• Marcela Almeida Linden, Thais Longo de Morais Teixeira, Renata Germano Borges de Oliveira Nascimento Freitas, Maria Ângela Bellomo Brandão, and Roberto José Negrão Nogueira.
• Pediatrics Department at State University of Campinas - UNICAMP, City of Campinas, São Paulo, SP, Brazil. Electronic address: marcelalinden@hotmail.com.
• Nutrition. 2022 Sep 1; 101: 111657.

ObjectiveThe aim of this study was to investigate the influence of supplementation with the immunomodulators arginine and glutamine on transthyretin levels in burn patients.MethodsThis systematic review followed the protocol proposed and registered in PROSPERO (CRD42021239526) and was carried out following the PRISMA checklist for systematic reviews. Forty-four studies were evaluated. Of the 44, we included 6 for complete analysis.ResultsIn five of the six clinical trials, glutamine was the most used immunomodulator (0.5 g·kg·d-1 or 12-14 g/d), followed by arginine in three of the clinical trials (10-14 g/d in adults or 2% of total energy value in children). The findings of the studies were that the patients who received either of these supplements presented the following results: increased transthyretin, lymphoproliferative response, and serum glutamine values, as well as shorter stay in the intensive care unit, a significant reduction in C-reactive protein values, and a tendency toward a faster healing of the burns compared with the control groups.ConclusionIn view of the content in the present review, it is possible to affirm that the supplementation of immunomodulators in burn patients is an effective strategy for their treatment, and that the adequate nutritional offer may be a predictor of a favorable outcome. However, regarding the increase in transthyretin values, this finding needs to be considered with reservations as the values can be altered by the inflammatory activity, and not necessarily related to the use of a supplement.Copyright © 2022 Elsevier Inc. All rights reserved.

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