title: Effect of glutamine supplementation on diarrhea, interleukin-8 and secretory immunoglobulin A in children with acute diarrhea.
abstract: OBJECTIVE
  Glutamine is an important fuel for rapidly dividing cells such as enterocytes and lymphocytes. Exogenous glutamine supplementation in catabolic states preserves intestinal mucosal structure and function, decreases bacterial translocation, and supports normal immunologic responses. This study was planned to assess the effect of glutamine supplementation on duration and severity of diarrhea and to assess its immunomodulatory effect by measuring serum interleukin-8 (IL-8) and salivary immunoglobulin A (sIgA) in children with acute diarrhea.
  
  
  METHODS
  In this placebo-controlled, double-blind and randomized trial, 6- to 24-month-old otherwise healthy children admitted to the Diarrheal Diseases Training and Treatment Center with acute diarrhea received either 0.3 g/kg/day of glutamine (n = 63) or placebo (n = 65) for 7 days. Serum IL-8 and sIgA levels were determined on admission and 7 days later. All cases were followed until the diarrheal episode ended. Anthropometric measurements and history of subsequent infectious diseases were monitored monthly for 3 months after treatment.
  
  
  RESULTS
  Mean duration of diarrhea in the glutamine treated group was significantly shorter than that of the placebo group (3.40 +/- 1.96 days, 4.57 +/- 2.48 days, respectively; P = 0.004). No differences in serum IL-8 and sIgA were found between groups on admission or 1 week later. During 3 month follow-up, mean weight gain and incidence of infectious diseases were similar in both groups.
  
  
  CONCLUSIONS
  Duration of diarrhea was shorter in children supplemented with glutamine. The beneficial impact of glutamine supplementation seems to be through effects on gastrointestinal mucosa rather than the host immune response.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey. siyalcin@hacettepe.edu.tr
authors.forename: S Songül
authors.initials: SS
authors.lastname: Yalçin
authors.forename: Kadriye
authors.initials: K
authors.lastname: Yurdakök
authors.forename: Ilhan
authors.initials: I
authors.lastname: Tezcan
authors.forename: Levent
authors.initials: L
authors.lastname: Oner
mesh_terms: D000208:Acute Disease; D003967:Diarrhea / Q000178:diet therapy* / Q000473:pathology; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D007071:Immunoglobulin A, Secretory / Q000187:drug effects / Q000378:metabolism*; D007223:Infant; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D012463:Saliva / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D007071:Immunoglobulin A, Secretory; D016209:Interleukin-8; D005973:Glutamine