title: The impact of oral glutamine supplementation on the intestinal permeability and incidence of necrotizing enterocolitis/septicemia in premature neonates.
abstract: OBJECTIVE
  To examine the impact of oral glutamine (Gln) supplementation on gut integrity and on the incidence of necrotizing enterocolitis (NEC)/septicemia of premature neonates.
  
  
  METHODS
  Preterm neonates (n = 101, gestational age <34 weeks, birth weight <2000 g) were randomly allocated to receive from day 3 to day 30 postpartum, either oral Gln (0.3 g/kg/day, n = 51-Gln group) or placebo (caloreen-isocaloric, n = 50-control group). Intestinal permeability was determined from the urinary lactulose/mannitol recovery (L/M ratio) following their oral administration and assessed at three time points: day 2 (before first administration), day 7 and day 30 of life. The incidence of NEC and septicemia over the study period was also recorded.
  
  
  RESULTS
  A decrease of lactulose recovery at days 7 (p = 0.001) and 30 (p < 0.001) and a decrease of L/M ratio at day 7 (p = 0.002) were observed only in the Gln group. Lactulose recovery and L/M ratio at day 7 (p = 0.022 and p = 0.004, respectively), as well as lactulose recovery (p = 0.001), mannitol recovery (p = 0.042), and L/M ratio (p = 0.001) at day 30, were decreased in the Gln group as compared to controls. NEC and septicemia were lower in the Gln group at the end of the first week (p = 0.009 and p = 0.041, respectively) and up to the end of the study (p < 0.001 and p = 0.048, respectively).
  
  
  CONCLUSIONS
  Oral Gln administration may have beneficial effects on intestinal integrity and the overall incidence of NEC/septicemia in preterm infants.
authors.affiliation: Department of Neonatology, Alexandra Regional General Hospital, Athens, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Sevastiadou
authors.forename: Ariadne
authors.initials: A
authors.lastname: Malamitsi-Puchner
authors.forename: Christos
authors.initials: C
authors.lastname: Costalos
authors.forename: Maria
authors.initials: M
authors.lastname: Skouroliakou
authors.forename: Despina D
authors.initials: DD
authors.lastname: Briana
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Roma-Giannikou
mesh_terms: D000284:Administration, Oral; D019587:Dietary Supplements; D004311:Double-Blind Method; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control*; D005260:Female; D005973:Glutamine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D007408:Intestinal Absorption / Q000187:drug effects; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D010539:Permeability / Q000187:drug effects; D018805:Sepsis / Q000517:prevention & control*
chemical_list: D005973:Glutamine