Effects of glutamine on wound healing

Abstract

Studies reporting the need for replacing amino acids such as glutamine (Gln), hydroxymethyl butyrate (HMB) and arginine (Arg) to accelerate wound healing are available in the literature. The primary objective of this study was to present the effects of Gln on tissue hydroxyproline (OHP) levels in wound healing. This study was conducted on 30 female Sprague Dawley rats with a mean weight of 230 ± 20 g. Secondary wounds were formed by excising 2 × 1 cm skin subcutaneous tissue on the back of the rats. The rats were divided into three equal groups. Group C (Control): the group received 1 ml/day isotonic solution by gastric gavage after secondary wound was formed. Group A (Abound): the group received 0·3 g/kg/day/ml Gln, 0·052 g/kg/day/ml HMB and 0·3 g/kg/day/ml Arg by gastric gavage after secondary wound was formed. Group R (Resource): the group received 0·3 g/kg/day/ml Gln by gastric gavage after secondary wound was formed. The OHP levels of the tissues obtained from the upper half region on the 8th day and the lower half region on the 21st day from the same rats in the groups were examined. Statistical analysis was performed using the statistics program SPSS version 17.0. No statistically significant differences were reported with regard to the OHP measurements on the 8th and 21st days (8th day: F = 0·068, P = 0·935 > 0·05; 21st day: F = 0·018, P = 0·983 > 0·05). The increase in mean OHP levels on the 8th and 21st days within each group was found to be statistically significant (F = 1146·34, P = 0·000 < 0·001). We conclude that in adults who eat healthy food, who do not have any factor that can affect wound healing negatively and who do not have large tissue loss at critical level, Gln, Arg and HMB support would not be required to accelerate secondary wound healing.

The effect of glutamine intake on complications of colorectal and colon cancer treatment: A systematic review

“…[ 47 ] Also, it has been assumed that fibroblasts, a type of cell that synthesizes the extra cellular matrix and collagen which plays a critical role in wound healing, use Gln as the main energy resource for proliferation. [ 34 51 ] In addition, proline, one of the Gln metabolism products, is essential for the collagen production. Furthermore, Gln can metabolize to arginine that it can promote wound healing in pharmacological doses.…”

Proline Precursors and Collagen Synthesis: Biochemical Challenges of Nutrient Supplementation and Wound Healing

“…Administration of a mixture of arginine, glutamine, and b-hydroxyb-methylbutyrate was also reported to decrease wound sizes at 10 and 14 d after injury (45). Administration of these same amino acids also increased hydroxyproline content in diabetic foot ulcers (46), but not in a basic science model of the same injury (47). Regardless, there is considerable variation in supplementation and wound outcomes and definitive studies are needed to determine whether or not glutamine could be used therapeutically, either alone or in combination with other amino acids, to facilitate wound healing in a clinical setting.…”

Targeted Amino Acid Supplementation in Diabetic Foot Wounds: Pilot Data and a Review of the Literature

“…In a study done in 2013 by Kesici et al, whose results contrasted with those of the study just discussed, in which supplementation was associated with improved scores for wound depth and appearance, amino acid supplementation in rats was not associated with significant increases in hydroxyproline concentrations. This finding is important in identifying a potential difference in the biochemical milieu of healing wounds in diabetic patients as compared with healthy controls [9]. The second human study identified in our literature review focused on arginine supplementation in patients with diabetic foot wounds.…”

“…Glutamine is a nonessential amino acid, found in abundance in human beings. Its tissue concentrations can be diminished by more than 50% and plasma concentrations may be diminished by more than 25% after a major catabolic insult [9]. Arginine is a semiessential amino acid that becomes essential in critical illness.…”

“…It is known to increase T-cell proliferation and the generation of lymphokine-activated killer cells, both of which are important factors in the human immune response. Betahydroxy-beta-methylbutyrate (HMB) is a metabolite of leucine and has also been implicated in improved outcomes of wound healing under conditions of physiologic stress [5,9].…”