0.000 description 2
- 229940037128 systemic glucocorticoids Drugs 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 230000000451 tissue damage Effects 0.000 description 2
- 231100000827 tissue damage Toxicity 0.000 description 2
- 230000001515 vagal effect Effects 0.000 description 2
- 230000008673 vomiting Effects 0.000 description 2
- 235000021119 whey protein Nutrition 0.000 description 2
- 230000029663 wound healing Effects 0.000 description 2
- HDTRYLNUVZCQOY-UHFFFAOYSA-N α-D-glucopyranosyl-α-D-glucopyranoside Natural products OC1C(O)C(O)C(CO)OC1OC1C(O)C(O)C(O)C(CO)O1 HDTRYLNUVZCQOY-UHFFFAOYSA-N 0.000 description 1
- OWEGMIWEEQEYGQ-UHFFFAOYSA-N 100676-05-9 Natural products OC1C(O)C(O)C(CO)OC1OCC1C(O)C(O)C(O)C(OC2C(OC(O)C(O)C2O)CO)O1 OWEGMIWEEQEYGQ-UHFFFAOYSA-N 0.000 description 1
- TWJNQYPJQDRXPH-UHFFFAOYSA-N 2-cyanobenzohydrazide Chemical compound NNC(=O)C1=CC=CC=C1C#N TWJNQYPJQDRXPH-UHFFFAOYSA-N 0.000 description 1
- PVXPPJIGRGXGCY-DJHAAKORSA-N 6-O-alpha-D-glucopyranosyl-alpha-D-fructofuranose Chemical compound O[C@@H]1[C@@H](O)[C@H](O)[C@@H](CO)O[C@@H]1OC[C@@H]1[C@@H](O)[C@H](O)[C@](O)(CO)O1 PVXPPJIGRGXGCY-DJHAAKORSA-N 0.000 description 1
- GUBGYTABKSRVRQ-XLOQQCSPSA-N Alpha-Lactose Chemical compound O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O GUBGYTABKSRVRQ-XLOQQCSPSA-N 0.000 description 1
- 235000019737 Animal fat Nutrition 0.000 description 1
- BSYNRYMUTXBXSQ-UHFFFAOYSA-N Aspirin Chemical compound CC(=O)OC1=CC=CC=C1C(O)=O BSYNRYMUTXBXSQ-UHFFFAOYSA-N 0.000 description 1
- 208000031729 Bacteremia Diseases 0.000 description 1
- 241001416153 Bos grunniens Species 0.000 description 1
- 241000283690 Bos taurus Species 0.000 description 1
- 235000014698 Brassica juncea var multisecta Nutrition 0.000 description 1
- 235000006008 Brassica napus var napus Nutrition 0.000 description 1
- 235000006618 Brassica rapa subsp oleifera Nutrition 0.000 description 1
- 244000188595 Brassica sinapistrum Species 0.000 description 1
- 235000004977 Brassica sinapistrum Nutrition 0.000 description 1
- 241000030939 Bubalus bubalis Species 0.000 description 1
- 241000282836 Camelus dromedarius Species 0.000 description 1
- 244000025254 Cannabis sativa Species 0.000 description 1
- 235000012766 Cannabis sativa ssp. sativa var. sativa Nutrition 0.000 description 1
- 235000012765 Cannabis sativa ssp. sativa var. spontanea Nutrition 0.000 description 1
- 241000283707 Capra Species 0.000 description 1
- 108010076119 Caseins Proteins 0.000 description 1
- 206010007733 Catabolic state Diseases 0.000 description 1
- 206010008531 Chills Diseases 0.000 description 1
- 244000045195 Cicer arietinum Species 0.000 description 1
- 235000010523 Cicer arietinum Nutrition 0.000 description 1
- 229920002261 Corn starch Polymers 0.000 description 1
- QNAYBMKLOCPYGJ-UHFFFAOYSA-N D-alpha-Ala Natural products CC([NH3+])C([O-])=O QNAYBMKLOCPYGJ-UHFFFAOYSA-N 0.000 description 1
- 244000000626 Daucus carota Species 0.000 description 1
- 235000002767 Daucus carota Nutrition 0.000 description 1
- 238000002965 ELISA Methods 0.000 description 1
- 241000196324 Embryophyta Species 0.000 description 1
- 241000283073 Equus caballus Species 0.000 description 1
- 229930091371 Fructose Natural products 0.000 description 1
- 239000005715 Fructose Substances 0.000 description 1
- RFSUNEUAIZKAJO-ARQDHWQXSA-N Fructose Chemical compound OC[C@H]1O[C@](O)(CO)[C@@H](O)[C@@H]1O RFSUNEUAIZKAJO-ARQDHWQXSA-N 0.000 description 1
- OPGOLNDOMSBSCW-CLNHMMGSSA-N Fursultiamine hydrochloride Chemical compound Cl.C1CCOC1CSSC(\CCO)=C(/C)N(C=O)CC1=CN=C(C)N=C1N OPGOLNDOMSBSCW-CLNHMMGSSA-N 0.000 description 1
- 208000018522 Gastrointestinal disease Diseases 0.000 description 1
- 102000007446 Glucagon-Like Peptide-1 Receptor Human genes 0.000 description 1
- 108010086246 Glucagon-Like Peptide-1 Receptor Proteins 0.000 description 1
- 102400000322 Glucagon-like peptide 1 Human genes 0.000 description 1
- DTHNMHAUYICORS-KTKZVXAJSA-N Glucagon-like peptide 1 Chemical compound C([C@@H](C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H](C)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCCN)C(=O)NCC(=O)N[C@@H](CCCNC(N)=N)C(N)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCCN)NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(N)=O)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C)NC(=O)[C@@H](N)CC=1N=CNC=1)[C@@H](C)O)[C@@H](C)O)C(C)C)C1=CC=CC=C1 DTHNMHAUYICORS-KTKZVXAJSA-N 0.000 description 1
- 101800000224 Glucagon-like peptide 1 Proteins 0.000 description 1
- 208000002705 Glucose Intolerance Diseases 0.000 description 1
- 206010018429 Glucose tolerance impaired Diseases 0.000 description 1
- WHUUTDBJXJRKMK-UHFFFAOYSA-N Glutamic acid Natural products OC(=O)C(N)CCC(O)=O WHUUTDBJXJRKMK-UHFFFAOYSA-N 0.000 description 1
- 108010024636 Glutathione Proteins 0.000 description 1
- 206010019233 Headaches Diseases 0.000 description 1
- 102000002812 Heat-Shock Proteins Human genes 0.000 description 1
- 108010004889 Heat-Shock Proteins Proteins 0.000 description 1
- 240000005979 Hordeum vulgare Species 0.000 description 1
- 235000007340 Hordeum vulgare Nutrition 0.000 description 1
- 206010061598 Immunodeficiency Diseases 0.000 description 1
- 208000029462 Immunodeficiency disease Diseases 0.000 description 1
- 208000022559 Inflammatory bowel disease Diseases 0.000 description 1
- 206010022004 Influenza like illness Diseases 0.000 description 1
- 206010022489 Insulin Resistance Diseases 0.000 description 1
- 102000019223 Interleukin-1 receptor Human genes 0.000 description 1
- 108050006617 Interleukin-1 receptor Proteins 0.000 description 1
- 101710144554 Interleukin-1 receptor antagonist protein Proteins 0.000 description 1
- 102100026018 Interleukin-1 receptor antagonist protein Human genes 0.000 description 1
- 108010017550 Interleukin-10 Receptors Proteins 0.000 description 1
- 108010038501 Interleukin-6 Receptors Proteins 0.000 description 1
- 102000015696 Interleukins Human genes 0.000 description 1
- 108010063738 Interleukins Proteins 0.000 description 1
- AYRXSINWFIIFAE-SCLMCMATSA-N Isomaltose Natural products OC[C@H]1O[C@H](OC[C@@H](O)[C@@H](O)[C@H](O)[C@@H](O)C=O)[C@@H](O)[C@@H](O)[C@@H]1O AYRXSINWFIIFAE-SCLMCMATSA-N 0.000 description 1
- QNAYBMKLOCPYGJ-UWTATZPHSA-N L-Alanine Natural products C[C@@H](N)C(O)=O QNAYBMKLOCPYGJ-UWTATZPHSA-N 0.000 description 1
- QNAYBMKLOCPYGJ-REOHCLBHSA-N L-alanine Chemical compound C[C@H](N)C(O)=O QNAYBMKLOCPYGJ-REOHCLBHSA-N 0.000 description 1
- 125000003412 L-alanyl group Chemical group [H]N([H])[C@@](C([H])([H])[H])(C(=O)[*])[H] 0.000 description 1
- GUBGYTABKSRVRQ-QKKXKWKRSA-N Lactose Natural products OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)C(O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-QKKXKWKRSA-N 0.000 description 1
- 208000017170 Lipid metabolism disease Diseases 0.000 description 1
- 241000219745 Lupinus Species 0.000 description 1
- 206010025476 Malabsorption Diseases 0.000 description 1
- 208000004155 Malabsorption Syndromes Diseases 0.000 description 1
- 229920002774 Maltodextrin Polymers 0.000 description 1
- GUBGYTABKSRVRQ-PICCSMPSSA-N Maltose Natural products O[C@@H]1[C@@H](O)[C@H](O)[C@@H](CO)O[C@@H]1O[C@@H]1[C@@H](CO)OC(O)[C@H](O)[C@H]1O GUBGYTABKSRVRQ-PICCSMPSSA-N 0.000 description 1
- 208000006670 Multiple fractures Diseases 0.000 description 1
- 241000699670 Mus sp. Species 0.000 description 1
- 208000000112 Myalgia Diseases 0.000 description 1
- 235000021360 Myristic acid Nutrition 0.000 description 1
- TUNFSRHWOTWDNC-UHFFFAOYSA-N Myristic acid Natural products CCCCCCCCCCCCCC(O)=O TUNFSRHWOTWDNC-UHFFFAOYSA-N 0.000 description 1
- DEFJQIDDEAULHB-UHFFFAOYSA-N N-D-alanyl-D-alanine Natural products CC(N)C(=O)NC(C)C(O)=O DEFJQIDDEAULHB-UHFFFAOYSA-N 0.000 description 1
- GXCLVBGFBYZDAG-UHFFFAOYSA-N N-[2-(1H-indol-3-yl)ethyl]-N-methylprop-2-en-1-amine Chemical compound CN(CCC1=CNC2=C1C=CC=C2)CC=C GXCLVBGFBYZDAG-UHFFFAOYSA-N 0.000 description 1
- 206010028813 Nausea Diseases 0.000 description 1
- 206010028980 Neoplasm Diseases 0.000 description 1
- 240000007594 Oryza sativa Species 0.000 description 1
- 235000007164 Oryza sativa Nutrition 0.000 description 1
- 208000002193 Pain Diseases 0.000 description 1
- 235000019482 Palm oil Nutrition 0.000 description 1
- 241000282376 Panthera tigris Species 0.000 description 1
- 241001494479 Pecora Species 0.000 description 1
- 108010044422 Peptamen Proteins 0.000 description 1
- 244000046052 Phaseolus vulgaris Species 0.000 description 1
- 235000016816 Pisum sativum subsp sativum Nutrition 0.000 description 1
- 241000282941 Rangifer tarandus Species 0.000 description 1
- 208000004756 Respiratory Insufficiency Diseases 0.000 description 1
- 229930006000 Sucrose Natural products 0.000 description 1
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 1
- 206010051379 Systemic Inflammatory Response Syndrome Diseases 0.000 description 1
- HDTRYLNUVZCQOY-WSWWMNSNSA-N Trehalose Natural products O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@@H]1O[C@@H]1[C@H](O)[C@@H](O)[C@@H](O)[C@@H](CO)O1 HDTRYLNUVZCQOY-WSWWMNSNSA-N 0.000 description 1
- 235000016383 Zea mays subsp huehuetenangensis Nutrition 0.000 description 1
- 229920002494 Zein Polymers 0.000 description 1
- 238000010521 absorption reaction Methods 0.000 description 1
- 229960001138 acetylsalicylic acid Drugs 0.000 description 1
- 239000002253 acid Substances 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 208000038016 acute inflammation Diseases 0.000 description 1
- 230000006022 acute inflammation Effects 0.000 description 1
- 229960003767 alanine Drugs 0.000 description 1
- HDTRYLNUVZCQOY-LIZSDCNHSA-N alpha,alpha-trehalose Chemical compound O[C@@H]1[C@@H](O)[C@H](O)[C@@H](CO)O[C@@H]1O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 HDTRYLNUVZCQOY-LIZSDCNHSA-N 0.000 description 1
- 125000003277 amino group Chemical group 0.000 description 1
- 238000000540 analysis of variance Methods 0.000 description 1
- 235000020244 animal milk Nutrition 0.000 description 1
- 230000006907 apoptotic process Effects 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 230000000386 athletic effect Effects 0.000 description 1
- 230000003190 augmentative effect Effects 0.000 description 1
- 230000001580 bacterial effect Effects 0.000 description 1
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 1
- GUBGYTABKSRVRQ-QUYVBRFLSA-N beta-maltose Chemical compound OC[C@H]1O[C@H](O[C@H]2[C@H](O)[C@@H](O)[C@H](O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@@H]1O GUBGYTABKSRVRQ-QUYVBRFLSA-N 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 238000010241 blood sampling Methods 0.000 description 1
- 230000036760 body temperature Effects 0.000 description 1
- 235000014121 butter Nutrition 0.000 description 1
- 238000004364 calculation method Methods 0.000 description 1
- 235000009120 camo Nutrition 0.000 description 1
- 201000011510 cancer Diseases 0.000 description 1
- 239000000828 canola oil Substances 0.000 description 1
- 235000019519 canola oil Nutrition 0.000 description 1
- 230000001925 catabolic effect Effects 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 230000005779 cell damage Effects 0.000 description 1
- 208000037887 cell injury Diseases 0.000 description 1
- 235000005607 chanvre indien Nutrition 0.000 description 1
- 230000001713 cholinergic effect Effects 0.000 description 1
- 208000037976 chronic inflammation Diseases 0.000 description 1
- 208000037893 chronic inflammatory disorder Diseases 0.000 description 1
- 230000004087 circulation Effects 0.000 description 1
- 239000003240 coconut oil Substances 0.000 description 1
- 235000019864 coconut oil Nutrition 0.000 description 1
- 230000002153 concerted effect Effects 0.000 description 1
- 230000036757 core body temperature Effects 0.000 description 1
- 235000005687 corn oil Nutrition 0.000 description 1
- 239000002285 corn oil Substances 0.000 description 1
- 239000008120 corn starch Substances 0.000 description 1
- 230000002596 correlated effect Effects 0.000 description 1
- 230000001186 cumulative effect Effects 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 230000003111 delayed effect Effects 0.000 description 1
- 206010012601 diabetes mellitus Diseases 0.000 description 1
- 238000011026 diafiltration Methods 0.000 description 1
- 235000013325 dietary fiber Nutrition 0.000 description 1
- 235000018823 dietary intake Nutrition 0.000 description 1
- 230000029087 digestion Effects 0.000 description 1
- 230000001079 digestive effect Effects 0.000 description 1
- 235000019961 diglycerides of fatty acid Nutrition 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 229940090949 docosahexaenoic acid Drugs 0.000 description 1
- 230000002183 duodenal effect Effects 0.000 description 1
- 150000002066 eicosanoids Chemical class 0.000 description 1
- 230000007071 enzymatic hydrolysis Effects 0.000 description 1
- 238000006047 enzymatic hydrolysis reaction Methods 0.000 description 1
- 239000003797 essential amino acid Substances 0.000 description 1
- 235000020776 essential amino acid Nutrition 0.000 description 1
- 238000013401 experimental design Methods 0.000 description 1
- 238000001914 filtration Methods 0.000 description 1
- 235000004426 flaxseed Nutrition 0.000 description 1
- 238000000684 flow cytometry Methods 0.000 description 1
- 235000012041 food component Nutrition 0.000 description 1
- 230000037406 food intake Effects 0.000 description 1
- 238000009472 formulation Methods 0.000 description 1
- 230000002538 fungal effect Effects 0.000 description 1
- 210000000232 gallbladder Anatomy 0.000 description 1
- 230000002496 gastric effect Effects 0.000 description 1
- 210000003736 gastrointestinal content Anatomy 0.000 description 1
- 230000002068 genetic effect Effects 0.000 description 1
- 235000013922 glutamic acid Nutrition 0.000 description 1
- 239000004220 glutamic acid Substances 0.000 description 1
- 229960003180 glutathione Drugs 0.000 description 1
- 150000004676 glycans Chemical class 0.000 description 1
- 230000005484 gravity Effects 0.000 description 1
- 231100000869 headache Toxicity 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 230000036541 health Effects 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 239000011487 hemp Substances 0.000 description 1
- 208000002672 hepatitis B Diseases 0.000 description 1
- 125000002887 hydroxy group Chemical group [H]O* 0.000 description 1
- 201000001421 hyperglycemia Diseases 0.000 description 1
- 230000001900 immune effect Effects 0.000 description 1
- 230000036737 immune function Effects 0.000 description 1
- 230000036039 immunity Effects 0.000 description 1
- 230000007813 immunodeficiency Effects 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 230000002401 inhibitory effect Effects 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 230000015788 innate immune response Effects 0.000 description 1
- 229910052500 inorganic mineral Inorganic materials 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 229940047122 interleukins Drugs 0.000 description 1
- 210000002490 intestinal epithelial cell Anatomy 0.000 description 1
- 230000003871 intestinal function Effects 0.000 description 1
- 230000004207 intestinal integrity Effects 0.000 description 1
- 230000035987 intoxication Effects 0.000 description 1
- 231100000566 intoxication Toxicity 0.000 description 1
- 238000010253 intravenous injection Methods 0.000 description 1
- 238000011835 investigation Methods 0.000 description 1
- DLRVVLDZNNYCBX-RTPHMHGBSA-N isomaltose Chemical compound O[C@@H]1[C@@H](O)[C@H](O)[C@@H](CO)O[C@@H]1OC[C@@H]1[C@@H](O)[C@H](O)[C@@H](O)C(O)O1 DLRVVLDZNNYCBX-RTPHMHGBSA-N 0.000 description 1
- 210000003734 kidney Anatomy 0.000 description 1
- 239000008101 lactose Substances 0.000 description 1
- 230000002045 lasting effect Effects 0.000 description 1
- 231100000225 lethality Toxicity 0.000 description 1
- 150000002617 leukotrienes Chemical class 0.000 description 1
- 230000000670 limiting effect Effects 0.000 description 1
- 229960004488 linolenic acid Drugs 0.000 description 1
- 239000000944 linseed oil Substances 0.000 description 1
- 235000021388 linseed oil Nutrition 0.000 description 1
- 150000004668 long chain fatty acids Chemical class 0.000 description 1
- 235000021237 low-digestible carbohydrates Nutrition 0.000 description 1
- 235000009973 maize Nutrition 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000002503 metabolic effect Effects 0.000 description 1
- 230000037323 metabolic rate Effects 0.000 description 1
- 235000013336 milk Nutrition 0.000 description 1
- 239000008267 milk Substances 0.000 description 1
- 210000004080 milk Anatomy 0.000 description 1
- 235000020166 milkshake Nutrition 0.000 description 1
- 239000011707 mineral Substances 0.000 description 1
- 235000010755 mineral Nutrition 0.000 description 1
- 238000002156 mixing Methods 0.000 description 1
- 235000019960 monoglycerides of fatty acid Nutrition 0.000 description 1
- 230000008383 multiple organ dysfunction Effects 0.000 description 1
- 238000008995 multiplex Luminex assay kit Methods 0.000 description 1
- 238000001728 nano-filtration Methods 0.000 description 1
- 230000008693 nausea Effects 0.000 description 1
- 229940021182 non-steroidal anti-inflammatory drug Drugs 0.000 description 1
- 150000002482 oligosaccharides Polymers 0.000 description 1
- 239000004006 olive oil Substances 0.000 description 1
- 235000008390 olive oil Nutrition 0.000 description 1
- 235000020660 omega-3 fatty acid Nutrition 0.000 description 1
- 238000001543 one-way ANOVA Methods 0.000 description 1
- 229940094443 oxytocics prostaglandins Drugs 0.000 description 1
- 238000004806 packaging method and process Methods 0.000 description 1
- 230000036407 pain Effects 0.000 description 1
- 239000002540 palm oil Substances 0.000 description 1
- 238000009928 pasteurization Methods 0.000 description 1
- 244000052769 pathogen Species 0.000 description 1
- 230000007170 pathology Effects 0.000 description 1
- 239000002831 pharmacologic agent Substances 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 229920001282 polysaccharide Polymers 0.000 description 1
- 239000005017 polysaccharide Substances 0.000 description 1
- 238000010149 post-hoc-test Methods 0.000 description 1
- 230000000291 postprandial effect Effects 0.000 description 1
- GCYXWQUSHADNBF-AAEALURTSA-N preproglucagon 78-108 Chemical compound C([C@@H](C(=O)N[C@@H]([C@@H](C)CC)C(=O)N[C@@H](C)C(=O)N[C@@H](CC=1C2=CC=CC=C2NC=1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CCCCN)C(=O)NCC(=O)N[C@@H](CCCNC(N)=N)C(=O)NCC(O)=O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCCN)NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(N)=O)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC=1C=CC(O)=CC=1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC(O)=O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC=1C=CC=CC=1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](C)NC(=O)[C@@H](N)CC=1N=CNC=1)[C@@H](C)O)[C@@H](C)O)C(C)C)C1=CC=CC=C1 GCYXWQUSHADNBF-AAEALURTSA-N 0.000 description 1
- 239000000955 prescription drug Substances 0.000 description 1
- 230000008569 process Effects 0.000 description 1
- 239000000047 product Substances 0.000 description 1
- 150000003180 prostaglandins Chemical class 0.000 description 1
- 239000003531 protein hydrolysate Substances 0.000 description 1
- 238000001243 protein synthesis Methods 0.000 description 1
- 238000003127 radioimmunoassay Methods 0.000 description 1
- 238000001959 radiotherapy Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 201000004193 respiratory failure Diseases 0.000 description 1
- 235000009566 rice Nutrition 0.000 description 1
- 238000011808 rodent model Methods 0.000 description 1
- 230000036186 satiety Effects 0.000 description 1
- 235000019627 satiety Nutrition 0.000 description 1
- 229920006395 saturated elastomer Polymers 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 210000004872 soft tissue Anatomy 0.000 description 1
- 239000003549 soybean oil Substances 0.000 description 1
- 235000012424 soybean oil Nutrition 0.000 description 1
- 241000894007 species Species 0.000 description 1
- 238000007619 statistical method Methods 0.000 description 1
- JIWBIWFOSCKQMA-UHFFFAOYSA-N stearidonic acid Natural products CCC=CCC=CCC=CCC=CCCCCC(O)=O JIWBIWFOSCKQMA-UHFFFAOYSA-N 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 239000005720 sucrose Substances 0.000 description 1
- 230000008961 swelling Effects 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 239000006188 syrup Substances 0.000 description 1
- 235000020357 syrup Nutrition 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 235000013619 trace mineral Nutrition 0.000 description 1
- 239000011573 trace mineral Substances 0.000 description 1
- 238000012549 training Methods 0.000 description 1
- 230000014616 translation Effects 0.000 description 1
- 238000011277 treatment modality Methods 0.000 description 1
- 230000001960 triggered effect Effects 0.000 description 1
- 238000007492 two-way ANOVA Methods 0.000 description 1
- 208000001072 type 2 diabetes mellitus Diseases 0.000 description 1
- 238000000108 ultra-filtration Methods 0.000 description 1
- 235000015112 vegetable and seed oil Nutrition 0.000 description 1
- 235000019871 vegetable fat Nutrition 0.000 description 1
- 239000008158 vegetable oil Substances 0.000 description 1
- 230000003612 virological effect Effects 0.000 description 1
- 229940088594 vitamin Drugs 0.000 description 1
- 235000013343 vitamin Nutrition 0.000 description 1
- 239000011782 vitamin Substances 0.000 description 1
- 229930003231 vitamin Natural products 0.000 description 1
- 239000005019 zein Substances 0.000 description 1
- 229940093612 zein Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
- A23L33/115—Fatty acids or derivatives thereof; Fats or oils
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
- A23L33/17—Amino acids, peptides or proteins
- A23L33/175—Amino acids
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
- A23L33/17—Amino acids, peptides or proteins
- A23L33/18—Peptides; Protein hydrolysates
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
- A23L33/17—Amino acids, peptides or proteins
- A23L33/185—Vegetable proteins
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/10—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
- A23L33/17—Amino acids, peptides or proteins
- A23L33/19—Dairy proteins
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23L—FOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
- A23L33/00—Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
- A23L33/40—Complete food formulations for specific consumer groups or specific purposes, e.g. infant formula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P3/00—Drugs for disorders of the metabolism
- A61P3/02—Nutrients, e.g. vitamins, minerals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
-
- A—HUMAN NECESSITIES
- A23—FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
- A23V—INDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
- A23V2002/00—Food compositions, function of food ingredients or processes for food or foodstuffs
Definitions
- the invention pertains to liquid nutritional compositions and to the use thereof for mitigating, attenuating or preventing an acute inflammatory response during or after surgery by intra-operative administration by tube feeding of a lipid-rich and protein-rich liquid nutritional composition.
- the body of mammals may respond to stressors with an inflammatory reaction.
- Stressors can be of infectious or non-infectious origin.
- Examples of stressors are microorganisms (viral, bacterial, fungal, or parasitical) or non-endogenous proteins or peptide-related materials which have invaded a tissue locally, physical traumas including surgery, severe blood loss, extracorporal circulation or extensive soft tissue damage and multiple fractures, ischemia/reperfusion events, or damage to cells or tissue due to burns, chemotherapy, radiation or intoxication.
- many factors play a role.
- Inflammatory mediators including acute- phase proteins, interleukins, prostaglandins, cytokines and leukotrienes, contribute to a concerted number of responses within the body in order to obtain an appropriate metabolism and host defence reaction (i.e. blood flow to the affected tissue, repair processes and combat against undesired exogenous components and apoptosis of endogenous cells) in order to obtain an appropriate host defence-reaction, in particular to rapidly and effectively neutralise stressors, obtain rapid wound healing, prevent tissue damage as caused by ischemia/- reperfusion processes or chemo- or radiotherapy and achieve a fast repair of tissue function.
- an appropriate metabolism and host defence reaction i.e. blood flow to the affected tissue, repair processes and combat against undesired exogenous components and apoptosis of endogenous cells
- host defence-reaction in particular to rapidly and effectively neutralise stressors
- Enteral feeding of patients during surgery is known for patients suffering from severe burn injuries (ref. 48-49).
- the feeding is not performed to mitigate, attenuate or prevent an acute inflammatory response during or after surgery but to meet their significant nutritional demands, reduce caloric deficit and because such patients cannot be fed otherwise.
- surgery is limited to skin surgery, i.e. non-invasive surgery.
- the administration of said enteral nutrition is practical to apply by the use of known enteral feeding devices, in particular tubes, and prevents in particular the development of a (too) strong or dysregulated inflammatory response during and following the presence of the stressor and the subsequent healing process by a rapid mode of action.
- the inflammatory reaction has already started, it prevents a further increase of the inflammatory reaction, a so-called hyperinflammation. A reduction of the hyperinflammatory response has been associated with an enhanced recovery after surgery.
- the problem to be solved by the invention is to provide a liquid nutritional composition capable of rapidly averting short-time inflammatory effects, in particular with a surgical medical intervention, preferably an invasive surgical medical intervention.
- An invasive surgical medical intervention is one which penetrates or breaks the skin or enters a body cavity. Examples of invasive procedures include those that involve perforation, an incision, a catheterization, or other entry into the body.
- An specific invasive surgical medical intervention is an open surgery cutting skin and tissues so the surgeon has a direct access to the structures or organs involved. The structures and tissues involved can be seen and touched, and they are directly exposed to the air of the operating room. Examples of open surgery include the removal of organs, such as the gallbladder or kidney, and most types of cardiac surgery and neurosurgery. Open surgery involves large incisions, in which the tissues are exposed to the air.
- lipid-rich nutrition is beneficial for attenuating or preventing an acute inflammatory response and organ damage via a cholecystokinin (CCK)-mediated vagovagal reflex.
- CCK cholecystokinin
- protein is beneficial for attenuating or preventing an acute inflammatory response and organ damage via a cholecystokinin (CCK)-mediated vagovagal reflex.
- the fat provides a fast and high CCK response whereas the protein delivers a lower but more sustainable CCK release. Surprisingly, both responses together deliver the optimal mediation of the cholecystokinin-mediated vagovagal reflex.
- the high amount of protein provides the necessary amino acids (in particular glutamine) for the recovery of patients, in particular by (i) minimizing catabolic protein response, (ii) maintaining gut function and gut immunity, and (iii) supporting the acute phase protein synthesis.
- intra-operative feeding is the main application area of the invention.
- the wording "peri-operative” and/or “peroperative” feeding is often found to denote a feeding protocol which includes preoperative (i.e. before surgery) and/or post-operative (i.e. after surgery) feeding, but excludes intra-operative feeding.
- intra-operative feeding refers to a feeding regime during operation and does not refer to pre- or post-operative feeding.
- the liquid nutritional composition of the invention can also be suitably used for pre- and post-operative feeding.
- the enteral feeding can be started before the surgical procedure, i.e. in the pre-operative phase, and can be continued after the surgical procedure, i.e. in the post-operative phase.
- the invention also relates to the liquid nutritional composition of the invention for peri-operative use.
- a percentage of the total energy of the composition is abbreviated as En% and is used to denote the energetic value of a digestible compound (fat, protein, carbohydrates, fibres) (in particular in a human or other mammal).
- the energetic value is based on the contribution of proteinaceous matter (including proteins, peptides and amino acids), lipids or fat and digestible carbohydrates, using the following calculation factors (Atwater factors): 4 kcal/g for digestible carbohydrates and proteinaceous matter, 9 kcal/g for lipids and 2 kcal/g for digestible fibres.
- the beneficial effect of a high fat enteral composition for the treatment and/or prevention of sepsis or for combating inflammatory conditions is known from the prior art.
- the beneficial effect of a high protein content in combination of a high fat content is not disclosed, nor is such a composition according to the invention.
- EP 1 411 951 Bl discloses the use of a composition containing a fat fraction comprising phospholipids , triglycerides and cholesterol in a weight ratio of 3-90 : 3-80 : 1 , a protein fraction and a digestible carbohydrate fraction for the treatment and/or prevention of sepsis, endotoxemia and/or bacteraemia, which may be associated with major surgery, critical illness, inflammatory bowel disease etc., caused by bacteria.
- EP 1 589 834 Bl similarly discloses the use of a composition containing a fat fraction comprising phospholipids and triglycerides in a weight ratio of greater than 1, with less than 0.5 weight% of cholesterol, a protein fraction and a digestible carbohydrate fraction, for the treatment of sepsis and associated conditions.
- a composition containing a fat fraction comprising phospholipids and triglycerides in a weight ratio of greater than 1, with less than 0.5 weight% of cholesterol, a protein fraction and a digestible carbohydrate fraction for the treatment of sepsis and associated conditions.
- the beneficial role of a high protein content is not disclosed, nor is a composition according to the invention.
- US 5,968,896 (Beth Israel Deaconess Medical Center) discloses a solid or semi-solid nutritional supplement for pre-operative feeding comprising 26 - 46 En% of fat, 20 - 40 En% of proteins and 25 - 45 En% of digestible carbohydrates for individuals preparing for an imminent major surgical procedure, preferably a non-baked extruded nutritional bar of approximately 200 kcal (one serving).
- EP 1 041 896 Bl discloses compositions containing a fat blend comprising [gamma] -linolenic acid, stearidonic acid and eicosapentaenoic acid (2 : 1 : 2) and phospholipids as an enteral food for the treatment of chronic inflammatory diseases, lipid metabolism disorders and weakened immune functions.
- EP 1 090 636 discloses a composition for use in the treatment of sepsis or inflammatory shock, which comprises more than 35 En% of lipids.
- the lipid fraction comprises 25-70 weight% MCT oil. Less than 15 weight% saturated fatty acids excluding MCT and the n- 6/n-3 ratio is about 2-7 : 1.
- EP 0 265 772 claims a nutritional formula comprising 45 - 60 En% of fat, 20 - 37 En% of digestible carbohydrates and 8 - 25 En% of proteins for humans suffering from glucose intolerance.
- the disclosed examples are limited to high fat compositions comprising at most 20 En% of proteins.
- EP 0 691 079 claims a nutritional formula comprising 30 - 45 En% of fat, at most 50 En% of digestible carbohydrates and 8 - 25 En% of proteins for use with diabetic patients.
- the disclosed example is limited to a composition comprising at 18 En% of proteins.
- EP 0 189 160 claims a high fat, low carbohydrate enteral nutritional composition comprising 45 - 60 En% of fat, at most 30 En% of digestible carbohydrates and 8 - 25 En% of proteins for treating patients with respiratory insufficiency.
- the example discloses a composition comprising 55 En% of fat, 19 En% of protein and 26 En% of carbohydrates.
- EP 0 611 568 (Fresenius) claims a nutritional composition for cancer patients suitable to be used as a tube feed, comprising 40 to 65 En% of fat, 20 to 45 En% of digestible carbohydrates and 12 to 25 En% of proteins. All examples disclose compositions with at most 20 En% of proteins.
- US 7,691,906 discloses an enteral composition for the treatment or prevention of sepsis or inflammatory shock, optionally administered by tube feeding, comprising at least 35 En% of fat which comprises at least 40 to 70 weight% of an MCT, 10 to 25 En% of proteins and 12 to 55 En% of carbohydrates.
- the invention pertains to liquid nutritional compositions comprising a high amount of fat and a high amount of proteinaceous matter and to the use thereof for mitigating, attenuating or preventing an acute inflammatory response during or after surgery of a patient undergoing said surgery, wherein said composition is to be administered to said patient by intra-operative tube feeding.
- This setting requires an immediate effect of the feeding, wherein the effect of the feeding consists in attenuation of the inflammatory response.
- the immediate response means that the attenuation starts within 30 minutes, preferably within 15 minutes, and lasts for several hours, in particular for 1 to 3 hours after the intervention has stopped.
- the invention relates to a liquid nutritional composition
- a liquid nutritional composition comprising fat and proteinaceous matter, wherein said fat contributes for at least 41 En% and said proteinaceous matter contributes for at least 23 En% to the total energy content of said composition or mitigating, attenuating or preventing an acute inflammatory response during or after surgery of a patient undergoing said surgery, wherein said composition is to be administered to said patient by intra-operative tube feeding.
- the invention relates to a liquid nutritional composition
- a liquid nutritional composition comprising fat, proteinaceous matter and digestible carbohydrates, wherein said fat contributes for at least 41 En%, said proteinaceous matter contributes for at least 23 En%, and said digestible carbohydrates contribute for at most 36 En% to the total energy content of said composition, optionally further comprising at least 1.5 gram, more preferably, at least 1.7 gram of L-glutamine (bound and/or free) per 100 ml of said composition, as well as to its use as a tube feed, in particular for mitigating, attenuating or preventing an acute inflammatory response during or after surgery of a patient.
- Proteinaceous matter comprising fat, proteinaceous matter and digestible carbohydrates, wherein said fat contributes for at least 41 En%, said proteinaceous matter contributes for at least 23 En%, and said digestible carbohydrates contribute for at most 36 En% to the total energy content of said composition, optionally further comprising at least 1.5 gram, more preferably, at least 1.7 gram of L-glut
- the liquid nutritional composition according to the invention comprises at least a source of proteinaceous matter.
- the liquid nutritional composition according to the invention comprises at least 23 En% of proteinaceous matter, preferably between 23 En% and 59 En%, more preferable between 23 En% and 45 %, most preferably between 23 En% and 40 En% of proteinaceous matter relative to the total energy content of said composition.
- proteinaceous matter is defined as protein, peptides and amino acids.
- proteinaceous matter of the liquid nutritional composition according to the invention is the sum of all proteins, peptides and amino acids, free or in any bound form, present in the liquid nutritional composition according to the invention.
- the proteinaceous matter comprises between 20 and 80 weight% intact protein, more preferably between 30 and 60 weight%, most preferably between 35 and 50 weight% of the total amount of proteinaceous matter present in the composition.
- the composition comprises less than 40 weight% free amino acids, preferably between 10 and 30 weight% of the total amount of proteinaceous matter present in the composition.
- the proteinaceous matter comprises a source of vegetable proteinaceous matter and a source of dairy proteinaceous matter.
- the proteinaceous matter comprises 20 to 80 weight% of vegetal proteinaceous matter and 20 to 80 weight% of dairy proteinaceous matter.
- the wording "vegetable” relates to proteinaceous matter from plant origin, such as, for instance originating from vegetables such as carrot, pea, chickpea, green pea, kidney bean, lupine, rice, soy, canola, hemp, zein, maize, corn, barley, flax, linseed, and wheat. Equivalent wording may be used, such as “vegetal”, “leguminous” or “plant- derived”.
- dairy proteinaceous matter relates to milk-derived proteinaceous matter, i.e. to proteinaceous matter from animal milk, such as derived from species such as camel, cow, goat, horse, human, reindeer, sheep, water buffalo and yak.
- the proteinaceous matter comprises a hydrolysed protein, for example an hydrolysate of soy, casein, whey or wheat proteins, and/or combinations thereof, preferably at least wheat proteins.
- the hydrolysed proteins are obtained by the enzymatic hydrolysis of proteins, for example whey proteins.
- suitable proteins can be found in Peptamen® (Nestle), a 100% whey peptide based enteral tube nutrition, ensuring optimal absorption and better protein utilization.
- the proteinaceous matter comprises any one or more of casein, whey, soy, pea and wheat protein.
- the liquid nutritional composition according to the invention preferably comprises one or more of said casein, whey, soy and wheat protein each individually in an amount between 0.1 and 10 gram of proteins per 100 ml of said liquid nutritional composition, more preferably between 1 and 10 gram per 100 ml of said liquid nutritional composition, more preferably 2, 3, 4, 5, 6, 7, 8 or 9 gram of proteinaceous matter per 100 ml of said liquid nutritional composition, or any integer and non-integer fraction in between.
- the liquid nutritional composition according to the invention comprises casein and wheat protein, each individually in an amount between 0.1 and 10 gram of proteins per 100 ml of said liquid nutritional composition, more preferably between 1 and 10 gram per 100 ml of said liquid nutritional composition, more preferably 2, 3, 4, 5, 6, 7, 8 or 9 gram of proteinaceous matter per 100 ml of said liquid nutritional composition, or any integer and non-integer fraction in between.
- the liquid nutritional composition according to the invention comprises 30 to 50 weight% of casein and 30 to 50 weight% of wheat protein relative to the total weight of the proteinaceous matter. More preferably, the caseimwheat protein weight ratio is about 1.
- the liquid nutritional composition according to the invention comprises 2 to 4 gram of casein and 2 to 4 gram of wheat protein per 100 ml of said liquid nutritional composition.
- the proteinaceous matter comprises an amount of L- glutamine (bound and/or free) which exceeds the amount naturally present in intact vegetal or dairy proteins.
- such amount of L-glutamine is at least 20 gram, more preferably at least 25 gram per 100 gram of total proteinaceous matter.
- L-Glutamine (abbreviated as Gin or Q) is one of the 20 amino acids encoded by the standard genetic code. It is not recognized as an essential amino acid but may become conditionally essential in certain situations, including intensive athletic training or certain gastrointestinal disorders. Its side-chain is an amide formed by replacing the side-chain hydroxyl of L-glutamic acid with an amine functional group. Therefore, it can be considered the amide of L-glutamic acid.
- glutamine or "L- glutamine” also comprises a glutamine equivalent, which is a compound that can be converted to L-glutamine in the body, such as an L-glutamine dipeptide or a 2-acylaminoglutaric acid monoamide.
- the composition comprises an L-glutamine dipeptide, or an L-glutamine containing dipeptide, such as further comprising L-alanyl or L-alanine, which is preferably present in the composition of the invention in an amount of between 10 to 40 weight%, preferably 15-30 weight%, more preferably about 20 weight% of the total amount of proteinaceous matter present in said composition. It is specifically stated here that (L-) glutamic acid is excluded from the definition of glutamine.
- the liquid nutritional composition according to the invention comprises at least 1.5 gram, more preferably, at least 1.7 gram of L-glutamine (bound and/or free) per 100 ml of total liquid nutritional composition.
- the liquid nutritional composition according to the invention comprises between 1.5 gram and 5 gram, more preferably between 1.7 gram and 4 gram, most preferably between 1.9 and 3 gram of L-glutamine (bound and/or free) per 100 ml of total liquid nutritional composition.
- L-glutamine required according to the invention cannot be provided by intact vegetal or dairy proteins alone and an L-glutamine-enriched source should be present.
- the source of L-glutamine is selected from the group of wheat protein, which is rich in L-glutamine, the free amino acid L-glutamine, and an L-glutamine-containing dipeptide, such as L-alanyl-L-glutamine.
- said L-alanyl-L-glutamine dipeptide is synthetically produced.
- the dipeptide is used, since the free amino acid is not stable during sterilization. Fat
- the liquid nutritional composition according to the invention comprises at least a source of fat.
- the total amount of energy supplied by the fat should be at least about 41 En%, at least about 42 En%, at least about 43 En% or at least about 44 En% per 100 ml of said liquid nutritional composition.
- the total amount of energy supplied by the fat should be preferably between 41 En% and 77 En%, more preferably between 41 En% and 70 En%, most preferably between 41 En% and 65 En%, relative to the total energy content of said composition.
- the fat may be an animal fat or a vegetable fat or both.
- animal fats such as lard or butter have essentially equal caloric and nutritional values and can be used interchangeably, vegetable oils are highly preferred in the practice of the present invention due to their readily availability, ease of formulation, absence of cholesterol and lower concentration of saturated fatty acids.
- the present composition comprises rapeseed oil, corn oil and/or sunflower oil.
- the fat may include a source of medium chain fatty acids, such as medium chain triglycerides (MCT, defined as 8 to 10 carbon atoms long), a source of long chain fatty acids, such as long chain triglycerides (LCT) and phospholipid-bound fatty acids such as phospholipid- bound EPA or DHA, or any combination of the two types of sources.
- MCT medium chain triglycerides
- LCT long chain triglycerides
- phospholipid-bound fatty acids such as phospholipid- bound EPA or DHA
- the liquid nutritional composition according to the invention comprises medium-chain fatty acids (MCTs), having a chain length of 8, 10 or 12 carbon atoms, preferably in an amount of 0 to 25 weight%, more preferably 0 to 20 weight%, and especially less than 3 weight%, and myristic acid (C 14:0).
- MCTs are beneficial because they are easily absorbed and metabolized in a metabolically-stressed patient. Moreover, the use of MCTs will reduce the risk of nutrient malabsorption.
- LCT sources such as canola oil, rapeseed oil, sunflower oil, soybean oil, olive oil, coconut oil, palm oil, linseed oil, marine oil or com oil are beneficial because it is known that LCTs may modulate the immune response in the human body.
- the fat in the liquid nutritional composition according to the invention comprises at most 25 weight% of medium chain triglycerides (MCTs), relative to the total weight of said fat.
- MCTs medium chain triglycerides
- the fat comprises a glyceride fraction.
- This may contain mono-, di- and tri-glycerides.
- part of the glyceride fraction consists of mono and/or diglycerides of fatty acids.
- the mono- and diglycerides were also found to assist in administering relatively large amounts of lipids, without excessively raising the caloric content of the composition.
- the lipid comprises at least 5 weight%, at least 6 weight%, or at least 7 weight% of polyunsaturated fatty acids (PUFA's), calculated relative to the total amount of fatty acids, preferably eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
- PUFA's polyunsaturated fatty acids
- EPA eicosapentaenoic acid
- DHA docosahexaenoic acid
- the lipid comprises at least 400 mg of PUFA's, preferably eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per 100 ml of liquid nutritional composition according to the invention, more preferably between 400 and 1000 mg, more preferably between 450 to 750 mg per 100 ml of said liquid nutritional composition.
- PUFA's preferably eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) per 100 ml of liquid nutritional composition according to the invention, more preferably between 400 and 1000 mg, more preferably between 450 to 750 mg per 100 ml of said liquid nutritional composition.
- the fat in the liquid nutritional composition according to the invention may contain phospholipids or cholesterol. According to one embodiment, the fat in the liquid nutritional composition according to the invention comprises less than 10 weight% of phospholipids, relative to the total weight of said fat, or the fat comprises less than 0.5 weight% of cholesterol, relative to the total weight of said fat.
- the liquid nutritional composition according to the invention comprises a digestible carbohydrate.
- the digestible carbohydrates positively influence the energy level of a subject, and add to the advantageous effect of the nutritional composition according to the invention.
- the digestible carbohydrate may comprise simple and/or complex digestible carbohydrates, or any mixture thereof. Suitable for use in the present invention are glucose, fructose, sucrose, lactose, trehalose, palatinose, corn syrup, malt, maltose, isomaltose, partially hydrolysed corn starch, maltodextrins, glucose oligo- and polysaccharides.
- the digestible carbohydrate contributes for at most 36 En% to the total energy content of the liquid nutritional composition.
- the digestible carbohydrate contributes for at most 35 %, 34 % , 33 En%, 32 En%, 31 En% or 30 En% to the total energy content of the liquid nutritional composition.
- a low digestible carbohydrate amount lowers the stress-induces hyperglycaemia, insulin resistance, and therefore the infection rate. Further components
- composition of the invention may further contain other nutritional components, such as trace elements, vitamins, minerals, dietary fibres, e.a. in an amount which is adapted to suit the needs of the patient.
- other nutritional components such as trace elements, vitamins, minerals, dietary fibres, e.a. in an amount which is adapted to suit the needs of the patient.
- the liquid composition according to the invention comprises fat, proteinaceous matter and digestible carbohydrates, wherein said fat contributes for at least 41 En%, said proteinaceous matter contributes for at least 23 En%, and said digestible carbohydrates contribute for at most 36 En% to the total energy content of said composition, further comprising at least 1.5 gram, more preferably, at least 1.7 gram of L-glutamine (bound and/or free) per 100 ml of said composition.
- the liquid composition according to the invention comprises about 45 En% of fat, about 23 En% of proteinaceous matter , about 29 En% of digestible carbohydrates, and about 2 gram of L-glutamine per 100 ml of said composition.
- the composition is a liquid composition, wherein liquid is defined as a substance being suitable for enteral administration by tube at room temperature, using for example a feeding pump, gravity, syringe administration and the like.
- Said composition has a certain viscosity, which is adapted to said enteral administration.
- the viscosity of the liquid enteral nutritional composition is lower than 500 mPa.s, measured at 20 °C (i.e. room temperature) at a shear rate of 100 s "1 , preferably between 10 and 200 mPa.s, more preferably between 10 and 100 mPa.s, most preferably below 50 mPa.s.
- the viscosity may suitably be determined using a rotational viscosity meter using a cone/plate geometry.
- This viscosity is ideal for orally administering the liquid enteral nutritional composition according to the invention because a person may easily consume a serving having a low viscosity such as that displayed by the present invention. This viscosity is also ideal for unit dosages that are tube fed.
- the density of the composition ranges between 1.00 g/ml and 1.20 g/ml, especially between 1.05 g/ml and 1.15 g/ml.
- the osmolarity of the composition lies below 625 mOsmol/L, preferably between 600 and 100, more preferably between 550 and 200, even more preferably between 500 and 250, most preferably between and 500 and 300 mOsm/L.
- the liquid enteral nutritional composition according to the invention may have the form of a complete food, i.e. it can meet all nutritional needs of the user.
- the liquid enteral nutritional composition according to the invention preferably contains 1000 to 2500 kcal per daily dosage. Depending on the condition of the patient, a daily dose is about 25 to 35 kcal/kg bodyweight/day. Therefore, a typical daily dose for a 70 kg person contains about 2000 kcal.
- the complete food can be in the form of multiple dosage units, e.g. from 8 (250 ml/unit) to 2 units (1 1/unit) per day for an energy supply of 2000 kcal/day using a liquid enteral nutritional composition according to the invention of 1.0 kcal/ml.
- the nutritional composition is adapted for tube feeding, i.e. in the form of a tube feed.
- the liquid enteral nutritional composition can also be a food supplement, especially for use as a tube feed to be administered to a patient undergoing surgery by intra-operative tube feeding.
- the liquid enteral nutritional composition contains per daily dosage less than 1500 kcal, in particular as a supplement, the liquid enteral nutritional composition contains 500 to 1000 kcal per daily dose.
- the food supplement can be in the form of multiple dosage units, e.g. from 2 (250 ml/unit) to 10 units (50 ml/unit) per day for an energy supply of 500 kcal/day using the liquid enteral nutritional composition according to the invention.
- the dosage unit may be adapted in size and composition.
- the liquid nutritional composition has a total energy content of less than 250 kcal, preferably less than 200 kcal, more preferably less than 160 kcal, most preferably about 125 kcal per 100ml of said composition.
- the amount of kcal per 100 ml is preferably higher than 100 kcal per 100 ml, more preferably higher than 110 kcal per 100 ml.
- the nutritional composition is packaged, stored and provided in a container such as plastic bag or a pouch or the like.
- a container such as plastic bag or a pouch or the like.
- a variety of such containers is known, for example 500 ml, 1000 ml, and 1500 ml containers are known in the art. It should be noted that any suitable container can be used to package, store and provide the nutritional composition according to the invention.
- the liquid enteral nutritional composition is provided in a ready to use liquid form and does not require reconstitution or mixing prior to use.
- the liquid enteral nutritional composition according to the invention can be tube fed or administered orally.
- the composition according to the invention can be provided in a can, on spike, and hang bag.
- a composition may be provided to a person in need thereof, in powder form, suitable for reconstitution using an aqueous solution or water such that the enteral nutritional composition according to the invention is produced.
- the present composition is in the form of a powder, accompanied with instructions to dissolve or reconstitute in an aqueous composition or water to arrive at the liquid nutritional enteral composition according to the present invention.
- the present liquid nutritional enteral composition may thus be obtained by dissolving or reconstituting a powder, preferably in an aqueous composition, in particular water.
- a suitable packaging mode is a powder in a container, e.g. a sachet, preferably with instructions to dissolve or reconstitute in an aqueous composition or water.
- liquid nutritional composition according to the invention may be prepared using standard preparation methods known to the skilled person and they will not be further described.
- the liquid nutritional composition according to the invention need to undergo some sort of sterilization treatment in order to reduce the number of or remove possible pathogens, for instance spores, bacteria and other microorganisms, which cause spoilage of the protein composition, preferably by using heat (sterilization, pasteurization), radiation (UV-treatment), or filtration methods (ultrafiltration, diafiltration, nanofiltration).
- Preferred sterilization treatments include heat treatments at high temperatures for a short period, such as using a UHT (Ultra High Temperature) treatment.
- the liquid nutritional composition according to the invention is in a sterilized or pasteurized form.
- the liquid nutritional composition of the invention may be used as a tube feed, i.e. for tube feeding a patient.
- Said tube feeding may be provided continuously, or intermittently.
- the liquid nutritional composition of the invention may be used for tube feeding of a patient undergoing surgery, in particular non-invasive surgery such as skin-surgery, invasive surgery such as organ surgery, cardiac surgery and neurosurgery, by intra-operative tube feeding.
- non-invasive surgery such as skin-surgery
- invasive surgery such as organ surgery, cardiac surgery and neurosurgery
- the liquid nutritional composition of the invention is also advantageously used for mitigating, attenuating or preventing an acute inflammatory response during or after surgery of a patient.
- the patient is a patient that is undergoing surgery, that has undergone surgery or that is a critically-ill patient.
- FIG. 1 Experimental design. Subjects are admitted to the intensive care unit (ICU) after an overnight fast. One hour prior to LPS administration, subjects are prehydrated and the continuous administration of enteral nutrition started in the nutritional intervention groups, lasting until six hours after LPS administration. Blood is withdrawn at indicated time points during the experiment. Subjects leave the hospital 12 hours after intravenous administration of LPS and return the day after for final blood sampling.
- ICU intensive care unit
- Enriched nutrition modulates the inflammatory response during endotoxemia.
- Enriched nutrition attenuates TNF-a, IL-6 and IL-IRA levels compared with control nutrition (p ⁇ .05) and fasting (p ⁇ .0001).
- FIG. 3 Administration of LPS results in sub-clinical intestinal damage. Intravenous administration of LPS results in a gradual increase of plasma i-FABP levels in all groups (A). Subjects fed enriched nutrition display a smaller increase in circulating i-FABP levels (A-B), although this does not reach statistical significance.
- Example 1 Tube-feed according to the invention (all values per 100 ml of total liquid composition)
- Example 2 Investigation of the immunomodulatory potential of enteral lipid- and protein- enriched nutrition during experimental human endotoxemia.
- Data are represented as mean ⁇ SEM; BMI, body mass index; TER, total energy requirement; NA, not applicable.
- the nutritional intervention groups received continuous postpyloric infusion of a liquid, enriched or an isocaloric control enteral nutrition for 7 hours via a self-advancing nasal-jejunal feeding tube (Tiger 2, Cook Medical, Bloomington, IN, Figure 1), which was placed on the evening before the experiment.
- the rate of feeding for each subject was based on their individual total energy requirement (TER).
- the TER was calculated by multiplying the basal metabolic rate of each subject with their activity level (1.55 times for all subjects) using the Harris-Benedict equation (Table 1).
- the enriched nutrition contained 44 En% fat, 25 En% protein and 31 En% carbohydrates.
- the protein consisted of intact casein, whey protein and soy protein hydrolysate.
- the control nutrition contained 20 En% fat, 16 En% protein and 64 En% carbohydrates. Both the enriched and control nutrition provided 1 kcal/ml.
- Systemic CCK levels were determined in plasma using a CCK- radioimmunoassay (Eurodiagnostica, Malmo, Sweden).
- TNF-a, IL-6, IL-10, and IL-1 receptor antagonists were measured batchwise using a multiplex Luminex Assay according to the manufacturer's instructions (Millipore, Billerica, MA). Intestinal-fatty acid binding protein (i-FABP) was determined in plasma using an in-house developed ELISA.
- i-FABP Intestinal-fatty acid binding protein
- T time expressed in hours after lipopolysaccharide administration
- MAP mean arterial pressure
- HR heart rate
- ND not determined.
- Intravenous administration of LPS resulted in a marked pro -inflammatory response.
- the TNF-a values of one subject in the enriched nutrition group were removed from the analysis after being identified as significant outlier.
- Treatment with enriched nutrition significantly attenuated TNF-a levels compared with fasted (p ⁇ 0.0001) and control nutrition (p ⁇ 0.05; Figure 2A).
- Enriched nutrition lowered peak TNF-a levels with 40 ⁇ 8% compared with fasted subjects and 29 ⁇ 10% compared to control nutrition.
- Enriched nutrition significantly reduced IL-6 plasma concentrations during the endotoxemia protocol compared with control nutrition (p ⁇ 0.001) and fasting (p ⁇ 0.05. Figure 2B), while the control nutrition did not affect IL-6 compared with fasted subjects (p 0.63).
- Intravenous injection of LPS is known to trigger a complex compensatory anti-inflammatory response.
- the specific IL-1 receptor antagonist, IL-IRA is released during inflammation and is thought to control the immune-modulatory effects of IL-1.
- Enriched nutrition decreased circulating IL-IRA during the experiment compared with control nutrition (p ⁇ 0.0001) and fasted (p ⁇ 0.0001; Figure 2C). Peak levels of IL-IRA were 37 ⁇ 8% lower in the enriched nutrition group compared with fasted subjects and 25 ⁇ 6% compared with control nutrition. The control nutrition did not affect IL-1 RA levels compared with fasted.
- the present study is the first to investigate the immediate immunomodulatory effect of continuous enteral administration of nutrition enriched with lipids and protein in human.
- Our data reveal that enriched nutrition modulates the innate immune response during human endotoxemia, resulting in attenuated plasma levels of TNF-a, IL-6, IL-IRA and elevated circulating IL-10, indicating a reduced pro-inflammatory response and an augmented anti-inflammatory response.
- the catabolic state of surgical and critically ill patients increasingly gained interest [23, 24].
- TNF-a Excess release of TNF-a is known to contribute to the development of systemic inflammatory response syndrome, organ damage and mortality in sepsis [30]. Furthermore, circulating levels of TNF-a and IL-6 are correlated with the severity of sepsis in patients [31].
- the current study demonstrates that enriched nutrition limits inflammation during human experimental endotoxemia by attenuating circulating levels of TNF-a and IL-6. Moreover, the intervention with enriched nutrition resulted in decreased IL-IRA plasma levels.
- IL-10 has been shown to reduce endotoxin-induced lethality in mice [36].
- the beneficial effect of enriched nutrition on the immune response during human endotoxemia is in line with previous studies using well-known pharmacological agents, including epinephrine and glucocorticoids which inhibit plasma levels of pro-inflammatory cytokines and augment circulating IL-10 [34, 37].
- epinephrine and glucocorticoids which inhibit plasma levels of pro-inflammatory cytokines and augment circulating IL-10 [34, 37].
- these data indicate that enriched enteral nutrition is a promising and physiological intervention to control acute inflammation.
- CCK-mediated activation of vagal afferents plays a dominant role in nutrient- induced digestive, metabolic and immunologic feedback [19, 42, 43]. Intestinal release of CCK is predominantly triggered by the luminal presence of lipid and protein [20, 44], while termination of nutrient exposure results in a rapid drop of CCK levels [44]. Taking these considerations into account, we chose to continuously administer nutrition enriched with lipids and proteins to induce a prolonged stimulation of the CCK-mediated anti-inflammatory pathway. Our nutritional intervention resulted in detectable circulating CCK levels during the entire endotoxin-induced inflammatory response.
- GLP-1 glucagon-like peptide 1
- Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation. Nature 2003, 421(6921):384-388.
- Lowry SF Human endotoxemia: a model for mechanistic insight and therapeutic targeting. Shock 2005, 24 Suppl 1 :94-100.
- Calder PC n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006, 83(6 Suppl): 1505S-1519S.
- Flohe SB, Flohe S, Schade FU Invited review: deterioration of the immune system after trauma: signals and cellular mechanisms. Innate Immun 2008, 14(6):333-344.
- IL-IRa Interleukin 1 receptor antagonist
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
BR112013025604A BR112013025604A2 (en) | 2011-04-06 | 2012-04-06 | use of a preparation in the manufacture of a liquid nutritional composition, liquid nutritional composition and use of liquid nutritional composition |
EP12717895.2A EP2693898A1 (en) | 2011-04-06 | 2012-04-06 | Food composition for intra-operative tube feeding |
CN201280027944.7A CN103596455B (en) | 2011-04-06 | 2012-04-06 | The food composition of tube feed in art |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/NL2011/050231 WO2012138212A1 (en) | 2011-04-06 | 2011-04-06 | Food composition for intra-operative tube feeding |
NLPCT/NL2011/050231 | 2011-04-06 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2012138224A1 true WO2012138224A1 (en) | 2012-10-11 |
Family
ID=46022604
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/NL2011/050231 WO2012138212A1 (en) | 2011-04-06 | 2011-04-06 | Food composition for intra-operative tube feeding |
PCT/NL2012/050234 WO2012138224A1 (en) | 2011-04-06 | 2012-04-06 | Food composition for intra-operative tube feeding |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/NL2011/050231 WO2012138212A1 (en) | 2011-04-06 | 2011-04-06 | Food composition for intra-operative tube feeding |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP2693898A1 (en) |
CN (1) | CN103596455B (en) |
BR (1) | BR112013025604A2 (en) |
WO (2) | WO2012138212A1 (en) |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN105795481A (en) * | 2016-03-24 | 2016-07-27 | 广州军区广州总医院 | Special nutritional supplement agent for preoperative patients |
CN110302214A (en) * | 2019-08-21 | 2019-10-08 | 中国人民解放军总医院 | A kind of lactic acid bacteria joint medium chain triglyceride is repairing the application in intestinal inflammatory |
Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0189160A2 (en) | 1985-01-22 | 1986-07-30 | Abbott Laboratories | High fat, low carbohydrate enteral nutritional formula |
EP0265772A2 (en) | 1986-10-27 | 1988-05-04 | Abbott Laboratories | Liquid nutritional formula for glucose intolerance |
EP0611568A1 (en) | 1993-02-13 | 1994-08-24 | Fresenius AG | Composition for enteral nutrition |
EP0691079A2 (en) | 1994-07-06 | 1996-01-10 | Clintec Nutrition Company, An Illinois Partnership | Enteral composition for diabetic patients |
US5968896A (en) | 1998-01-16 | 1999-10-19 | Beth Israel Deaconess Medical Center | Nutritional supplement for preoperative feeding |
EP1090636A1 (en) | 1999-09-13 | 2001-04-11 | Société des Produits Nestlé S.A. | High lipid diet |
EP1041896B1 (en) | 1997-12-23 | 2002-02-20 | N.V. Nutricia | Fat blend |
EP1589834B1 (en) | 2003-02-05 | 2007-04-11 | N.V. Nutricia | Enteral composition for the prevention and/or treatment of sepsis |
EP1411951B1 (en) | 2001-07-27 | 2007-09-26 | N.V. Nutricia | Enteral compositions for the prevention and/or treatment of sepsis |
WO2009099316A1 (en) * | 2008-02-08 | 2009-08-13 | N.V. Nutricia | Use of lipid-rich nutrition for the treatment of post-operative ileus |
WO2010033424A2 (en) * | 2008-09-19 | 2010-03-25 | Nestec S.A. | Nutritional support of the immune system during anti-cancer treatment |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5714472A (en) * | 1993-12-23 | 1998-02-03 | Nestec Ltd. | Enternal formulation designed for optimized nutrient absorption and wound healing |
JP5069121B2 (en) * | 2004-11-12 | 2012-11-07 | エヌ.ブイ.・ヌートリシア | Food composition for rapidly reducing inflammatory response |
-
2011
- 2011-04-06 WO PCT/NL2011/050231 patent/WO2012138212A1/en active Application Filing
-
2012
- 2012-04-06 BR BR112013025604A patent/BR112013025604A2/en not_active Application Discontinuation
- 2012-04-06 WO PCT/NL2012/050234 patent/WO2012138224A1/en active Application Filing
- 2012-04-06 CN CN201280027944.7A patent/CN103596455B/en active Active
- 2012-04-06 EP EP12717895.2A patent/EP2693898A1/en not_active Withdrawn
Patent Citations (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0189160A2 (en) | 1985-01-22 | 1986-07-30 | Abbott Laboratories | High fat, low carbohydrate enteral nutritional formula |
EP0265772A2 (en) | 1986-10-27 | 1988-05-04 | Abbott Laboratories | Liquid nutritional formula for glucose intolerance |
EP0611568A1 (en) | 1993-02-13 | 1994-08-24 | Fresenius AG | Composition for enteral nutrition |
EP0691079A2 (en) | 1994-07-06 | 1996-01-10 | Clintec Nutrition Company, An Illinois Partnership | Enteral composition for diabetic patients |
EP1041896B1 (en) | 1997-12-23 | 2002-02-20 | N.V. Nutricia | Fat blend |
US5968896A (en) | 1998-01-16 | 1999-10-19 | Beth Israel Deaconess Medical Center | Nutritional supplement for preoperative feeding |
EP1090636A1 (en) | 1999-09-13 | 2001-04-11 | Société des Produits Nestlé S.A. | High lipid diet |
US7691906B2 (en) | 1999-09-13 | 2010-04-06 | Nestec S.A. | High lipid diet |
EP1411951B1 (en) | 2001-07-27 | 2007-09-26 | N.V. Nutricia | Enteral compositions for the prevention and/or treatment of sepsis |
EP1589834B1 (en) | 2003-02-05 | 2007-04-11 | N.V. Nutricia | Enteral composition for the prevention and/or treatment of sepsis |
WO2009099316A1 (en) * | 2008-02-08 | 2009-08-13 | N.V. Nutricia | Use of lipid-rich nutrition for the treatment of post-operative ileus |
WO2010033424A2 (en) * | 2008-09-19 | 2010-03-25 | Nestec S.A. | Nutritional support of the immune system during anti-cancer treatment |
Non-Patent Citations (52)
Title |
---|
ABRAHAM E; LATERRE PF; GARBINO J; PINGLETON S; BUTLER T; DUGEMIER T; MARGOLIS B; KUDSK K; ZIMMERLI W; ANDERSON P ET AL.: "Lenercept (p55 tumor necrosis factor receptor fusion protein) in severe sepsis and early septic shock: a randomized, double-blind, placebo-controlled, multicenter phase III trial with 1,342 patients", CRIT CARE MED, vol. 29, no. 3, 2001, pages 503 - 510 |
ANDEL ET AL.: "Impact of intraoperative duodenal feeding on the oxygen balance of the splanchnic region in severely burned patients", BURNS, vol. 31, 2005, pages 302 - 305, XP004883069, DOI: doi:10.1016/j.burns.2004.10.011 |
ARZT E; SAUER J; POLLMACHER T; LABEUR M; HOLSBOER F; REUL JM; STALLA GK: "Glucocorticoids suppress interleukin-1 receptor antagonist synthesis following induction by endotoxin", ENDOCRINOLOGY, vol. 134, no. 2, 1994, pages 672 - 677 |
BOROVIKOVA LV; IVANOVA S; ZHANG M; YANG H; BOTCHKINA GI; WATKINS LR; WANG H; ABUMRAD N; EATON JW; TRACEY KJ: "Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin", NATURE, vol. 405, no. 6785, 2000, pages 458 - 462, XP001152663, DOI: doi:10.1038/35013070 |
CALDER PC: "n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases", AM J CLIN NUTR, vol. 83, no. 6, 2006, pages 1505S - 1519S |
CHANDRA R; LIDDLE RA: "Cholecystokinin", CURR OPIN ENDOCRINOL DIABETES OBES, vol. 14, no. 1, 2007, pages 63 - 67 |
CHEUNG GW; KOKOROVIC A; LAM CK; CHARI M; LAM TK: "Intestinal cholecystokinin controls glucose production through a neuronal network", CELL METAB, vol. 10, no. 2, 2009, pages 99 - 109 |
CINEL I; OPAL SM: "Molecular biology of inflammation and sepsis: a primer", CRIT CARE MED, vol. 37, no. 1, 2009, pages 291 - 304 |
DE HAAN JJ; LUBBERS T; DERIKX JP; RELJA B; HENRICH D; GREVE JW; MARZI I; BUURMAN WA: "Rapid development of intestinal cell damage following severe trauma: a prospective observational cohort study", CRIT CARE, vol. 13, no. 3, 2009, pages R86, XP021061353 |
DE HAAN JJ; LUBBERS T; HADFOUNE M; LUYER MD; DEJONG CH; BUURMAN WA; GREVE JW: "Postshock Intervention With High-Lipid Enteral Nutrition Reduces Inflammation and Tissue Damage", ANN SURG, vol. 248, no. 5, 2008, pages 842 - 848 |
DE KRUIFMD; LEMAIRE LC; GIEBELEN IA; VAN ZOELEN MA; PATER JM; VAN DEN PANGAART PS; GROOT AP; DE VOS AF; ELLIOTT PJ; MEIJERS JC ET: "Prednisolone dose-dependently influences inflammation and coagulation during human endotoxemia", J IMMUNOL, vol. 178, no. 3, 2007, pages 1845 - 1851 |
DERIKX JP; POEZE M; VAN BIJNEN AA; BUURMAN WA; HEINEMAN E: "Evidence for intestinal and liver epithelial cell injury in the early phase of sepsis", SHOCK, vol. 28, no. 5, 2007, pages 544 - 548 |
DERIKX JP; VAN WAARDENBURG DA; THUIJLS G; WILLIGERS HM; KOENRAADS M; VAN BIJNEN AA; HEINEMAN E; POEZE M; AMBERGEN T; VAN OOIJ A ET: "New Insight in Loss of Gut Barrier during Major Non-Abdominal Surgery", PLOS ONE, vol. 3, no. 12, 2008, pages E3954 |
DOIG GS; HEIGHES PT; SIMPSON F; SWEETMAN EA; DAVIES AR: "Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a meta-analysis of randomised controlled trials", INTENSIVE CARE MEDICINE, vol. 35, no. 12, 2009, pages 2018 - 2027, XP019755529, DOI: doi:10.1007/s00134-009-1664-4 |
EL NAKEEB A; FIKRY A; EL METWALLY T; FOUDA E; YOUSSEF M; GHAZY H; BADR S; KHAFAGY W; FARID M: "Early oral feeding in patients undergoing elective colonic anastomosis", INT J SURG, vol. 7, no. 3, 2009, pages 206 - 209, XP026194791, DOI: doi:10.1016/j.ijsu.2009.03.003 |
FINK MP; DELUDE RL: "Epithelial barrier dysfunction: a unifying theme to explain the pathogenesis of multiple organ dysfunction at the cellular level", CRITICAL CARE CLINICS, vol. 21, no. 2, 2005, pages 177 - 196 |
FLESHNER M; GOEHLER LE; SCHWARTZ BA; MCGORRY M; MARTIN D; MAIER SF; WATKINS LR: "Thermogenic and corticosterone responses to intravenous cytokines (IL-lbeta and TNF- alpha) are attenuated by subdiaphragmatic vagotomy", J NEUROIMMUNOL, vol. 86, no. 2, 1998, pages 134 - 141 |
FLOHE SB; FLOHE S; SCHADE FU: "Invited review: deterioration of the immune system after trauma: signals and cellular mechanisms", INNATE IMMUN, vol. 14, no. 6, 2008, pages 333 - 344, XP009127661, DOI: doi:10.1177/1753425908100016 |
GABAY C; SMITH MF; EIDLEN D; AREND WP: "Interleukin 1 receptor antagonist (IL-IRa) is an acute-phase protein", J CLIN INVEST, vol. 99, no. 12, 1997, pages 2930 - 2940 |
HARBARTH S; HOLECKOVA K; FROIDEVAUX C; PITTET D; RICOU B; GRAU GE; VADAS L; PUGIN J: "Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis", AM JRESPIR CRIT CARE MED, vol. 164, no. 3, 2001, pages 396 - 402, XP002350238 |
HARRIS HW; JOHNSON JA; WIGMORE SJ: "Endogenous lipoproteins impact the response to endotoxin in humans", CRIT CARE MED, vol. 30, no. 1, 2002, pages 23 - 31 |
HOUDIJK A P J ET AL: "Randomised trial of glutamine-enriched enteral nutrition on infectious morbidity in patients with multiple trauma", THE LANCET, LANCET LIMITED. LONDON, GB, vol. 352, no. 9130, 5 September 1998 (1998-09-05), pages 772 - 776, XP004265558, ISSN: 0140-6736, DOI: 10.1016/S0140-6736(98)02007-8 * |
HOWARD M; MUCHAMUEL T; ANDRADE S; MENON S: "Interleukin 10 protects mice from lethal endotoxemia", JEXP MED, vol. 177, no. 4, 1993, pages 1205 - 1208, XP002926524, DOI: doi:10.1084/jem.177.4.1205 |
JENKINS ET AL.: "Enteral feeding during operative procedures in thermal injuries", J. OF BURN CARE AND REHABILITATION, March 1994 (1994-03-01) |
KARHUNEN LJ; JUVONEN KR; HUOTARI A; PURHONEN AK; HERZIG KH: "Effect of protein, fat, carbohydrate and fibre on gastrointestinal peptide release in humans", REGUL PEPT, vol. 149, no. 1-3, 2008, pages 70 - 78, XP023783714, DOI: doi:10.1016/j.regpep.2007.10.008 |
KREYMANN KG; BERGER MM; DEUTZ NE; HIESMAYR M; JOLLIET P; KAZANDJIEV G; NITENBERG G; VAN DEN BERGHE G; WERNERMAN J; EBNER C ET AL.: "ESPEN Guidelines on Enteral Nutrition: Intensive care", CLIN NUTR, vol. 25, no. 2, 2006, pages 210 - 223, XP005472161 |
LOWRY SF: "Human endotoxemia: a model for mechanistic insight and therapeutic targeting", SHOCK, vol. 24, no. 1, 2005, pages 94 - 100 |
LUBBERS T JDH; HADFOUNE M; ZABEAU L; TAVERNIER J; ZHANG Y; GRUNDY D; GREVE JW; BUURMAN WA.: "Chylomicron formation and glucagon-like peptide 1 receptor are involved in activation of the nutritional anti-inflammatory pathway", JOURNAL OF NUTRITIONAL BIOCHEMISTRY |
LUBBERS T; DE HAAN JJ; HADFOUNE M; LUYER MD; ZHANG Y; GRUNDY D; BUURMAN WA; GREVE JW: "Lipid-enriched enteral nutrition controls the inflammatory response in murine gram-negative sepsis", CRITICAL CARE MEDICINE, 2010 |
LUBBERS T; DE HAAN JJ; LUYER MD; VERBAEYS I; HADFOUNE M; DEJONG CH; BUURMAN WA; GREVE JW: "Cholecystokinin/Cholecystokinin-1 receptor-mediated peripheral activation of the afferent vagus by enteral nutrients attenuates inflammation in rats", ANN SURG, vol. 252, no. 2, pages 376 - 382 |
LUBBERS T; LUYER MD; DE HAAN JJ; HADFOUNE M; BUURMAN WA; GREVE JW: "Lipid-Rich Enteral Nutrition Reduces Postoperative Ileus in Rats via Activation of Cholecystokinin-Receptors", ANN SURG, vol. 249, no. 3, 2009, pages 481 - 487, XP009128679, DOI: doi:10.1097/SLA.0b013e318194d187 |
LUYER MD; GREVE JW; HADFOUNE M; JACOBS JA; DEJONG CH; BUURMAN WA: "Nutritional stimulation of cholecystokinin receptors inhibits inflammation via the vagus nerve", J EXP MED, vol. 202, no. 8, 2005, pages 1023 - 1029 |
MARSHALL JC; CHARBONNEY E; GONZALEZ PD: "The immune system in critical illness", CLIN CHEST MED, vol. 29, no. 4, 2008, pages 605 - 616 |
NOBLETT SE; WATSON DS; HUONG H; DAVISON B; HAINSWORTH PJ; HORGAN AF: "Pre-operative oral carbohydrate loading in colorectal surgery: a randomized controlled trial", COLORECTAL DIS, vol. 8, no. 7, 2006, pages 563 - 569 |
OSUCHOWSKI MF; WELCH K; SIDDIQUI J; REMICK DG: "Circulating cytokine/inhibitor profiles reshape the understanding of the SIRS/CARS continuum in sepsis and predict mortality", J IMMUNOL, vol. 177, no. 3, 2006, pages 1967 - 1974 |
PARRISH WR; GALLOWITSCH-PUERTA M; CZURA CJ; TRACEY KJ: "Experimental therapeutic strategies for severe sepsis: mediators and mechanisms", ANN N YACAD SCI, vol. 1144, 2008, pages 210 - 236, XP009137394, DOI: doi:10.1196/annals.1418.011 |
PAVLOV VA; OCHANI M; YANG LH; GALLOWITSCH-PUERTA M; OCHANI K; LIN X; LEVI J; PARRISH WR; ROSAS-BALLINA M; CZURA CJ ET AL.: "Selective alpha7-nicotinic acetylcholine receptor agonist GTS-21 improves survival in murine endotoxemia and severe sepsis", CRIT CARE MED, vol. 35, no. 4, 2007, pages 1139 - 1144 |
PICKKERS P; DORRESTEIJN MJ; BOUW MP; VAN DER HOEVEN JG; SMITS P: "In vivo evidence for nitric oxide-mediated calcium-activated potassium-channel activation during human endotoxemia", CIRCULATION, vol. 114, no. 5, 2006, pages 414 - 421 |
PILICHIEWICZ AN; LITTLE TJ; BRENNAN IM; MEYER JH; WISHART JM; OTTO B; HOROWITZ M; FEINLE-BISSET C: "Effects of load, and duration, of duodenal lipid on antropyloroduodenal motility, plasma CCK and PYY, and energy intake in healthy men", AM J PHYSIOL REGUL INTEGR COMP PHYSIOL, vol. 290, no. 3, 2006, pages R668 - 677 |
REIDELBERGER RD; KALOGERIS TJ; SOLOMON TE: "Plasma CCK levels after food intake and infusion of CCK analogues that inhibit feeding in dogs", AM J PHYSIOL, vol. 256, 1989, pages R1148 - 1154 |
RICE TW; WHEELER AP; BERNARD GR; VINCENT JL; ANGUS DC; AIKAWA N; DEMEYER I; SAINATI S; AMLOT N; CAO C ET AL.: "A randomized, double-blind, placebo-controlled trial of TAK-242 for the treatment of severe sepsis", CRIT CARE MED, vol. 38, no. 8, pages 1685 - 1694, XP055115621, DOI: doi:10.1097/CCM.0b013e3181e7c5c9 |
RIEDEMANN NC; GUO RF; WARD PA: "Novel strategies for the treatment of sepsis", NAT MED, vol. 9, no. 5, 2003, pages 517 - 524 |
See also references of EP2693898A1 * |
SOREIDE E; LJUNGQVIST O: "Modern preoperative fasting guidelines: a summary of the present recommendations and remaining questions", BEST PRACT RES CLIN ANAESTHESIOL, vol. 20, no. 3, 2006, pages 483 - 491, XP005631359, DOI: doi:10.1016/j.bpa.2006.03.002 |
URS GIGER ET AL: "Preoperative Immunonutrition Suppresses Perioperative Inflammatory Response in Patients with Major Abdominal Surgery-A Randomized Controlled Pilot Study", ANNALS OF SURGICAL ONCOLOGY, SPRINGER-VERLAG, NE, vol. 14, no. 10, 15 July 2007 (2007-07-15), pages 2798 - 2806, XP019522833, ISSN: 1534-4681 * |
VAN DER POLL T; COYLE SM; BARBOSA K; BRAXTON CC; LOWRY SF: "Epinephrine inhibits tumor necrosis factor-alpha and potentiates interleukin 10 production during human endotoxemia", J CLIN INVEST, vol. 97, no. 3, 1996, pages 713 - 719 |
VAN DER POLL T; VAN DEVENTER SJ; TEN CATE H; LEVI M; TEN CATE JW: "Tumor necrosis factor is involved in the appearance of interleukin- receptor antagonist in endotoxemia", J INFECT DIS, vol. 169, no. 3, 1994, pages 665 - 667 |
VAN GINHOVEN TM; MITCHELL JR; VERWEIJ M; HOEIJMAKERS JH; IJZERMANS JN; DE BRUIN RW: "The use of preoperative nutritional interventions to protect against hepatic ischemiareperfusion injury", LIVER TRANSPL, vol. 15, no. 10, 2009, pages 1183 - 1191 |
VERMEULEN MA; VAN DE POLL MC; LIGTHART-MELIS GC; DEJONG CH; VAN DEN TOL MP; BOELENS PG; VAN LEEUWEN PA: "Specific amino acids in the critically ill patient--exogenous glutamine/arginine: a common denominator?", CRIT CARE MED, vol. 35, no. 9, 2007, pages 5568 - 576 |
WANG H; YU M; OCHANI M; AMELLA CA; TANOVIC M; SUSARLA S; LI JH; WANG H; YANG H; ULLOA L ET AL.: "Nicotinic acetylcholine receptor alpha7 subunit is an essential regulator of inflammation", NATURE, vol. 421, no. 6921, 2003, pages 384 - 388, XP002277770, DOI: doi:10.1038/nature01339 |
YENDE S; D'ANGELO G; KELLUM JA; WEISSFELD L; FINE J; WELCH RD; KONG L; CARTER M; ANGUS DC: "Inflammatory markers at hospital discharge predict subsequent mortality after pneumonia and sepsis", AM JRESPIR CRIT CARE MED, vol. 177, no. 11, 2008, pages 1242 - 1247 |
ZANDEN EP; SNOEK SA; HEINSBROEK SE; STANISOR 01; VERSEIJDEN C; BOECKXSTAENS GE; PEPPELENBOSCH MP; GREAVES DR; GORDON S; DE JONGE W: "Vagus nerve activity augments intestinal macrophage phagocytosis via nicotinic acetylcholine receptor alpha4beta2", GASTROENTEROLOGY, 2009 |
Also Published As
Publication number | Publication date |
---|---|
EP2693898A1 (en) | 2014-02-12 |
CN103596455B (en) | 2016-07-06 |
BR112013025604A2 (en) | 2016-08-09 |
CN103596455A (en) | 2014-02-19 |
WO2012138212A1 (en) | 2012-10-11 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
ES2700463T3 (en) | Use of aspartate to regulate blood glucose levels | |
JP5069121B2 (en) | Food composition for rapidly reducing inflammatory response | |
US8703725B2 (en) | Nutritional compositions | |
JP5574561B2 (en) | Total enteral nutrition composition | |
EP2296643B1 (en) | Nutritional composition for improving the mammalian immune system | |
US20060159746A1 (en) | Compositions comprising fatty acids and amino acids | |
JP5315996B2 (en) | Total enteral nutrition composition | |
KR20200039748A (en) | Amino acid composition for treatment of liver disease | |
AU2007204347B2 (en) | Treatment of stressed patients | |
US20140308369A1 (en) | Dietary product intended to reduce visceral fat during the pre-operative phase prior to bariatric surgery | |
US10064835B2 (en) | Combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine for use in treating diabetic ulcers | |
US9492502B2 (en) | Method for producing a protein comprising composition with reduced digestive coagulation | |
EP2869707B1 (en) | Method for producing a protein and lipid comprising composition with reduced digestive coagulation | |
EP2693898A1 (en) | Food composition for intra-operative tube feeding | |
JP4328065B2 (en) | Enteral nutrition | |
Aliyazicioglu et al. | Effects of Standard and/or Glutamine Dipeptide and/or Omega-3 Fatty Ascid-Supplemented Parenteral Nutrition on Neutrophil Functions, Interleukin-8 Level and Length of Stay-A Double Blind, Controlled, Randomised Study | |
KR20200095255A (en) | Pharmaceutical composition comprising omega fatty acids, and infusion preparation comprising the same | |
WO2012133198A1 (en) | Nutritional composition for inflammatory diseases | |
Lubbers et al. | Lipid-and protein-enriched enteral nutrition limits inflammation during experimental human endotoxemia | |
JP6693413B2 (en) | Composition for improving digestive tract disorders | |
US11272728B2 (en) | High protein enteral tube feed for ICU patients | |
JP6764856B2 (en) | Stomach volume reducer | |
Van Schalkwyk | Nutritional management of a critically injured patient | |
Narciso | Glutamine–One of the Bodies Most Important Aminos! | |
Weimann | Nutritional Support in the Perioperative Period Topic 17 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 12717895 Country of ref document: EP Kind code of ref document: A1 |
|
DPE1 | Request for preliminary examination filed after expiration of 19th month from priority date (pct application filed from 20040101) | ||
WWE | Wipo information: entry into national phase |
Ref document number: 2012717895 Country of ref document: EP |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
REG | Reference to national code |
Ref country code: BR Ref legal event code: B01A Ref document number: 112013025604 Country of ref document: BR |
|
ENP | Entry into the national phase |
Ref document number: 112013025604 Country of ref document: BR Kind code of ref document: A2 Effective date: 20131003 |