Interrelations between Copper doses administered to critical patients receiving parenteral nutrition and changes in serum Copper, Ceruloplasmin and Interleukin-6 levels.

MENÉNDEZ AM; MONTEMERLO H; WEISSTAUB A,; PORTELLA ML; ZENI SN

Las Vegas, USA

Congreso; Sección Ibero-Latino-Americana ILAS/ASPEN 34o Congreso Clínico de ASPEN (Clinical Nutrition Week 2010); 2010

Background: Human serum Interleukin 6 (IL-6) is a major inducer of acute phase reactions in response to tissue injury, detected in severe inflammatory situations. It was postulated that its production is influenced by Copper (Cu) levels in tissues. However, although Cu is an essential micromineral, its excess could exacerbate the acute-phase response thus being necessary to control the amount of Cu provided to critical patients receiving Total Parenteral Nutrition (TPN) and to carry out the patients´ clinical and biochemical evolution follow-up. Objectives: the aim of this work was to study the response of serum Interleukin-6 and ceruloplasmin in relation to serum Cu and Cu doses administered to critical patients (n= 11) receiving TPN after a major abdominal surgery (fistula, pancreatitis, intestinal or pancreatic cancer). Methods: At the beginning (To) and during the patients´ follow-up (6-21 days) the following was determined: Cu in TPN and in serum (Atomic Absorption Spectrometry), serum IL-6 (ELISA, EASIATM, BioSource, USA) and ceruloplasmin (Cp) (ferroxidase activity). Results: (mean±standard deviation and ranges) were: Cu provided by TPN (mg/d) 1.6±0.9 (0.5-3.0). Biochemical parameters were:       At To: SCu: 156±45 (99-238); IL-6 (pg/mL): 90±64 (181-10);                   Cp:  712±494 (1863-239).       At Tf : SCu: 132±47 (51-238); IL-6 (pg/mL): 124±214 (761-11);                   Cp: 571±235 (972-266). There was a high correlation between Cp and SCu at To but not at Tf. Changes in SCu,  Cp and serum IL-6 levels did not correlate between them nor with daily TPN Cu administration.  One patient showed a great increase in IL-6 level and a decrease in Cp levels; this patient, who received the lowest TPN Cu doses, died. Conclusions: These results showed a lack of correlation between the studied biochemical parameters and Cu doses in the range from 0.5 to 3 mg/d, administered in TPN. Financed by Buenos Aires University (UBA), grant B 103.