The Effects of Genistein as Supplement to Oral/Enteral Nutrition on Inflammatory Cytokines in Septic ICU patients: A Prospective, Single-center, Randomized Controlled Pilot Study
1Division of Intensive Care, Department of Medicine, Erciyes University Faculty of Medicine, Kayseri, Türkiye
2Department of Clinical Nutrition, Erciyes University, Health Science Institute, Kayseri, Türkiye
3Department of Clinical Biochemistry, Erciyes University Faculty of Medicine, Kayseri, Türkiye
4Department of Hematology and Medical Oncology, Emory University Faculty of Medicine, Atlanta, GA, USA
5Department of Internal Medicine, Lokman Hekim University School of Medicine, Ankara, Türkiye
J Clin Pract Res 2023; 45(2): 131-137 DOI: 10.14744/etd.2022.55492
Full Text PDF

Abstract

Objective: Genistein has an anti-inflammatory effect that may be beneficial in many inflammatory diseases. The aim of this study was to determine the effects of supplementation of oral/enteral nutrition (EN) with genistein on the level of inflammatory cytokines in septic patients.
Materials and Methods: This prospective, randomized controlled study included critically ill adult patients with sepsis receiving EN or oral/EN. The patients were randomly divided into a genistein or a control group. Genistein (60 mg/day) was administered as a supplement to EN in the genistein group and the control group received only EN or oral/EN. Serum interleukin 1 beta (IL-1β), interleukin 6 (IL-6), high mobility group box 1 protein (HMGB-1), tumor necrosis factor alfa (TNF-α), procalcitonin (PCT), and C-reactive protein (CRP) concentrations were serially measured at the baseline, 24th hour, and 72nd hour after admission.
Results: Thirty-two participants (genistein group: 16 patients, control group: 16 patients) were included. The mean age was 56±17 years. The serum IL-1β concentration in the genistein group was significantly higher than that of the control group in follow-up (p=0.001). The control group had a significantly lower serum IL-6 value at the 72nd hour compared with the baseline and 24th-hour values (p=0.001). The TNF-α concentration was significantly greater (p<0.001, both groups), while the PCT values were lower in follow-up measurements (genistein group: p=0.031; control group: p=0.004). The CRP level was higher in the genistein group than in the control group at the baseline (p=0.019) and significantly lower in follow-up measurements (p=0.028). At all of the study time points, the serum IL-6, TNF-α, HMGB-1, and PCT level of the genistein group was similar to that of the control group.
Conclusion: Genistein supplementation may add to the inflammation process and worsen the prognosis of sepsis patients in the acute period.