Glutamine: recent developments in research on the clinical significance of glutamine.
OBJECTIVE
The aim of this review is to describe the clinical relevance of supplementation of glutamine from the recent literature. First, new basic research is examined and subsequently recent clinical trials and a metaanalysis are illustrated.


RESULTS
Glutamine has a major impact on the functionality of the immune system. It has recently been established that glutamine not only has a protective effect on cells of the immune system, but also on other cells of the body, for instance cardiomyocytes. Evidence is accumulating for an effect of glutamine via glutathione, heat shock proteins as well as taurine. Another area of interest is the way glutamine enhances gut barrier function. More and more research is concentrating on the positive effect of glutamine on the gut-associated lymphoid tissue.


CONCLUSIONS
Based on a recent meta-analysis and up-to-date clinical trials, we may conclude that glutamine has a beneficial effect on infectious complications and reduces hospital stay. In critically ill patients glutamine supplementation may reduce morbidity and mortality. The greatest effect was observed in patients receiving high dose parenteral glutamine. A recent study with high dose enteral glutamine demonstrated a reduced mortality in the glutamine supplemented group. In the future more trials with larger numbers of participants are needed, especially with high dose enteral glutamine in the perioperatively and the intensive care unit setting.
Melis
Gerdien C
GC
Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
ter Wengel
Nathalie
N
Boelens
Petra G
PG
van Leeuwen
Paul A M
PA
D000818:Animals; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D019587:Dietary Supplements; D005973:Glutamine / Q000276:immunology / Q000627:therapeutic use*; D005978:Glutathione / Q000096:biosynthesis / Q000187:drug effects; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000276:immunology; D008221:Lymphoid Tissue / Q000276:immunology / Q000378:metabolism; D015201:Meta-Analysis as Topic; D017202:Myocardial Ischemia / Q000188:drug therapy; D009748:Nutrition Disorders / Q000188:drug therapy; D018529:Nutritional Support; D051381:Rats; D015427:Reperfusion Injury / Q000517:prevention & control; D013654:Taurine / Q000096:biosynthesis / Q000187:drug effects
D005973:Glutamine; D013654:Taurine; D005978:Glutathione