Abstract
Several respiratory diseases feature increased inflammatory response and catabolic activity, which are associated with glutamine depletion; thus, the benefits of exogenous glutamine administration have been evaluated in clinical trials and models of different respiratory diseases. Recent reviews and meta-analyses have focused on the effects and mechanisms of action of glutamine in a general population of critical care patients or in different models of injury. However, little information is available about the role of glutamine in respiratory diseases. The aim of the present review is to discuss the evidence of glutamine depletion in cystic fibrosis (CF), asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and lung cancer, as well as the results of exogenous glutamine administration in experimental and clinical studies. Exogenous glutamine administration might be beneficial in ARDS, asthma, and during lung cancer treatment, thus representing a potential therapeutic tool in these conditions. Further experimental and large randomized clinical trials focusing on the development and progression of respiratory diseases are necessary to elucidate the effects and possible therapeutic role of glutamine in this setting.
Highlights
IntroductionGlutamine is the most abundant amino acid in humans, contributing to approximately 60% of the free amino acid pool in muscle and approximately 20% of the amino acid pool in plasma [1]
Glutamine is the most abundant amino acid in humans, contributing to approximately 60% of the free amino acid pool in muscle and approximately 20% of the amino acid pool in plasma [1].Glutamine is a nutrient that participates in various cellular processes, including energy and nucleotide formation [2], redox homeostasis [3], acid-base balance [4], and glucose metabolism [5]
The aim of the present review is to discuss the role of glutamine depletion in cystic fibrosis (CF), asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and lung cancer, as well as the results of exogenous glutamine administration in these conditions
Summary
Glutamine is the most abundant amino acid in humans, contributing to approximately 60% of the free amino acid pool in muscle and approximately 20% of the amino acid pool in plasma [1]. Glutamine requirements appear to exceed the mammalian body’s capacity to synthesize this amino acid, leading to a decrease of plasma and intracellular glutamine concentrations. This represents the rationale for administration of exogenous glutamine to critically ill patients. Several recent meta-analyses have evaluated the effects of parenteral and enteral glutamine in critical care settings. Another systematic review studied the impact of enteral glutamine supplementation in patients with critical illness (defined as ICU admission). In a systematic review and meta-analysis including clinical trials of patients admitted to ICU that used both parenteral and enteral glutamine, supplementation was not found to reduce in-hospital mortality, ICU mortality, or the rate of infection [12]. The aim of the present review is to discuss the role of glutamine depletion in cystic fibrosis (CF), asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and lung cancer, as well as the results of exogenous glutamine administration in these conditions
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