Does glutamine contribute to immunosuppression after major burns?

Parry-Billings, Mark; Calder, Philip C.; Newsholme, Eric A.; Evans, Judy

doi:10.1016/0140-6736(90)92083-t

Cited by 335 publications

(186 citation statements)

References 16 publications

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“…27,28 The extent of glutamine depletion has been correlated with an increased incidence of mortality. 27,28 Animal studies have shown that the GI mucosal breakdown produced by radiation and chemotherapy can be prevented by enteral or parenteral administration of glutamine. Klimberg et al 29 demonstrated that rats fed a diet poor in glutamine develop edema and ulceration of their GI tract with loss of villi.…”

Section: Discussionmentioning

confidence: 99%

“…23,24 During injury or stress, intracellular glutamine concentration falls by 40-50% (approximately 14 g of free glutamine) in uncomplicated cases 25,26 and does not return to normal levels for as long as 30 days after injury. 27,28 The extent of glutamine depletion has been correlated with an increased incidence of mortality. 27,28 Animal studies have shown that the GI mucosal breakdown produced by radiation and chemotherapy can be prevented by enteral or parenteral administration of glutamine.…”

Section: Discussionmentioning

confidence: 99%

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A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study

Aquino

Harvey

Garvin

et al. 2005

Bone Marrow Transplant

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study

Aquino

Harvey

Garvin

et al. 2005

Bone Marrow Transplant

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“…In vitro studies have shown that, despite the presence of all other nutrients including glucose, only altering the glutamine concentration in the medium led to a reduction in lymphocyte proliferative ability. This was coupled with a decrease in response time of the cells (Parry-Billings et al, 1990).…”

Section: Glutamine and Immune Cellsmentioning

confidence: 98%

“…lymphocyte proliferation, or DNA repair and mRNA synthesis in macrophages (Ardawi and Newsholme, 1983;. The concentration of plasma glutamine (p [Gln]) is decreased during stress such as major surgery or burns, or after prolonged, intensive exercise (Askenazi et al, 1980;Parry-Billings et al, 1990Castell et al, 1996). In vitro studies have shown that, despite the presence of all other nutrients including glucose, only altering the glutamine concentration in the medium led to a reduction in lymphocyte proliferative ability.…”

Section: Glutamine and Immune Cellsmentioning

confidence: 99%

Sleep Deprivation in Humans, Immunodepression and Glutamine Supplementation

Castell¹,

Gough²,

Cardenas³

et al. 2005

PsycEXTRA Dataset

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“…Glutamine supplementation augments the cytotoxic activity of natural killer and lymphokine-activated killer cells (Alverdy, 1990;Babst et al 1993;Horig et al 1993) as well as adequate lymphocyte, killer cell and macrophage proliferation (Griffiths & Keast, 1990;Parry-Billings et al 1990) and function (Griffiths & Keast, 1990;Wallace & Keast, 1992;Calder & Newsholme, 1992;Calder, 1994;Juretic et al 1994). Leucocyte glutaminase activity is high, thus indicating a high rate of glutamine utilization (Calder, 1994).…”

Section: Glutaminementioning

confidence: 99%

The scientific basis of immunonutrition

2000

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Substrates with immune-modulating actions have been identified among both macro-and micronutrients. Currently, the modes of action of individual immune-modulating substrates, and their effects on clinical outcomes, are being examined. At present, some enteral formulas are available for the clinical setting which are enriched with selected immune-modulating nutrients. The purpose of the present paper is to review the scientific rationale of enteral immunonutrition. The major aspects considered are mucosal barrier structure and function, cellular defence function and local or systemic inflammatory response. It is notable that in critical illness the mucosal barrier and cellular defence are impaired and a reinforcement with enteral immunonutrition is desirable, while local or systemic inflammatory response should be down regulated by nutritional interventions. The results available from clinical trials are conflicting. Meta-analyses of recent trials show improvements such as reduced risk of infection, fewer days on a ventilator, and reduced length of intensive care unit and hospital stay. Thus, a grade A recommendation was proclaimed for the clinical use of enteral immune-modulating diets. Improvement in outcome was only seen when critical amounts of the immune-modulating formula were tolerated in patients classified as being malnourished. However, in other patients with severe sepsis, shock and organ failure, no benefit or even disadvantages from immunonutrition were reported. In such severe conditions we hypothesize that systemic inflammation might be undesirably intensified by arginine and unsaturated fatty acids, directly affecting cellular defence and inflammatory response. We therefore recommend that in patients suffering from systemic inflammatory response syndrome great caution should be exercised when immune-enhancing substrates are involved which may aggravate systemic inflammation.

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Does glutamine contribute to immunosuppression after major burns?

Cited by 335 publications

References 16 publications

A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study

A double-blind randomized placebo-controlled study of oral glutamine in the prevention of mucositis in children undergoing hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium study

Sleep Deprivation in Humans, Immunodepression and Glutamine Supplementation

The scientific basis of immunonutrition

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