To quantitate glutamine kinetics in premature infants and determine whether glutamine affects leucine metabolism. 11 very low birth weight (< 1250 g) neonates received 4-h i.v. infusions of L-[2H3]leucine and L-[13C5]glutamine, along with orogastric infusion of L-[I-13C]leucine and L-[I-13C]glutamine on the 10th d of life and in the fed state. Patients were receiving parenteral nutrition and were randomized to receive either hypocaloric, enteral preterm formula alone (controls; n = 5), or glutamine (0.2 g.kg-1.d-1 on the day of the study) supplemented formula (GL.n; n = 6). The rates of appearance (Ra) of leucine and glutamine, and their rates of splanchnic extraction were determined from isotopic enrichments in plasma at steady state. Leucine release from protein breakdown did not differ between groups (123 +/- 51 versus 162 +/- 94 mumol.kg-1h-1 in the controls and GLN group, respectively). Glutamine de novo synthesis accounted for > 80% of overall glutamine Ra, and was similar in both groups (626 +/- 177 versus 525 +/- 86 mumol.kg-1.h-1; NS); 46 +/- 16% and 53 +/- 31% of the enteral glutamine underwent first-pass splanchnic extraction in the controls and GLN group, respectively. These findings indicate that the pathways of glutamine de novo synthesis and glutamine utilization in the splanchnic bed are functional in very low birth weight humans by the 10th d of life. Glutamine supplementation provided at low doses on a hypocaloric regimen results in no apparent differences in flux of glutamine or leucine.
Glutamine synthetase (GS) is a key enzyme involved in the endogenous biosynthesis of glutamine, an amino acid known to be essential for small intestinal metabolism and function. This study describes the ontogeny of rat small intestinal GS from fetal life through adulthood with enzyme activities, protein immunoblotting, and steady state levels of GS mRNA by RNA gel blots and dot blots. Enzyme activities progressively increased from 21 d of fetal life to 32 d postnatally, then decreased in adulthood. The amount of GS immunoreactive protein in the small intestine increased from fetal life to 10-day-old infants and persisted into adulthood. GS mRNA, as quantified by dot blots was highest at 19 d postnatally. The ontogenic changes in rat small intestinal GS appear to correspond temporally with rapid growth and weaning. The steady increase in GS enzyme activity up to 32 d of age with a subsequent drop in adulthood is not paralleled by an increase in GS mRNA or protein. These findings suggest an apparent complex regulation of the enzyme activity at a transcriptional or translational levels.
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