Alterations in innate antibacterial response after immunomodulatory nutrition

Septic infections in malnourished surgical patients show the highest morbidity and mortality rate. The attempt to correct postoperative immune and nutritional disorders by introducing immune-enhancing nutrition (immunonutrition) is a promising way of improving outcome, but as yet little is known about the mechanisms of correcting an extensive postoperative inflammatory response (systemic inflammatory response syndrome [SIRS]) to a massive infection using this type of nutrition. A significant role in the innate antibacterial and inflammatory response is played by Toll-like receptors (TLRs) that recognize pathogen-associated molecular patterns (PAMPs). The regulatory impact of immunonutrition on TLR expression in surgical septic patients seems to be a new research direction. In this paper special emphasis was put on clinical trials and the research results for the TLR-dependent immune response and anti-bacterial/anti-inflammatory response applying immunomodulatory nutrition with increased concentrations of glutamine and unsaturated fatty acids.