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Military Strategies for Sustainment of Nutrition and Immune Function in the Field (1999)
Institute of Medicine (IOM)

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. "8 Cytokines and Nutritional Status: Possible Correlations and Investigations." Military Strategies for Sustainment of Nutrition and Immune Function in the Field. Washington, DC: The National Academies Press, 1999.

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working with is trying to get us to send them serum instead of plasma, but it is easier for us to use plasma. Do you have an opinion on which is better?

JEFFREY ROSSIO: We have done a lot of measurements both ways. Plasma is usually easier to get and more available. We haven't had a lot of trouble in measuring cytokines in plasma. So, probably you have to talk to the laboratory and see if they have a problem with standardizing their assays one way, and they don't want to go to the trouble of standardizing them again or not. We haven't found interfering substances.

Now, in some of our studies in cancer patients, we have gone to the extent of doing a double molecular filtration to remove everything with a molecular weight of over 50,000 and everything under a molecular weight of 15,000 or 10,000 with centrifugal filters to see if there were inhibitors around that were affecting our results. The conclusion of that study was that it was not worthwhile to go to the trouble of performing a double molecular filtration.

DAVID NIEMAN: One follow-up question. Immediately after heavy exertion when we take a sample and separate the plasma and try to freeze it within 30 minutes, on doing that we find that IL-6 goes up about sixfold. Is there anything you can recommend like deliverance timing for freezing, or is 30 minutes okay?

JEFFREY ROSSIO: I don't know. We usually just recommend as fast as possible. I think 30 minutes is probably okay. When cytokines are present in low concentrations, like any protein in low concentration, they have a tendency to adhere to glass, to adhere to polystyrene. So, we are usually trying to do it as quickly as possible and get it frozen as quickly as possible.

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Front Matter (R1-R14)
Executive Summary (1-16)
I Committee Summary, Responses to Questions, Conclusions, and Recommendations (17-18)
1 A Review of the Role of Nutrition in Immune Function (19-98)
2 Committee Responses to Questions (99-124)
3 Committee Conclusions and Recommendations (125-135)
II Stage Setting: The Military Situation (137-138)
4 Why is the Army Interested in Nutrition and Immune Function? (139-162)
5 Physiological and Immunological Impact of U.S. Army Special Operations Training: A Model for the Assessment of Nutritional Intervention Effects on Temporary Immunosuppression (163-184)
6 Immune Function Studies During the Ranger Training Course of the Norwegian Military Academy (185-202)
III Introduction to Immune Function (203-204)
7 Nutrition and Immune Responses: What Do We Know? (205-220)
8 Cytokines and Nutritional Status: Possible Correlations and Investigations (221-232)
IV Assessment (233-234)
9 Methodological Issues in Assessment of Human Immune Function (235-248)
10 Application of Whole-Blood Cultures to Field Study Measurements (249-262)
V Nutrition (263-264)
11 Glutamine (265-278)
12 Vitamin A and Immune Function (279-288)
13 Vitamin E, Vitamin C, and Immune Response: Recent Advances (289-304)
14 Fatty Acids and Immune Functions (305-316)
15 Iron Metabolism, Microbial Virulence, and Host Defenses (317-336)
16 Trace Minerals, Immune Function, and Viral Evolution (337-359)
VI Health and Stress (361-362)
17 Exercise, Infection, and Immunity: Practial Applications (363-390)
18 Neuroendocrine Consequences of Systemic Inflammation (391-408)
19 Inflammatory Stress and the Immune System (409-436)
20 Chronobiology of the Immune System (437-496)
21 Conclusion: Militarily Important Issues Identified in this Report (497-508)
Appendixes (509-510)
Appendix A: Overview of the Immune System and Other Host Defense Mechanisms (511-526)
Appendix B: Glossary of Immunological Terms (527-536)
Appendix C: Overview of Immune Assessment Tests (537-542)
Appendix D: Emerging Infections, Nutritional Status, and Immunity (543-552)
Appendix E: Workshop Agenda (553-558)
Appendix F: Biographical Sketches (559-574)
Appendix G: Acronyms and Abbreviations (575-580)
Appendix H: Nutrition and Immune Function: A Selected Bibliography (581-656)
Index (657-708)