Influência da suplementação alimentar com concentrado de proteínas do soro do leite na mucosite oral em pacientes submetidos ao transplante de células tronco hematopoéticas

Abstract

Patients conditioning regimen for stem cell transplantation hematopoietic have a high incidence of the more severe forms of oral mucositis. The whey protein concentrate is composed of various cell growth factors, including beta transforming growth factors-β. Transforming growth factors-β compose a family of milk peptides and contributes to tissue repair. Based on the hypothesis that dietary supplementation with whey protein concentrate has the potential to reduce the oral mucositis, we developed a prospective study with patients undergoing autologous and allogeneic stem cell transplantation hematopoietic at the University Hospital of the Federal University of Juiz de Fora and Monte Sinai Hospital with different conditioning protocols. Patients were supplemented with a daily intake of whey protein concentrate containing 50% of the daily protein requirements as Dietary Reference Intakes and classified later as supplement ingested amount of up median onset of oral mucositis. A total of 73 patients were evaluated. Forty three e were part of the historical control and 30 were supplemented with whey protein concentrate. The oral mucositis had a mean duration of 5.3 days (SD: 4.5), ranging from the day of the infusion of stem cells until the 17th day after infusion and a median of 5 days after infusion. Oral mucositis time was influenced by the conditioning protocol (p < 0.01) and whey protein concentrate (p = 0.01). Patients who consumed the whey protein concentrate in an amount equal to or greater than 40% of daily protein requirements submitted a duration of oral mucositis 35% smaller (p = 0.007) and 11% reduction in the incidence of oral mucositis in grades 3 and 4 (p = 0.004). The nutritional status and adverse reactions as diarrhea, nausea and vomiting, dysphagia, dry mouth and drooling showed no statistically significant differences. The whey protein concentrate intake greater than or equal to 40% of daily protein requirements, helped to reduce the severity and duration of oral mucositis’s time. It's necessary new studies in this population in order to assess their action style.