{"id":65069,"date":"2025-02-10T05:00:29","date_gmt":"2025-02-10T08:00:29","guid":{"rendered":"https:\/\/nutritotal.com.br\/pro\/?p=65069"},"modified":"2025-02-06T09:00:11","modified_gmt":"2025-02-06T12:00:11","slug":"o-que-e-terapia-nutricional-imunomoduladora","status":"publish","type":"post","link":"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/","title":{"rendered":"O que \u00e9 terapia nutricional imunomoduladora?"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_75 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Conte\u00fado<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Quais_os_beneficios_da_terapia_nutricional_imunomoduladora\" >Quais os benef\u00edcios da terapia nutricional imunomoduladora?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Principais_nutrientes_imunomoduladores\" >Principais nutrientes imunomoduladores<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Glutamina\" >Glutamina<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Arginina\" >Arginina<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Omega-3\" >\u00d4mega-3<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#O_que_podemos_concluir\" >O que podemos concluir?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/nutritotal.com.br\/pro\/o-que-e-terapia-nutricional-imunomoduladora\/#Referencias\" >Refer\u00eancias:<\/a><\/li><\/ul><\/nav><\/div>\n<p><span style=\"font-weight: 400;\">A terapia nutricional imunomoduladora trata-se da administra\u00e7\u00e3o de dieta (oral, enteral ou parenteral) que cont\u00e9m nutrientes com o objetivo de apoiar a fun\u00e7\u00e3o do sistema imunol\u00f3gico ou modular sua atividade.\u00a0<\/span><\/p>\n<div id=\"attachment_65071\" style=\"width: 1160px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-65071\" class=\"wp-image-65071 size-full\" src=\"https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2025\/02\/portal-para-nutricionistas-terapia-nutricional-imunomoduladora.png\" alt=\"terapia nutricional imunomoduladora\" width=\"1150\" height=\"460\" srcset=\"https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2025\/02\/portal-para-nutricionistas-terapia-nutricional-imunomoduladora.png 1150w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2025\/02\/portal-para-nutricionistas-terapia-nutricional-imunomoduladora-300x120.png 300w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2025\/02\/portal-para-nutricionistas-terapia-nutricional-imunomoduladora-768x307.png 768w, https:\/\/nutritotal.com.br\/pro\/wp-content\/uploads\/2025\/02\/portal-para-nutricionistas-terapia-nutricional-imunomoduladora-1024x410.png 1024w\" sizes=\"(max-width: 1150px) 100vw, 1150px\" \/><p id=\"caption-attachment-65071\" class=\"wp-caption-text\">Fonte: Canva<\/p><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Quais_os_beneficios_da_terapia_nutricional_imunomoduladora\"><\/span><b>Quais os benef\u00edcios da terapia nutricional imunomoduladora?<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">A imunonutri\u00e7\u00e3o pode modular mecanismos espec\u00edficos envolvidos em v\u00e1rias vias imunes e inflamat\u00f3rias.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">No <\/span><b>contexto cir\u00fargico<\/b><span style=\"font-weight: 400;\">, demonstrou reduzir o risco de complica\u00e7\u00f5es e mortalidade, bem como encurtar a interna\u00e7\u00e3o hospitalar. Em cirurgia gastrointestinal, pode ajudar a manter a fun\u00e7\u00e3o da barreira intestinal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A imunonutri\u00e7\u00e3o tamb\u00e9m parece aliviar rea\u00e7\u00f5es adversas em <\/span><b>pacientes oncol\u00f3gicos<\/b><span style=\"font-weight: 400;\"> submetidos \u00e0 radioterapia e quimioterapia, aumentar sua efic\u00e1cia, melhorar a fun\u00e7\u00e3o imunol\u00f3gica, reduzir a inflama\u00e7\u00e3o e tratar a caquexia de pacientes oncol\u00f3gicos.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Em outras condi\u00e7\u00f5es, como<\/span><b> trauma e queimaduras<\/b><span style=\"font-weight: 400;\">, o uso de imunonutrientes tamb\u00e9m parece auxiliar os desfechos cl\u00ednicos.\u00a0<\/span><\/p>\n<p><b>O uso da terapia nutricional imunomoduladora em pacientes cl\u00ednicos, sem as condi\u00e7\u00f5es anteriores, ainda permanece controverso<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Por exemplo, a Sociedade Brasileira de Nutri\u00e7\u00e3o Parenteral e Enteral (BRASPEN) afirma que f\u00f3rmulas enterais imunomoduladoras n\u00e3o devem ser utilizadas rotineiramente em UTI, \u00e0 exce\u00e7\u00e3o de pacientes cir\u00fargicos hemodinamicamente est\u00e1veis, e em p\u00f3s-operat\u00f3rio de cirurgias de grande porte, principalmente por c\u00e2ncer.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Entretanto, um estudo observacional prospectivo multic\u00eantrico com 406 pacientes em UTI sugeriu um poss\u00edvel benef\u00edcio com o uso de f\u00f3rmulas enterais imunomoduladoras. Os pacientes que receberam essa terapia apresentaram menor necessidade de vasopressores e terapia de substitui\u00e7\u00e3o renal cont\u00ednua (RRT), melhor suprimento cal\u00f3rico e proteico e melhor sobreviv\u00eancia.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"Principais_nutrientes_imunomoduladores\"><\/span><b>Principais nutrientes imunomoduladores<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Diversos nutrientes podem ser utilizados na terapia nutricional imunomoduladora, sozinhos ou em combina\u00e7\u00e3o. Dentre eles:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/parceiros\/glutamina-na-pratica-clinica-beneficios-para-a-saude-intestinal-e-novas-evidencias\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Glutamina<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/arginina-no-tratamento-da-covid-19\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Arginina<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/omega-3-em-np-aprimora-recuperacao-pos-operatoria-em-doenca-de-crohn\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">\u00d4mega-3<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vitaminas (A, C, D, E)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Minerais (zinco, sel\u00eanio)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nucleot\u00eddeos<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Contudo, os principais nutrientes imunomoduladores investigados na literatura cient\u00edfica e citados pelas diretrizes de sa\u00fade s\u00e3o <\/span><b>a glutamina, a arginina e o \u00f4mega-3<\/b><span style=\"font-weight: 400;\">. Conhe\u00e7a cada um deles a seguir.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Glutamina\"><\/span><b>Glutamina<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A glutamina \u00e9 o amino\u00e1cido livre mais abundante no organismo e desempenha um papel essencial na fun\u00e7\u00e3o imunol\u00f3gica, no equil\u00edbrio de nitrog\u00eanio, no combate \u00e0 infec\u00e7\u00f5es, e na manuten\u00e7\u00e3o da integridade da mucosa intestinal.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Durante per\u00edodos de estresse catab\u00f3lico, como no <\/span><a href=\"https:\/\/nutritotal.com.br\/pro\/quimioterapia-pode-piorar-a-composicao-corporal-de-mulheres-com-cancer\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">c\u00e2ncer<\/span><\/a><span style=\"font-weight: 400;\">, sua demanda pode exceder a capacidade de s\u00edntese do corpo, tornando-se condicionalmente essencial.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">No sistema imunol\u00f3gico, a glutamina \u00e9 fundamental para a prolifera\u00e7\u00e3o de linf\u00f3citos e macr\u00f3fagos, al\u00e9m de aumentar a produ\u00e7\u00e3o de glutationa, um antioxidante chave na defesa contra o estresse oxidativo. Tamb\u00e9m atua na prote\u00e7\u00e3o da mucosa gastrointestinal, prevenindo a transloca\u00e7\u00e3o bacteriana e reduzindo complica\u00e7\u00f5es infecciosas.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">N\u00e3o obstante, a glutamina \u00e9 recomendada pela Sociedade Europeia de Nutri\u00e7\u00e3o Cl\u00ednica e Metabolismo (ESPEN) em pacientes com <\/span><b>queimaduras, trauma, paciente cir\u00fargicos, e pacientes polim\u00f3rbidos com \u00falceras por press\u00e3o<\/b><span style=\"font-weight: 400;\">. Entretanto, n\u00e3o est\u00e1 recomendada para pacientes de UTI em geral, incluindo aqueles com insufici\u00eancia hep\u00e1tica e renal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A BRASPEN tamb\u00e9m sugere o uso de glutamina em determinadas situa\u00e7\u00f5es, como pacientes com <\/span><b>pancreatite aguda grave, trauma, e para a cicatriza\u00e7\u00e3o de feridas<\/b><span style=\"font-weight: 400;\">, embora n\u00e3o recomende para pacientes cr\u00edticos, fase aguda da doen\u00e7a grave e pacientes queimados.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A depender de cada caso, as doses podem variar, em uma escala geralmente de 0.2 a 0.5 g\/kg\/dia.\u00a0<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Arginina\"><\/span><b>Arginina<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">A arginina, um amino\u00e1cido condicionalmente essencial em doen\u00e7as cr\u00edticas, desempenha um papel importante na imunidade e na recupera\u00e7\u00e3o tecidual. Ela estimula a prolifera\u00e7\u00e3o de linf\u00f3citos T, aumenta a resposta imunol\u00f3gica e contribui para a deposi\u00e7\u00e3o de prote\u00edna e col\u00e1geno em feridas.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Al\u00e9m disso, regula a inflama\u00e7\u00e3o p\u00f3s-operat\u00f3ria, eleva a concentra\u00e7\u00e3o de IgM e influencia a imunoterapia por meio das vias da arginase e do \u00f3xido n\u00edtrico (NO). No entanto, a produ\u00e7\u00e3o excessiva de NO pode causar danos teciduais, exigindo cautela na suplementa\u00e7\u00e3o, especialmente em casos de inflama\u00e7\u00e3o grave.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A recomenda\u00e7\u00e3o para suplementa\u00e7\u00e3o de arginina pelas diretrizes de sa\u00fade \u00e9 escassa. Por exemplo, a BRASPEN n\u00e3o recomenda para pacientes s\u00e9pticos, sob poss\u00edvel risco de aumentar a mortalidade.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">J\u00e1 a ESPEN afirma n\u00e3o haver evid\u00eancias suficientes para a suplementa\u00e7\u00e3o intravenosa ou enteral de arginina como subst\u00e2ncia isolada, embora seja indicada em f\u00f3rmulas combinadas (arginina + \u00f4mega-3 + ribonucleot\u00eddeos) para <\/span><b>pacientes desnutridos submetidos \u00e0 cirurgia oncol\u00f3gica de grande porte<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h3><span class=\"ez-toc-section\" id=\"Omega-3\"><\/span><b>\u00d4mega-3<\/b><span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">O <\/span><a href=\"https:\/\/nutritotal.com.br\/pro\/omega-3-quais-os-beneficios-para-a-saude\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">\u00f4mega-3<\/span><\/a><span style=\"font-weight: 400;\"> corresponde a um grupo de \u00e1cidos graxos essenciais, incluindo \u00e1cido alfa-linol\u00eanico (ALA), \u00e1cido docosahexaenoico (DHA) e \u00e1cido eicosapentaenoico (EPA). Como imunonutrientes, suas fun\u00e7\u00f5es incluem:<\/span><\/p>\n<p><b>(1) Regula\u00e7\u00e3o da inflama\u00e7\u00e3o<\/b><span style=\"font-weight: 400;\">: Reduz citocinas inflamat\u00f3rias, como IL-6 e TNF-\u03b1, ajudando a resolver inflama\u00e7\u00f5es; e tamb\u00e9m modulam a produ\u00e7\u00e3o de eicosanoides, diminuindo seus efeitos pr\u00f3-inflamat\u00f3rios e imunossupressores.<\/span><\/p>\n<p><b>(2) Sa\u00fade intestinal<\/b><span style=\"font-weight: 400;\">: Melhoram a microbiota, aumentando a diversidade e a abund\u00e2ncia de bact\u00e9rias ben\u00e9ficas; protegem a barreira intestinal e reduzem a transloca\u00e7\u00e3o bacteriana, prevenindo complica\u00e7\u00f5es p\u00f3s-operat\u00f3rias.<\/span><\/p>\n<p><b>(3) Preven\u00e7\u00e3o do c\u00e2ncer<\/b><span style=\"font-weight: 400;\">: Os \u00e1cidos graxos \u00f4mega-3 j\u00e1 demonstram efeito antiproliferativo, al\u00e9m de potencializa\u00e7\u00e3o da a\u00e7\u00e3o de quimioter\u00e1picos.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A ESPEN afirma que f\u00f3rmulas enterais enriquecidas com \u00f4mega-3 podem ser administradas dentro das doses nutricionais na UTI. Al\u00e9m disso, emuls\u00f5es lip\u00eddicas parenterais enriquecidas com EPA+DHA (dose de \u00f3leo de peixe de 0,1-0,2 g\/kg\/dia) podem ser administradas em pacientes recebendo terapia nutricional parenteral.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ademais, em pacientes com c\u00e2ncer avan\u00e7ado em quimioterapia e em risco de perda de peso ou desnutridos, sugere-se usar suplementa\u00e7\u00e3o com \u00f4mega-3 para estabilizar ou melhorar o apetite, a ingest\u00e3o de alimentos, a massa corporal magra e o peso corporal.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A BRASPEN tamb\u00e9m recomenda o uso de \u00f4mega-3 parenteral para diversos p\u00fablicos, como no c\u00e2ncer e em pacientes sob cuidados perioperat\u00f3rios, com benef\u00edcios atrelados a redu\u00e7\u00e3o no tempo de interna\u00e7\u00e3o hospitalar e\/ou UTI e o menor uso de antibi\u00f3ticos. Saiba mais em: <\/span><a href=\"https:\/\/nutritotal.com.br\/pro\/material\/uso-clinico-de-omega-3-via-parenteral\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Posicionamento BRASPEN: uso de \u00f4mega-3 via parenteral<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"O_que_podemos_concluir\"><\/span><b>O que podemos concluir?<\/b><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"font-weight: 400;\">A terapia nutricional imunomoduladora apresenta diversos benef\u00edcios, sendo geralmente indicada para pacientes cir\u00fargicos e oncol\u00f3gicos desnutridos, auxiliando na redu\u00e7\u00e3o de complica\u00e7\u00f5es, tempo de interna\u00e7\u00e3o, resposta inflamat\u00f3ria, entre outros.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">No entanto, seu uso em outras condi\u00e7\u00f5es cl\u00ednicas ainda \u00e9 debatido. Frequentemente, as diretrizes citam a necessidade de mais estudos, com melhor qualidade metodol\u00f3gica, para indicar essa abordagem nutricional para outros p\u00fablicos.<\/span><\/p>\n<p><b>Se voc\u00ea gostou deste conte\u00fado, leia tamb\u00e9m<\/b><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/tv-nutritotal\/imunonutricao-e-cance-esofagico\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Imunonutri\u00e7\u00e3o e c\u00e2ncer esof\u00e1gico: conhe\u00e7a os benef\u00edcios da suplementa\u00e7\u00e3o<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/parceiros\/glutamina-na-pratica-clinica-beneficios-para-a-saude-intestinal-e-novas-evidencias\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Glutamina na pr\u00e1tica cl\u00ednica: benef\u00edcios para a sa\u00fade intestinal e novas evid\u00eancias<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/nutritotal.com.br\/pro\/terapia-nutricional-imunomoduladora-e-os-efeitos-na-dudodenopancreatectomia\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Terapia Nutricional imunomoduladora e os efeitos na dudodenopancreatectomia<\/span><\/a><\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"Referencias\"><\/span><b>Refer\u00eancias<\/b><span style=\"font-weight: 400;\">:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><a href=\"https:\/\/clinicalnutritionespen.com\/article\/S1751-4991(08)00067-X\/fulltext\" target=\"_blank\" rel=\"noopener\" class=\"broken_link\"><span style=\"font-weight: 400;\">Basics in clinical nutrition: Immunonutrition \u2013 Nutrients which influence immunity: Effect and mechanism of action<\/span><\/a><span style=\"font-weight: 400;\">. Grimble, Robert F. European e-Journal of Clinical Nutrition and Metabolism, Volume 4, Issue 1, e10 &#8211; e13, 2009.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Castro, M. G., Ribeiro, P. C., de Matos, L. B. N., Abreu, H. B., de Assis, T., Barreto, P. A., &#8230; &amp; Toledo, D. O. (2023). <\/span><a href=\"https:\/\/braspenjournal.org\/article\/10.37111\/braspenj.diretrizDOENTEGRAVE\/pdf\/braspen-38-2%2C+Supl+2-6537d6b0a953950ad57860b3.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Diretriz BRASPEN de Terapia Nutricional no Paciente Grave<\/span><\/a><span style=\"font-weight: 400;\">. BRASPEN Journal, 38(2, Supl 2), 0-0.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Castro, M. G., Torrinhas, R., Waitzberg, D. L., da Silva, M. D. L. T., de AguilarNascimento, J. E., Alves, J. T. M., &#8230; &amp; Correia, M. I. T. (2023). <\/span><a href=\"https:\/\/braspenjournal.org\/article\/doi\/10.37111\/braspenj.2022.BRASPEN_position_w3\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Posicionamento BRASPEN sobre o uso cl\u00ednico de \u00f4mega 3 via parenteral<\/span><\/a><span style=\"font-weight: 400;\">. BRASPEN Journal, 37(2), 199-138.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Lopez-Delgado, J.C.; Grau-Carmona, T.; Trujillano-Cabello, J.; Garc\u00eda-Fuentes, C.; Mor-Marco, E.; Bordeje-Laguna, M.L.; Portugal-Rodriguez, E.; Lorencio-Cardenas, C.; Vera-Artazcoz, P.; Macaya-Redin, L.; et al. <\/span><a href=\"https:\/\/www.mdpi.com\/2072-6643\/14\/9\/1904\" target=\"_blank\" rel=\"noopener\" class=\"broken_link\"><span style=\"font-weight: 400;\">The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?<\/span><\/a><span style=\"font-weight: 400;\"> Nutrients 2022, 14, 1904. https:\/\/doi.org\/10.3390\/nu14091904<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ma X, Pei B, Wu N, Wang C, Yu Y, Yang W. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39308867\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Current research and future prospects of immunonutrition in gastrointestinal malignancies<\/span><\/a><span style=\"font-weight: 400;\">. Front Immunol. 2024 Sep 6;15:1420415. doi: 10.3389\/fimmu.2024.1420415. PMID: 39308867; PMCID: PMC11412812.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Miller LJ, Douglas C, McCullough FS, Stanworth SJ, Calder PC. <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36067585\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Impact of enteral immunonutrition on infectious complications and immune and inflammatory markers in cancer patients undergoing chemotherapy: A systematic review of randomised controlled trials<\/span><\/a><span style=\"font-weight: 400;\">. Clin Nutr. 2022 Oct;41(10):2135-2146. doi: 10.1016\/j.clnu.2022.07.039. Epub 2022 Aug 10. PMID: 36067585.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, H\u00fctterer E, Isenring E, Kaasa S, Krznaric Z, Laird B, Larsson M, Laviano A, M\u00fchlebach S, Oldervoll L, Ravasco P, Solheim TS, Strasser F, de van der Schueren M, Preiser JC, Bischoff SC. E<\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33946039\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">SPEN practical guideline: Clinical Nutrition in cancer<\/span><\/a><span style=\"font-weight: 400;\">. Clin Nutr. 2021 May;40(5):2898-2913. doi: 10.1016\/j.clnu.2021.02.005. Epub 2021 Mar 15. PMID: 33946039.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Singer P, Blaser AR, Berger MM, Calder PC, Casaer M, Hiesmayr M, Mayer K, Montejo-Gonzalez JC, Pichard C, Preiser JC, Szczeklik W, van Zanten ARH, Bischoff SC. <\/span><a href=\"https:\/\/www.espen.org\/files\/ESPEN-Guidelines\/ESPEN_practical_and_partially_revised_guideline_Clinical_nutrition_in_the_intensive_care_unit.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit<\/span><\/a><span style=\"font-weight: 400;\">. Clin Nutr. 2023 Sep;42(9):1671-1689. doi: 10.1016\/j.clnu.2023.07.011. Epub 2023 Jul 15. PMID: 37517372.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Weimann A, Braga M, Carli F, Higashiguchi T, H\u00fcbner M, Klek S, Laviano A, Ljungqvist O, Lobo DN, Martindale RG, Waitzberg D, Bischoff SC, Singer P. <\/span><a href=\"https:\/\/www.espen.org\/files\/ESPEN-Guidelines\/ESPEN_practical_guideline_Clinical_nutrition_in_surgery.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">ESPEN practical guideline: Clinical nutrition in surgery<\/span><\/a><span style=\"font-weight: 400;\">. Clin Nutr. 2021 Jul;40(7):4745-4761. doi: 10.1016\/j.clnu.2021.03.031. Epub 2021 Apr 19. PMID: 34242915.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Wunderle C, Gomes F, Schuetz P, Stumpf F, Austin P, Ballesteros-Pomar MD, Cederholm T, Fletcher J, Laviano A, Norman K, Poulia KA, Schneider SM, Stanga Z, Bischoff SC. <\/span><a href=\"https:\/\/www.espen.org\/files\/ESPEN-Guidelines\/ESPEN_guideline_on_nutritional_support_for_polymorbid_medical_in_patients.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">ESPEN guideline on nutritional support for polymorbid medical inpatients<\/span><\/a><span style=\"font-weight: 400;\">. Clin Nutr. 2023 Sep;42(9):1545-1568. doi: 10.1016\/j.clnu.2023.06.023. Epub 2023 Jul 8. PMID: 37478809.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A terapia nutricional imunomoduladora trata-se da administra\u00e7\u00e3o de dieta (oral, enteral ou parenteral) que cont\u00e9m nutrientes com o objetivo de apoiar a fun\u00e7\u00e3o do sistema imunol\u00f3gico ou modular sua atividade.\u00a0 Quais os benef\u00edcios da terapia nutricional imunomoduladora? A imunonutri\u00e7\u00e3o pode modular mecanismos espec\u00edficos envolvidos em v\u00e1rias vias imunes e inflamat\u00f3rias. No contexto cir\u00fargico, demonstrou reduzir [&hellip;]<\/p>\n","protected":false},"author":114981,"featured_media":65070,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2959],"tags":[3603,185,3604],"divisao":[2185,3327],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>O que \u00e9 terapia nutricional imunomoduladora?<\/title>\n<meta name=\"description\" content=\"Descubra como a terapia nutricional imunomoduladora pode fortalecer o sistema imunol\u00f3gico, reduzir complica\u00e7\u00f5es p\u00f3s-operat\u00f3rias e auxiliar pacientes oncol\u00f3gicos. 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