Supplemental Protein and Multi‐Nutrient Beverage Improve Immune Response at Experimental Wound Site during 72‐h Sleep Restriction
Authors: Smith Tracey J , Wilson Marques A , Young Andrew J , Montain Scott J 
Published: November 2023

The suctionblister model creates experimental skin wounds and permits evaluation of local immune response and wound healing. Sleep restriction negatively affects immune function at the wound site and delays skin barrier restoration; however, the impact of nutrition intervention on local immune response and skin barrier restoration of experimental wounds concomitant with sleep restriction is not known. This study assessed the effect of a high protein diet and multi‐nutrient beverage on cytokine concentrations of wound exudate and skin barrier restoration of experimental wounds in participants who underwent 72‐h of sleep restriction. The experimental group (EXP), compared to the control group (CON), consumed additional protein (~1.5 versus 0.8 g/kg bodyweight/d, respectively) and a multi‐nutrient beverage administered twice daily during the 3‐d sleep restriction period and five days afterwards. The beverage contained L‐arginine (20 g· d−1), L‐glutamine (30 g· d−1), omega‐3 fatty acids (1 g· d−1), zinc sulfate (24 mg· d−1), vitamin D3 (800 IU· d−1) and vitamin C (400 mg· d−1). On the second day of a 3‐d sleep restriction period (monitored in laboratory with ~2‐h sleep per night), up to 8 blisters (~30 mm2) were induced via suction on participant's forearm, and top layer of blisters was removed to reveal wounds. Wound exudate was sampled at 4, 7, 24 and 48‐h post blistering to assess cytokine response via multiplex assay and area‐under‐the‐curve with respect to baseline cytokine concentrations (AUCi) was calculated. Skin barrier restoration was assessed by transepidermal water loss, measured daily until values were within 90% of unbroken skin. Data was analyzed with mixed models analysis of variance and independent samples t‐tests. Twenty participants in each group (CON, 21 ± 4 years [mean±SD]and EXP, 21 ± 3 years) completed the study. Sleep duration in the 5‐days leading up to either the sleep restriction period was not different between CON and EXP (7.71 ± 0.67 hrs· d−1and 7.64 ± 0.5 hrs· d−1, respectively, p = 0.71). Wound exudate concentrations of IL6, IL8, MIP1α, MIP1β and TNFα significantly increased over time for both groups (p<0.05);and, concentrations of IL6, IL8 and MIP1β were higher for (EXP) compared to (CON)at various time‐points (p < 0.05). The AUCi was higher for (EXP) compared to (CON) with regard to IL6 (log10,5.7 ±0.3 and 5.3 ± 0.3, respectively, p < 0.0001) and IL8 (log10,6.3 ±0.5 and 5.6 ± 0.1, respectively, p < 0.0001). Skin barrier restoration was not significantly different between (CON) and (EXP): 5.0 ± 0.9 days and 4.6± 0.8 days (P = 0.18). These data indicate that local immune function is positively impacted by additional protein and a multi‐nutrient beverage during and after 72‐h sleep restriction, but no between‐group differences in skin barrier restoration were detected. A cross‐over study to confirm the findings is warranted.DisclaimerThe views expressed in this abstract are those of the authors and do not reflect the official policy of the Department of Army, Department of Defense, or the U.S. Government.Support or Funding InformationFunded by the Medical Research and Materiel Command, Aberdeen Proving Ground, Maryland.