Oral Glutamine Supplementation Research Articles

MON-PP084: Oral Glutamine Supplementation Reduces the Severity of Mucositis in Patients with Head and Neck Cancer During Radiotherapy

MON-PP084: Oral Glutamine Supplementation Reduces the Severity of Mucositis in Patients with Head and Neck Cancer During Radiotherapy

Oral glutamine supplementation reduces radiotherapy- induced esophagitis in lung cancer patients.

The purpose of this study was to assess the the efficacy of oral glutamine (GLN) in prevention of acute radiation-induced esophagitis in patients with lung cancer and determine the predictive role of clinical and dosimetric parameters. Thirty-two patients diagnosed with lung cancer were studied prospectively. Sixteen patients (50%) received prophylactic powdered GLN orally in doses of 10g/8h. Patients were treated 2 Gy per fraction daily, 5 days a week. We evaluated the grading of esophagitis daily at the end of each fraction of each treatment day until a cumulative dose of 50 Gy was reached. The primary end point was radiation-induced esophagitis. All patients tolerated GLN well. Toxicity grade, weight loss, serum cytokine levels and esophageal transit times exhibited statistically significant improvement in the GLN receiving group. GLN suppressed the inflammation related to the disease and treatment and reduced toxicity with statistical significance. This study suggests a benefical role of oral GLN use in prevention and/or delay of radiation-induced esophagitis, in terms of esophageal transit time and serum immunological parameters, as well as weight loss.

Effects of Carnitine with and without Glutamine Supplementation on Markers of Muscle Damage and Muscle Soreness among Football Players: A Randomized Controlled Clinical Trial

Background: Exercise-induced muscle damage can affect exercise performance. The purpose of this study is to examine the effects of Carnitine and Glutamine supplementation on markers of muscle damage and muscle soreness after physical exertion on football players.Materials and Methods: Twenty eight healthy male football players aged 21.1±0.7 were recruited in a double blind, randomized, placebo-controlled clinical trial on 3 weeks of supplementation. Before supplementation protocol, each participant had to run on a treadmill for 30 minutes at 75% VO2max. Participants were randomly divided into 4 groups: L-Carnitine, L- Glutamine, L-Carnitine plus L- Glutamine and placebo. Blood samples were obtained pre-exercise and immediately after exercise. Muscle soreness was assessed on both occasions and two days after each exercise.Results: L-Carnitine and L-Glutamine supplementation for 21 days significantly decreased Creatine Kinase activity as a marker of muscle’s damage before (P=0.014) and after exercise (P=0.047), and muscle soreness two days after physical exertion (P=0.057). However, Lactate Dehydrogenase activity was affected by Carnitine supplementation after exercise.Conclusion: Chronic oral supplementation of Carnitine and Glutamine before exercise can reduce chemical markers of muscle tissue damage after exercise. In addition, these supplements may reduce muscle pain after exercise and optimize the processes of muscle tissue repair.[GMJ. 2014;3(4):207-15]

Glycemic effects and safety of L-Glutamine supplementation with or without sitagliptin in type 2 diabetes patients-a randomized study.

Background and AimsL-glutamine is an efficacious glucagon-like peptide (GLP)-1 secretagogue in vitro. When administered with a meal, glutamine increases GLP-1 and insulin excursions and reduces postprandial glycaemia in type 2 diabetes patients. The aim of the study was to assess the efficacy and safety of daily glutamine supplementation with or without the dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin in well-controlled type 2 diabetes patients.MethodsType 2 diabetes patients treated with metformin (n = 13, 9 men) with baseline glycated hemoglobin (HbA1c) 7.1±0.3% (54±4 mmol/mol) received glutamine (15 g bd)+ sitagliptin (100 mg/d) or glutamine (15 g bd) + placebo for 4 weeks in a randomized crossover study.ResultsHbA1c (P = 0.007) and fructosamine (P = 0.02) decreased modestly, without significant time-treatment interactions (both P = 0.4). Blood urea increased (P<0.001) without a significant time-treatment interaction (P = 0.8), but creatinine and estimated glomerular filtration rate (eGFR) were unchanged (P≥0.5). Red blood cells, hemoglobin, hematocrit, and albumin modestly decreased (P≤0.02), without significant time-treatment interactions (P≥0.4). Body weight and plasma electrolytes remained unchanged (P≥0.2).ConclusionsDaily oral supplementation of glutamine with or without sitagliptin for 4 weeks decreased glycaemia in well-controlled type 2 diabetes patients, but was also associated with mild plasma volume expansion.Trial RegistrationClincalTrials.gov NCT00673894

Effect of oral glutamine supplementation on gut permeability and endotoxemia in patients with severe acute pancreatitis: a randomized controlled trial.

The aim of this study is to evaluate the effect of oral glutamine (GL) supplementation on gut permeability and endotoxemia (surrogate end point) in patients with severe acute pancreatitis. In a randomized controlled trial, patients were randomized to be given placebo or GL for 7 days. The primary outcome measures include the effect on gut permeability (assessed by lactulose/mannitol excretion in urine and endotoxemia assessed by endotoxin core antibodies type IgG and IgM (EndoCab IgG and IgM). The secondary outcome measures include infectious complications, mortality, total hospital/intensive care unit stay, C-reactive protein, and prealbumin levels. Patients were assigned to GL (n = 41) and placebo (n = 39) groups. There was no change in gut permeability after the intervention. However, the EndoCab IgM levels increased significantly (33 [4, 175] to 40 [8, 350] GMU/mL; P = 0.0164) and the C-reactive protein levels decreased significantly (133 [1, 287] to 88 [1, 267] ng/mL; P = 0.0236) in the GL group. No difference was observed in infectious complication, prealbumin value, hospital/intensive care unit stay, and mortality in both groups. No significant trend was identified for an effect of GL on gut permeability. Decreased inflammation and endotoxemia did not translate into reduced infectious complications in severe acute pancreatitis. However, the study was underpowered to detect the aforementioned difference (trial registration: CTRI/2009/000945).

The effects of acute oral glutamine supplementation on exercise-induced gastrointestinal permeability and heat shock protein expression in peripheral blood mononuclear cells.

Chronic glutamine supplementation reduces exercise-induced intestinal permeability and inhibits the NF-κB pro-inflammatory pathway in human peripheral blood mononuclear cells. These effects were correlated with activation of HSP70. The purpose of this paper is to test if an acute dose of oral glutamine prior to exercise reduces intestinal permeability along with activation of the heat shock response leading to inhibition of pro-inflammatory markers. Physically active subjects (N = 7) completed baseline and exercise intestinal permeability tests, determined by the percent ratio of urinary lactulose (5g) to rhamnose (2g). Exercise included two 60-min treadmill runs at 70% of VO2max at 30°C after ingestion of glutamine (Gln) or placebo (Pla). Plasma levels of endotoxin and TNF-α, along with peripheral blood mononuclear cell (PBMC) protein expression of HSP70 and IκBα, were measured pre- and post-exercise and 2 and 4h post-exercise. Permeability increased in the Pla trial compared to that at rest (0.06 ± 0.01 vs. 0.02 ± 0.018) and did not increase in the Gln trial. Plasma endotoxin was lower at the 4-h time point in the Gln vs. 4h in the Pla (6.715 ± 0.046pg/ml vs. 7.952 ± 1.11pg/ml). TNF-α was lower 4h post-exercise in the Gln vs. Pla (1.64 ± 0.09pg/ml vs. 1.87 ± 0.12pg/ml). PBMC expression of IkBα was higher 4h post-exercise in the Gln vs. 4h in the Pla (1.29 ± 0.43 vs. 0.8892 ± 0.040). HSP70 was higher pre-exercise and 2h post-exercise in the Gln vs. Pla (1.35 ± 0.21 vs. 1.000 ± 0.000 and 1.65 ± 0.21 vs. 1.27 ± 0.40). Acute oral glutamine supplementation prevents an exercise-induced rise in intestinal permeability and suppresses NF-κB activation in peripheral blood mononuclear cells.

Effect of glutamine supplementation on cardiovascular risk factors in patients with type 2 diabetes

ObjectiveThe aim of this study was to assess clinical relevance of long-term oral glutamine supplementation on lipid profile and inflammatory and metabolic factors in patients with diabetes. MethodSixty-six patients with type 2 diabetes between the ages of 18 and 65 y were randomized to receive glutamine 30 g/d (10 g powder, three times a day) or placebo, in a double-blind, placebo-controlled trial during a 6-wk treatment period. Fifty-three patients completed the trial. Independent samples t test and analysis of covariance were used. ResultsAfter a 6-wk treatment period, a significant difference was observed between the two groups in body fat mass (P = 0.01) and percentage of body fat (P = 0.008). Moreover, a significant reduction in waist circumference (P < 0.001) and a tendency for an increase in fat-free mass (P = 0.03), with no change in body weight and body mass index (BMI) was found. Enhancement in body fat-free mass was mainly attributed to trunk (P = 0.03). There was a downward trend in systolic blood pressure (P = 0.005) but not diastolic. Fasting blood glucose (mmol/L) concentration significantly decreased after the 6-wk intervention (P = 0.04). Mean hemoglobin A1c was significantly different between the groups at week 6 (P = 0.04). No significant difference was detected for fasting insulin, homeostasis model assessment for insulin resistance and quantitative insulin sensitivity index between groups (P > 0.05). No significant difference was observed between groups in total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglyceride. No treatment effect on C-reactive protein was found (P = 0.44). ConclusionWe demonstrated that the 6-wk supplementation with 30 g/d glutamine markedly improved some cardiovascular risk factors, as well as body composition, in patients with type 2 diabetes. Future glutamine dose–response studies are warranted in these areas.

The Effects of Acute Oral Glutamine Supplementation on Gastrointestinal Permeability and Heat Shock Protein Regulation in Peripheral Blood Mononuclear Cells of Endurance Runners

The Effects of Acute Oral Glutamine Supplementation on Gastrointestinal Permeability and Heat Shock Protein Regulation in Peripheral Blood Mononuclear Cells of Endurance Runners

Effects of oral glutamine supplementation on exercise-induced gastrointestinal permeability and tight junction protein expression

The objectives of this study are threefold: 1) to assess whether 7 days of oral glutamine (GLN) supplementation reduces exercise-induced intestinal permeability; 2) whether supplementation prevents the proinflammatory response; and 3) whether these changes are associated with upregulation of the heat shock response. On separate occasions, eight human subjects participated in baseline testing and in GLN and placebo (PLA) supplementation trials, followed by a 60-min treadmill run. Intestinal permeability was higher in the PLA trial compared with baseline and GLN trials (0.0604 ± 0.047 vs. 0.0218 ± 0.008 and 0.0272 ± 0.007, respectively; P < 0.05). IκBα expression in peripheral blood mononuclear cells was higher 240 min after exercise in the GLN trial compared with the PLA trial (1.411 ± 0.523 vs. 0.9839 ± 0.343, respectively; P < 0.05). In vitro using the intestinal epithelial cell line Caco-2, we measured effects of GLN supplementation (0, 4, and 6 mM) on heat-induced (37° or 41.8°C) heat shock protein 70 (HSP70), heat shock factor-1 (HSF-1), and occludin expression. HSF-1 and HSP70 levels increased in 6 mM supplementation at 41°C compared with 0 mM at 41°C (1.785 ± 0.495 vs. 0.6681 ± 0.290, and 1.973 ± 0.325 vs. 1.133 ± 0.129, respectively; P < 0.05). Occludin levels increased after 4 mM supplementation at 41°C and 6 mM at 41°C compared with 0 mM at 41°C (1.236 ± 0.219 and 1.849 ± 0.564 vs. 0.7434 ± 0.027, respectively; P < 0.001). GLN supplementation prevented exercise-induced permeability, possibly through HSF-1 activation.

Dietary glutamine supplementation prevents mucosal injury and modulates intestinal epithelial restitution following acetic acid induced intestinal injury in rats

Beneficial effects of glutamine (GLN) have been described in many gastrointestinal disorders. The aim of the present study was to evaluate the preventative effect of oral GLN supplementation against acetic acid (AA) induced intestinal injury in a rat. Male Sprague–Dawley rats were divided into four experimental groups: control (CONTR) rats underwent laparotomy, control-glutamine (CONTR-GLN) rats were treated with enteral glutamine given in drinking water (2%) 48 hours before and five days following laparotomy, AA rats underwent laparotomy and injection of AA into an isolated jejunal loop, and acetic acid-glutamine (AA-GLN) rats underwent AA-induced injury and were treated with enteral GLN 48 hours before and 5 days following laparotomy. Intestinal mucosal damage (Park’s injury score), mucosal structural changes, enterocyte proliferation and enterocyte apoptosis were determined five days following intestinal injury. Western blotting was used to determine p-ERK and bax protein levels. AA-induced intestinal injury resulted in a significantly increased intestinal injury score with concomitant inhibition of cell turnover (reduced proliferation and enhanced apoptosis). Treatment with dietary GLN supplementation resulted in a decreased intestinal injury score with concomitant stimulation of cell turnover (enhanced proliferation and reduced apoptosis). In conclusion, pre-treatment with oral GLN prevents mucosal injury and improves intestinal recovery following AA-induced intestinal injury in rats.

No Benefit of Glutamine Supplementation on Persistent Diarrhea in Ugandan Children

We evaluated the efficacy of oral glutamine supplementation in children 2 to 60 months of age with persistent diarrhea by 1:1 randomization to standard treatment alone or together with twice daily glutamine. The failure rate was similar in both arms (relative risk: 1.8 [95% confidence interval: 0.8-3.7], P = 0.12). Glutamine supplementation showed no benefit on the outcome of persistent diarrhea.

Plasma glutathione resettlement by oral glutamine supplementation is associated with glycine normalization in HIV+ treated patients

HIV+ patients present low concentrations of reduced GSH and its precursors. To investigate the responses of the GSH pathway to Gln dietary supplements in 12 HIV+ treated patients (6 men and 6 women, 22 – 45 years old) and 20 healthy controls (Co, 10 men and 10 women, 20 – 59 years old) were studied at their usual diet (Do) and after 7‐day dietary‐supplements containing glutamine (Gln, 20g/d). Blood samples were drawn after overnight fast and HPLC plasma analysis of amino acids, total (GSH) and oxidized glutathione (GSSG) were carried out at moments before (M0) and after the intervention period (M1). Statistical comparisons were made between groups (Co X HIV+) with p&lt;0.05. Under Do the HIV+ group showed higher GSSG along with lower concentrations of GSH and all amino acids except Hcy. Met, Gly and GSH were normalized by the dietary Gln. The 71.4% increase of GSH in Gln group at M1 was followed by the increase of its precursors markedly Gly (27.2%) and slightly by Glu (13.7%) and Cys (10.8%), nevertheless without detectable reduction in the GSSG/GSH ratio. Moreover the intervention led to an increased Tau/Cys (18.9%) and decrease of Glu/Gln (6.6%) ratios relatively to Co. In conclusion, the restoration of GSH normal levels by Gln was markedly supported by Gly replenishment. The restricted contribution of Cys and Glu to GSH generation could be due to either their limited formation (Gln→Glu) and/or higher utilization (Cys→Tau).Supported by FAPESP, CAPES, CNPq

Oral glutamine supplementation improves intestinal permeability dysfunction in a murine acute graft-vs.-host disease model

Although a profound barrier dysfunction has been reported, little is known about the pathophysiological mechanism evoking gastrointestinal graft-vs.-host disease (GI-GvHD) and apparent therapeutic options. The aim of this study was to evaluate the influence of oral glutamine on the course of GI-GvHD in an acute semiallogenic graft-vs.-host disease (GvHD) in irradiated B6D2F1 mice. An acute semiallogenic GvHD was induced by intraperitoneal injection of lymphocytes from C57BL/6 mice to irradiated B6D2F1 mice. Half of the GvHD animals received oral glutamine supplementation for 6 days started at the time of lymphocyte transfer. Six days after induction of the semiallogenic GvHD, jejunum specimens were prepared. The expression of the proinflammatory cytokine TNF-α and the tight junction protein occludin was investigated by PCR. Histological changes along with the apoptotic response were evaluated and intestinal permeability was assessed. Animals with GvHD showed a strong increase in paracellular permeability as a sign of the disturbed barrier function. TNF-α expression was significantly increased and the expression of the tight junction protein occludin decreased. GvHD led to mucosal atrophy, crypt hyperplasia, crypt apoptosis, and a disintegration of the tight junctions. Glutamine-treated mice showed reduced expression of TNF-α, increased occludin expression, fewer histological changes in the jejunum, smaller number of apoptotic cells in the crypt, and reduced gastrointestinal permeability. In conclusion, oral glutamine seems to have beneficial effects on the severity of inflammatory changes in the course of GvHD and might be a therapeutic option.

Oral Glutamine Supplement Inhibits Ascites Formation in Peritoneal Carcinomatosis Mouse Model

Background. Peritoneal carcinomatosis (PC) accompanied with ascites formation causes several distressing symptoms, resulting in poor quality of life. Methods. Twenty BALB/c nude mice generated by direct orthotopic injection of human pancreatic cancer PANC-1 cells were randomized to receive either a stock laboratory diet or a stock diet supplemented with glutamine. Half of the mice were sacrificed at day 76 to measure the amount of ascitic fluid and pancreatic tumor volume. The remaining mice were subject to survival analysis. Serum albumin levels were estimated every 2 weeks. Results. At day 76, the average amount of ascitic fluid measured in the control group was 1.2 ± 0.3 mL compared to 0.5 ± 0.5 mL from the glutamine-supplemented mice (P = 0.045). The volume of pancreatic tumor was 2.60 ± 0.8 cm3 in the control group and 1.98 ± 1.3 cm3 in glutamine-supplemented mice (P = 0.39). The mean survival time of glutamine-supplemented mice was prolonged from 87 ± 4 to 101 ± 2 days (P = 0.0024). Mean serum albumin levels were higher in the glutamine-supplemented group. Conclusions. This preclinical study showed that oral supplementation of glutamine may provide ascites-reducing activity in pancreatic cancer patients with PC, via a cell-mediated immunity-independent mechanism.

Influence of oral glutamine supplementation on survival outcomes of patients treated with concurrent chemoradiotherapy for locally advanced non-small cell lung cancer

BackgroundGlutamine (Gln) supplementation during concurrent chemoradiotherapy (C-CRT) effectively reduces the incidence and severity of acute radiation-induced esophagitis (RIE). However, there are concerns that Gln might stimulate tumor growth, and therefore negatively impact the outcomes of anticancer treatment. We retrospectively investigated the effect of co-administration of oral Gln during C-CRT on survival outcomes of patients with stage IIIB non-small cell lung carcinoma (NSCLC). We additionally evaluated role of oral Gln in preventing C-CRT-induced weight change, acute and late toxicities.MethodsThe study included 104 patients: 56 (53.8%) received prophylactic powdered Gln (Gln+) orally at a dose of 10 g/8 h and 48 (46.2%) did not receive Gln (Gln-) and served as controls. The prescribed radiation dose to the planning target volume was 66 Gy in 2-Gy fractions. Primary endpoints of progression-free survival (PFS), local/regional progression-free survival (LRPFS), and overall survival (OS) were correlated with status of Gln supplementation.ResultsOral Gln was well tolerated except for mild nausea/vomiting in 14 (25.0%) patients. There was no C-CRT-related acute or late grade 4–5 toxicity. Administration of Gln was associated with a decrease in the incidence of grade 3 acute radiation-induced esophagitis (RIE) (7.2% vs. 16.7% for Gln+ vs. Gln-; p=0.02) and late-RIE (0% vs. 6.3%; p=0.06), a reduced need for unplanned treatment breaks (7.1% vs. 20.8%; p=0.04), and reduced incidence of weight loss (44.6% vs. 72.9%; p=0.002). At a median follow-up of 24.2 months (range 9.2-34.4) the median OS, LRPFS, and PFS for Gln+ vs. Gln- cohorts were 21.4 vs. 20.4 (p=0.35), 14.2 vs.11.3 (p=0.16), and 10.2 vs. 9.0 months (p=0.11), respectively.ConclusionIn our study, supplementation with Gln during C-CRT had no detectable negative impact on tumor control and survival outcomes in patients with Stage IIIB NSCLC. Furthermore, Gln appeared to have a beneficial effect with respect to prevention of weight loss and unplanned treatment delays, and reduced the severity and incidence of acute- and late-RIE.

1620 - Weight Loss Despite Oral Glutamine Supplementation Predicts Poor Prognosis in Locally Advanced Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy

ABSTRACT Background In this retrospective study, we investigated potential impact of weight change according to oral glutamine supplementation (GLT) on survival in patients with stage IIIB non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy. Materials and methods Of the 142 patient evaluated retrospectively, 84 received GLT (GLT+), and 58 refused GLT intake (GLT-) and analyzed as control group. GLT was given at a daily dose of 30 g in powder form mixed with fruit juices. All patients received thoracic radiotherapy (TRT) to a total dose of 60-66 Gy (2Gy/Fx) concurrently with 2 cycles of cisplatin-based chemotherapy. Results During CRT, 76 (53.5) cases lost weight while remaining cases retained or gained weight. Weight loss in GLT- group (74.1%) was more frequent than GLT+ group (39.3%) (p Table 1 ) revealed cases in GLT+ group that retained or gained weight had the best outcome compared to the others. Bonferoni correction of two groups that retained of gained weight (p must be Table: 1620 Survival results according to glutamine supplementation (GLT) and wieght loss (WL) GLT- and KK+ GLT- and KK- GLT+ and KK+ GLT+ and KK- P-value Median OS Months) (95%CI) 15.7 (11.8-19.6) 21,7 (12.1-31.3) 13.5 (9.8-17.2) Not reached yet 1-year OS 65.1 93.3 60.6 98.0 2-year OS 12.1 44.9 3.8 58.3 Conclusion Results of this study demonstrated that GLT supplementation during CRT could prevent weight loss, yielding a better survival outcome in locally advanced NSCLC. Moreover, weight loss indicates poor prognosis irrespective of GLT use, and no long term survivors in GLT- group with weight loss suggests GLT resistance as a potentially poor prognostic factor, which warrants to be verified by further studies with larger cohorts. Disclosure All authors have declared no conflicts of interest.

EFEITO DA SUPLEMENTAÇÃO ORAL DE GLUTAMINA NA PERFORMANCE DE NADADORES DE MEIO-FUNDO E FUNDO

The purpose of this study was to determine the influence of oral glutamine supplement on exercise performance in endurance swimmers. Ten male swimmers, 13 to 18 years of age, all specialized in 400-m and/or 800-m distances, participated in this investigation. The athletes were divided in two groups, placebo group with five swimmers, that ingested 5/day of corn starch, and glutamine group with five swimmers that ingested 5/day of glutamine. The swimmers received the intervention for 30 days. The exercise performance measures (800-m time trial and anaerobic threshold, crawl technique) were obtained before and after the intervention. To compare results paired t test was used. There weren’t significant differences in the results of 800-m time trial and anaerobic threshold, in both groups. These data suggest that this oral glutamine supplementation dose didn’t influence exercise performance in endurance swimmers. Keywords: Swimming. Glutamine. Performance.

Could be Reversed the Detrimental Effect of 5-Fluorouracil on Healing of Colonic Anastomosis by Oral Glutamine Supplementation?

Background/Aim: The anti-neoplastic agents are known to impair tissue healing which may lead to significant post-operative complications, like anastomotic leaks. There has been a number of studies that have shown the protective affects of glutamine on the enteric mucosa. Our study aimed to test whether the addition of enteral glutamine to 5-fluorouracil (5FU) used as immediate post-colectomy chemotherapy caused less anastomotic complications compared to 5-FU alone. Materials and methods: Thirty-six female Wistar-Albino rats were initially divided into three groups of twelve rats. The first and the second twelve formed the control (CG) and the 5-FU groups respectively, and were fed on standard laboratory diet and water for seven days. The third group was the Glutamine group (GG) which had oral glutamine supplements in addition to the standard diet. All animals had a laparotomy on day 7. The left colon was transected and a hand sewn colocolic anastomosis was undertaken (hangi teknik, hand-sewn, single layer, sero-submucosal). All groups were further divided into two subgroups (a total of six groups). The first subgroup in each main group was sacrificed on post-operative day 3, the remainder were killed on day 7. Bursting pressures, tissue-hydroxyproline and histopathology were compared by Anova test. Results: Bursting pressure values were significantly reduced by 5FU treatment, both at day 3 and day 7 postoperatively. Glutamine treatment prevented the reduction of bursting pressure in 5FU treated animals, which was not significantly different from animals not treated with 5FU. The lowest mean tissue hydroxyproline levels were found in the 5FU-day 3 & day 7 groups, histopathology was superior in 5FU-glutamine-day 7 group. Conclusion: Glutamine neutralised the detrimental affects of 5-FU on tissue healing. This may enable the early inititiation of adjuvant chemotherapy.

Oral glutamine supplementation during preoperative radiochemotherapy in patients with rectal cancer: A randomised double blinded, placebo controlled pilot study

Enteral glutamine may have protective effects on gut function and reduce metabolic stress in patients receiving radiochemotherapy. The aim of our study was to evaluate its influence in patients with rectal cancer undergoing preoperative radiochemotherapy. We performed a randomized double blind, placebo controlled pilot study in 33 patients. 30g of glutamine, average dose 0.41g/kg (SD=0.07) g/kg/day was administered orally in three doses per day for five weeks during preoperative radiochemotherapy of rectal cancer. 30g of maltodextrin was given as placebo. Body weight was measured and NRS 2002 screening was performed before and after treatment. Bowel function was evaluated by stool consistency and frequency. Plasma levels of inflammatory parameters and hormones were measured. There was no difference between groups in frequency and severity of diarrhoea during radiochemotherapy (p=0.5 and p=0.39 respectively), insulin levels significantly increased in both groups, IL-6 only in glutamine group. Results of this small pilot study in rectal cancer patients receiving preoperative radiochemotherapy, showed that ingestion of larger quantities of glutamine given more often as previously reported did not diminish the incidence and severity of diarrhoea and did not affect inflammatory and metabolic activity compared to the placebo treatment with maltodextrin.

Oral Glutamine Supplementation Improves Intestinal Permeability Dysfunction in a Murine Acute Graft Versus Host Disease Model

Oral Glutamine Supplementation Improves Intestinal Permeability Dysfunction in a Murine Acute Graft Versus Host Disease Model