Role of arginine in immunonutrition

Arginine plays an important role in many physiologic and biologic processes beyond its role as a protein-incorporated amino acid. Dietary supplementation of arginine can enhance wound healing, regulate endocrine activity and potentiate immune activity. Under normal unstressed conditions the arginine requirement of adult humans is fulfilled by endogenous sources, however this is compromised during times of stress, especially in critical illness. These finding have led to use of arginine supplementation as part of an immune-enhancing dietary regimen to help combat the immune suppression seen in such patients. Though the results from studies examining the use of this type of immunonutrition in critically ill patients are far from definitive, they are promising that this mode of therapy may be of some advantage. A better understanding of the in vivo biology of arginine and its metabolism is necessary to truly define a benefit from arginine supplementation.