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 (vol 45, pg 131, 2023)

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-1 beta), interleukin 6 (IL-6). high mobility group box 1 protein (HMGB-1), tumor necrosis factor alfa (TNF-alpha), 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-113 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-alpha 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-alpha, 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.