Glutamine and acute illness

Current Opinion in Critical Care

Volumn 9, Issue 4, 2003, Pages 279-285

  Wernerman, Jan ^a  

^a KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

GLUTAMINE; GLUTATHIONE;

BONE MARROW TRANSPLANTATION; CRITICAL ILLNESS; DIET SUPPLEMENTATION; EXERCISE; GASTROINTESTINAL TRACT; HEPATIC ENCEPHALOPATHY; HUMAN; IMMUNE SYSTEM; INTENSIVE CARE UNIT; MORTALITY; NUTRITION; NUTRITIONAL DEFICIENCY; NUTRITIONAL SUPPORT; PREMATURITY; PROGNOSIS; REVIEW;

ACUTE DISEASE; CRITICAL CARE; CRITICAL ILLNESS; GLUTAMINE; HUMANS; NUTRITIONAL SUPPORT; PREDICTIVE VALUE OF TESTS;

EID: 0043269747     PISSN: 10705295     EISSN: None     Source Type: Journal    
DOI: 10.1097/00075198-200308000-00005     Document Type: Review

References (101)

1. Novak F, Heyland DK, Avenell A, et al.: Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med 2002, 30:2022-2029. A systematic as well as a comprehensive review combined with a metaanalysis. There are already some more studies published, however.
2. Buchman AL: Glutamine:commercially essential or conditionally essential? A critical appraisal of the human data. Am J Clin Nutr 2001, 74:25-32.
3. Boelens PG, Houdijk AP, Haarman HJ, et al.: Glutamine-enriched enteral nutrition decreases infectious complications in trauma patients. Am J Clin Nutr 2002, 76:253-254.
4. Cynober LA: Clinical nutrition: commercially or clinically essential? Am J Clin Nutr 2002, 76:255-256.
5. Kelly D, Wischmeyer PE: Role of L-glutamine in critical illness: new insights. Curr Opin Clin Nutr Metab Care 2003, 6:217-222.
6. Griffiths RD, Andrews F: Glutamine: a life-threatening deficiency in the critically ill? Intensive Care Med 2001, 27:12-15.
7. Hornsby-Lewis L, Shike M, Brown P, et al.: L-glutamine supplementation in home total parenteral nutrition patients: stability, safety, and effects on intestinal absorption. JPEN J Parenter Enteral Nutr 1994, 18:268-273.
8. Oppong K, Al-Mardini H, Thick M, et al.: Oral glutamine challenge in cirrhotics awaiting liver transplantation: a psychometric and analyzed EEG study. Gastroenterology 1995, 108:A1138.
9. Peeters MA, Salabelle A, Attal N, et al.: Excessive glutamine sensitivity in Alzheimer's disease and Down syndrome lymphocytes. J Neurol Sci 1995, 133:31-41.
10. Ward E, Picton S, Reid U, et al.: Oral glutamine in pediatric oncology patients: a dose finding study. Eur J Clin Nutr 2003, 57:31-36.
11. Tjäder I, Essen P, Wernerman J: Glutamine to ICU patients restores plasma glutamine concentrations in a dose dependent way, whereas muscle glutamine remains unaffected. Clin Nutr 2001, 20(suppl 3):53.
12. Berg A, Forsberg E, Wernerman J: The local vascular tolerance to an intravenous infusion of a concentrated glutamine solution in ICU patients. Clin Nutr 2002, 21:135-139.
13. Liu W, Lopez JM, Van der Jagt DJ, et al.: Evaluation of aminoaciduria in severely traumatized patients. Clin Chim Acta 2002, 316:123-128.
14. Berg A, Gamrin L, Martling C, et al.: Glutazmine losses due to continuous renal replacement therapym(ORRP) in ICU patients. Clin Nutr 2002, 21 (suppl 1):85.
15. Oudemans-van Straaten HM, Bosman RJ, Treskes M, et al.: Plasma glutamine depletion and patient outcome in acute ICU admissions. Intensive Care Med 2001, 27:84-90.
16. Becker RM, Wu G, Galanko JA, et al.: Reduced serum amino acid concentrations in infants with necrotizing enterocolitis. J Pediatr 2000, 137:785-793.
17. Griffiths RD, Jones C, Palmer TE: Six-month outcome of critically ill patients given glutamine-supplemented parenteral nutrition. Nutrition 1997, 13:295-302.
18. Goeters C, Wenn A, Metres N, et al.: Parenteral L-alanyl-L-glutamine improves 6-month outcome in critically ill patients. Crit Care Med 2002, 30:2032-2037. A new prospective study of intravenous glutamine supplementation to ICU patients. Unfortunately, results of primary endpoint and the outcome after 5 days of treatment are not given explicitly in article.
19. Conejero R, Bonet A, Grau T, et al.: Effect of a glutamine-enriched enteral diet on intestinal permeability and infectious morbidity at 28 days in critically patients with systemic inflammatory response syndrome: a randomised, single-blind, prospective, multicenter study. Nutrition 2002, 18:716-721. A new prospective study of morbidity in systemic inflammatory response syndrome patients.
20. Ockenga J, Borchert K, Rifai K, et al.: Effect of glutamine-enriched total parenteral nutrition in patients with acute pancreatitis. Clin Nutr 2002, 21:409-416. A new study of length of stay in ICU patients.
21. Wischmeyer PE, Lynch J, Liedel J, et al.: Glutamine administration reduces Gram-negative bacteremia in severely burned patients: a prospective, randomised, double-blind trial versus isonitrogenous control. Crit Care Med 2001, 29:2075-2080.
22. Biolo G, Fleming RY, Maggi SP, et al.: Inhibition of muscle glutamine formation in hypercatabolic patients. Clin Sci (Lond) 2000, 99:189-194.
23. Vesali RF, Klaude M, Rooyackers OE, et al.: Longitudinal pattern of glutamine/glutamate balance across the leg in long-stay intensive care unit patients. Clin Nutr 2002, 21:505-514. A descriptive study in ICU patients demonstrating that the efflux of glutamine from muscle tissue does not decrease over time.
24. Bruins MJ, Deutz NE, Soeters PB: Aspects of organ protein, amino acid and glucose metabolism in a porcine model of hypermetabolic sepsis. Clin Sci (Lond) 2003, 104:127-141.
25. O'Leary MJ, Ferguson CN, Rennie MJ, et al.: Sequential changes in in vivo muscle and liver protein synthesis and plasma and tissue glutamine levels in sepsis in the rat. Clin Sci (Lond) 2001, 101:295-304.
26. Heuschen UA, Allemeyer EH, Hinz U, et al.: Glutamine distribution in patients with ulcerative colitis and patients with familial adenomatous polyposis coli before and after restorative proctocolectomy. Int J Colorectal Dis 2002, 17:245-252.
27. Sharma U, Atri S, Sharma MC, et al.: Skeletal muscle metabolism in Duchenne muscular dystrophy (DMD): an in vitro proton NMR spectroscopy study. Magn Reson Imaging 2003, 21:145-153.
28. Stehle P, Zander J, Mertes N, et al.: Effect of parenteral glutamine peptide supplements on muscle glutamine loss and nitrogen balance after major surgery. Lancet 1989, 1:231-233.
29. Hammarqvist F, Wernerman J, vonder Decken A, et al.: Alanyl-glutamine counteracts the depletion of free glutamine and the postoperative decline in protein synthesis in skeletal muscle. Ann Surg 1990, 212:637-644
30. Gore DC, Wolfe RR: Glutamine supplementation fails to affect muscle protein kinetics in critically ill patients. JPEN J Parenter Enteral Nutr 2002, 26:342-349. A pilot study in ICU patients demonstrating that exogenous glutamine has little effect upon glutamine metabolism in muscle tissue.
31. Svanberg E, Moller-Loswick AC, Matthews DE, et al.: The effect of glutamine on protein balance and amino acid flux across arm and leg tissues in healthy volunteers. Clin Physiol 2001, 21:478-489.
32. Humbert B, Nquyen P, Dumon H, et al.: Does enteral glutamine modulate whole-body leucine kinetics in hypercatabolic dogs in a fed state? Metabolism 2002, 51:628-635.
33. Holecek M, Skopec F, Sprongl L, et al.: Effect of alanyl-glutamine on leucine and protein metabolism irradiated rats. Amino Acids 2002, 22:95-108.
34. Lima AA, Carvalho GH, Figueiredo AA, et al.: Effects of an alanyl-glutamine-based oral rehydration and nutrition therapy solution on electrolyte and water absorption in rat model of secretory diarrhea induced by cholera toxin. Nutrition 2002, 18:458-462.
35. Hwang JM: Chan de C, Chang TM, Tsao TY, Tsou SS, Lu RH, Tsai LM. Effects of oral arginine and glutamine on radiation-induced injury in the rat. J Surg Res 2003, 109:149-154.
36. Salvalaggio PR, Neto CZ, Tolazzi AR, et al.: Oral glutamine does not prevent bacterial translocation in rat subjected to intestinal obstruction and Escherichia coli challenge but reduces systemic bacteria spread. Nutrition 2002, 18:334-337.
37. Li JY, Lu Y, Hu S, et al.: Preventive effect of glutamine on intestinal barrier dysfunction induced by severe trauma. World J Gastroenterol 2002, 8:168-171.
38. Lin MT, Saito H, Furukawa S, et al.: Alanyl-glutamine enriched total parenteral nutrition improves local, systemic, and remote organ responses to intraperitoneal bacterial challenge. JPEN J Parenter Enteral Nutr 2001, 25:346-351.
39. Choi SH, Lee S, Lee MD: Glutamine on the luminal microbial environment after massive small bowel resection. J Korean Med Sci 2002, 17:778-783.
40. Ikeda S, Zarzaur BL, Johnson CD, et al.: Total parenteral nutrition supplementation with glutamine improves survival after gut ischemia/reperfusion. JPEN J Parenter Enteral Nutr 2002, 26:169-173.
41. Brooks HW, White DG, Wagstaff AJ, et al.: Evaluation of a glutamine-containing oral rehydration solution for the treatment of calf diarrhoea using an Escherichia coli model. Vet J 1997, 153:163-169.
42. Velasco N, Hernandez G, Wainstein C, et al.: Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients. Nutrition 2001, 17:907-911.
43. Scolapio JS, McGreevy K, Tennyson GS, et al.: Effect of glutamine in short-bowel syndrome. Clin Nutr 2001, 20:319-323.
44. Akobeng AI, Clayton PE, Miller V, et al.: Low serum concentration of insulin-like growth factor-I in children with active Crohn disease: effect of enteral nutrition support and glutamine supplementation. Scand J Gastroenterol 2002, 37:1422-1427.
45. Coeffier M, Claeyssens S, Hecketsweiler B, et al.: Enteral non-essential amino acids stimulate protein synthesis and glutamine decreases ubiquitin mRNA level in human gut mucosal. Am J Physiol Gastrointest Liver Physiol [serial online] April 17, 2003.
46. Coeffier M, Le Pessot F, Leplingard A, et al.: Acute enteral glutamine infusion enhances heme oxygenase-1 expression in human duodenal mucosal. J Nutr 2002, 132:2570-2573.
47. Roth E, Oehler R, Manhart N, et al.: Regulative potential of glutamine-relation to glutathione metabolism. Nutrition 2002, 18:217-221.
48. Tretter L, Repassy R, Adam-Vizi V: Endogenous glutamate contributes to the maintenance of glutathione level under oxidative stress in isolated nerve terminals. Neurochem Int 2003, 42:393-400.
49. Yu JC, Jiang ZM, Li DM: Glutamine: a precursor of glutathione and its effect on liver. World J Gastroenterol 1999, 5:143-146.
50. Fläring UB, Rooyackers OE, Wernerman J, et al.: Glutamine attenuates post-traumatic glutathione depletion in human muscle. Clin Sci (Lond) 2003, 104:275-282. A small interventional study in postoperative patients showing that glutamine supplementation improves muscle glutathione status.
51. Oehler R, Roth E: Regulative capacity of glutamine. Curr Opin Clin Nutr Metab Care 2003, 6:277-282. A very nice overview of some of the present hypotheses for effects of glutamine.
52. Wischmeyer PE: Glutamine and heat shock protein expression. Nutrition 2002, 18:225-228.
53. Tazuke Y, Wasa M, Shimizu Y, et al.: Alanyl-glutamine-supplemented parenteral nutrition prevents intestinal ischemia-reperfusion injury in rats. JPEN J Parenter Enteral Nutr 2003, 27:110-115.
54. Wischmeyer PE, Vanden Hock TL, Li C, et al.: Glutamine preserves cardiomyocyte viability and enhances recovery of contractile function after ischemia-reperfusion injury. JPEN J Parenter Enteral Nutr 2003, 27:116-122.
55. Scharte M, Baba HA, van Aken H, et al.: Alanyl-glutamine dipeptide does not affect hemodynamics despite a greater increase in myocardial heat shock protein 7 immunoreactivity in endotoxemic sheep. J Nutr 2001, 131:1433-1437.
56. Khogali SE, Pringle SD, Weryk BV, et al.: Is glutamine beneficial in ischemic heart disease? Nutrition 2002, 18:123-126. A small study indicating the possibility that glutamine may have a role in patients with ischemic heart conditions.
57. Newsholme P, Procopio J, Lima MM, et al.: Glutamine and glutamate - their central role in cell metabolism and function. Cell Biochem Funct 2003, 21:1-9.
58. Welbourne T, Routh R, Yudkoff M, et al.: The glutamine/glutamate couplet and cellular function. News Physiol Sci 2001, 16:157-160.
59. Wischmeyer PE, Kahana M, Wolfson R, et al.: Glutamine reduces cytokine release, organ damage, and mortality in a rat model of endotoxemia. Shock 2001, 16:398-402.
60. Exner R, Tamandl D, Goetzinger P, et al.: Perioperative GLY-GLN infusion diminishes the surgery-induced period of immunosuppression: accelerated restoration of the lipopolysaccharide-stimulated tumor necrosis factor-Alpha response. Ann Surg 2003, 237:110-115.
61. Pithon-Curi TC, Schumacher RI, Freitas JJ, et al.: Glutamine delays spontaneous apoptosis in neutrophils. Am J Physiol Cell Physiol 2003, 284:C1355-C1361.
62. Ikeda S, Kudsk KA, Le T, et al.: Glutamine improves impaired cellular exudation and polymorphonuclear neutrophil phagocytosis induced by total parenteral nutrition after glycogen-induced murine peritonit. Shock 2003, 19:50-54.
63. Exner R, Weingartmann G, Eliasen MM, et al.: Glutamine deficiency renders human monocytic cells more susceptible to specific apoptosis triggers. Surgery 2002, 131:57-80.
64. Kircher B, Eibl G, Enrich B, et al.: The role of L-alanyl-L-glutamine in the immune response in vitro. Wien Klin Wochenschr 2002, 30:702-708.
65. Boelens PG, Houdijk AP, Fonk JC, et al.: Glutamine-enriched enteral nutrition increases HLA-DR expression on monocytes of trauma patients. J Nutr 2002, 132:2580-2586.
66. Oehler R, Pusch E, Dungel P, et al.: Glutamine depletion impairs cellular stress response in human leucocytes. Br J Nutr 2002, 87(suppl 1):S17-S21.
67. Wischmeyer PE, Riehm J, Singleton KD, et al.: Glutamine attenuates tumor necrosis factor-alpha release and enhances heat shock protein 72 in human peripheral blood mononuclear cells. Nutrition 2003, 19:1-6.
68. Wischmeyer PE, Kahana M, Wolfson R, et al.: Glutamine induces heat shock protein and protects against endotoxin shock in the rat. J Appl Physiol 2001, 90:2403-2410.
69. Hayashi Y, Sawa Y, Fukuyama N, et al.: Preoperative glutamine administration induces heat-shock protein 70 expression and attenuates cardiopulmonary bypass induced inflammatory response by regulating nitric oxide synthase activity. Circulation 2002, 106:2601-2607.
70. Albrecht J, Dolinska M: Glutamine as a pathogenic factor in hepatic encephalopathy. J Neurosci Res 2001, 65:1-5.
71. Cooper AJ: Role of glutamine in cerebral nitrogen metabolism and ammonia neurotoxicity. Ment Retard Dev Disabil Res Rev 2001, 7:280-286.
72. Häussinger D, Schliess F, Kircheis G: Pathogenesis of hepatic encephalopathy. J Gasteroenterol Hepatol 2002, 17(suppl 3):S253-S259.
73. Olde Damink SW, Jalan R, Redhead DN, et al.: Interorgan ammonia and amino acid metabolism in metabolically stable patients with cirrhosis and a TIPSS. Hepatology 2002, 36:1163-1171.
74. Romero-Gomez M, Grande L, Camacho I, et al.: Altered response to oral glutamine challenge as prognostic factor for overt episodes in patients with minimal hepatic encephalopathy. J Hepatol 2002, 37:781-787.
75. Masini A, Efrati C, Merli M, et al.: Effect of blood ammonia elevation following oral glutamine load on the psychometric performance of cirrhotic patients. Metab Brain Dis 2003, 18:27-35.
76. Murray SM, Pindoria S: Nutrition support for bone marrow transplant patients. Cochrane Database Syst Rev 2002, 2:CD002920.
77. Ziegler TR: Glutamine supplementation in bone marrow transplantation. Br J Nutr 2002, 87(suppl 1):S9-15.
78. Pytlik R, Benes P, Patorkova M, et al.: Standardized parenteral alanyl-glutamine dipeptide supplementation is not beneficial in autologous transplant patients: a randomized, double-blind, placebo controlled study. Bone Marrow Transplant 2002, 30:953-961. An important study indicating the possibility that glutamine supplementation may have effects on malignancies. More information from this study and others is necessary, however, before anything can be concluded.
79. Piccirillo N, De Matteis S, Laurenti L, et al.: Glutamine-enriched parenteral nutrition after autologous peripheral blood stem cell transplantation: effects on immune reconstitution and mucositis. Haematologica 2003, 88:192-200.
80. Neu J, Roig JC, Meetze WH, et al.: Enteral glutamine supplementation for very low birth weight infants decreases morbidity. J Pediatr 1997, 131:691-699.
81. Tubman TR, Thompson SW: Glutamine supplementation for prevention of morbidity in preterm infants. Cochrane Database Syst Rev 2001, 4:CD001457.
82. Mercier A, Eurin D: Poulet-Young, Marret S, Dechelotte P. Effect of enteral supplementation with glutamine mesenteric blood flow in premature neonates. Clin Nutr 2003, 22:133-137.
83. Des Robert C, Le Bacquer O, Piloquet H, et al.: Acute effects of intravenous glutamine supplementation on protein metabolism in very low birth weight infants: a stable isotope study. Pediatr Res 2002, 51:87-93.
84. Vejchapipat P, Eaton S, Fukumoto K, et al.: Hepatic glutamine metabolism during endotoxemia in neonatal rats. Nutrition 2002, 18:293-297.
85. Garrett-Cox RG, Pierro A, Spitz L, et al.: Body temperature and heat production in suckling rat endotozaemia: beneficial effect of glutamine. J Pediatr Surg 2003, 38:37-44.
86. Poindexter BB, Ehrenkranz RA, Stoll BJ, et al.: Effect of parenteral glutamine supplementation on plasma amino acid concentrations in extremely low-birth-weight infants. Am J Clin Nutr 2003, 77:737-743.
87. Antonio J, Sanders MS, Kalman D, et al.: The effects of high-dose glutamine ingestion on weightlifting performance. J Strength Cond Res 2002, 16:157-160.
88. Candow DG, Chilibeck PD, Burke DG, et al.: Effect of glutamine supplementation combined with resistance training in young adults. Eur J Appl Physiol 2001, 86:142-149.
89. Castell L: Glutamine supplementation in vitro and in vivo, in exercise and in immunodepressiion. Sports Med 2003, 33:323-345.
90. Krzywkowski K, Petersen EW, Ostrowski K, et al.: Effect of glutamine supplementation on exercise-induced changes in lymphocyte function. Am J Physiol Cell Physiol 2001, 281:C1259-C1265.
91. Hiscock NJ, Petersen EW, Krzywkowski K, et al.: Glutamine supplementation further enhances exercise-induced plasma IL-6. J Appl Physiol [serial online] February 28, 2003.
92. Takala J, Ruokonen E, Webster NR, et al.: Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med 1999, 341:785-792.
93. Gamrin L, Essen P, Hultman E, et al.: Protein Sparing Effect in Skeletal Muscle of Growth Hormone Treatment in Critically Ill Patients. Ann Surg 2000, 231:577-586.
94. Mjaaland M, Unneberg K, Larsson J, et al.: Growth hormone after gastrointestinal surgery: attenuated forearm glutamine, alanine, 3-methylhistidine and total amino acid efflux in patients treated with total parenteral nutrition. Ann Surg 1993, 217:413-422.
95. Kolstad O, Jenssen TG, Ingebretsen OC, et al.: Combination of recombinant human growth hormone and glutamine-enriched total parenteral nutrition to surgical patients: effects on circulating amino acids. Clin Nutr 2001, 20:503-510.
96. Hammarqvist F, Sandgren A, Andersson K, et al.: Growth hormone together with glutamine-containing total parenteral nutrition maintains muscle glutamine levels and results in a less negative nitrogen balance after surgical trauma. Surgery 2001, 129:576-586.
97. Umpleby AM, Carroll PV, Russell-Jones DL, et al.: Glutamine supplementation and GH/IGF-1 treatment in critically ill patients: effects on glutamine metabolism and protein balance. Nutrition 2002, 18:127-129.
98. Gu Y, Wu ZH, Xie JX, et al.: Effects of growth hormone (rhGH) and glutamine supplemented parenteral nutrition on intestinal adaption in short bowel rats. Clin Nutr 2001, 20:159-166.
99. Jung SE, Youn YK, Lim YS, et al.: Combined administration of glutamine and growth hormone synergistically reduces bacterial translocation in sepsis. J Korean Med Sci 2003, 18:17-22.
100. O'Leary MJ, Ferguson CN, Rennie M, et al.: Effect of growth hormone on muscle and liver protein synthesis in septic rats receiving glutamine-enriched parenteral nutrition. Crit Care Med 2002, 30:1099-1105.
101. O'Leary MJ, Ferguson CN, Coakley JH, et al.: Influence of starvation, surgery, and sepsis on cardiac protein synthesis in rats: effects of parenteral nutrition, glutamine, and growth hormone. Shock 2002, 18:265-271.