Oral glutamine reduces myocardial damage after coronary revascularization under cardiopulmonary bypass. A randomized clinical trial

Chávez-Tostado, Mariana; Carrillo-Llamas, Fernando; Martínez-Gutiérrez, Porfirio E; Alvarado-Ramírez, Araceli; López-Taylor, Jaime Gilberto; Vásquez-Jiménez, José Clemente; Rendón-Félix, Jorge; Irusteta-Jiménez, Leire; Calil-Romero, Vanessa Carolina; Ramírez-Jiménez, José Antonio; Michel-Espinoza, Luis Rodrigo; Contreras-López, Carmen Karina; Cuesta-Márquez, Lizbeth; González-Ojeda, Alejandro

doi:10.20960/nh.519

Cited by 13 publications

(8 citation statements)

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“…In addition, a genome-wide association study identified a genetic variant associated with diminished GS expression, which may lead to a Gln deficiency, to the development of coronary artery disease in type 2 diabetes [42]. Interestingly, small clinical trials indicate that Gln supplementation enhances myocardial repair in patients with coronary artery disease and limits cardiac damage after coronary revascularization [43,44,45]. Moreover, a prospective study in two large, well-defined and independent cohorts showed that dietary intake of Gln and the plasma Gln:Glu ratio were inversely related to the risk of cardiovascular mortality, independent of other dietary or lifestyle factors [46].…”

Section: L-glutamine and Cardiometabolic Diseasementioning

confidence: 99%

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

Durante

2019

Nutrients

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Emerging evidence indicates that l-glutamine (Gln) plays a fundamental role in cardiovascular physiology and pathology. By serving as a substrate for the synthesis of DNA, ATP, proteins, and lipids, Gln drives critical processes in vascular cells, including proliferation, migration, apoptosis, senescence, and extracellular matrix deposition. Furthermore, Gln exerts potent antioxidant and anti-inflammatory effects in the circulation by inducing the expression of heme oxygenase-1, heat shock proteins, and glutathione. Gln also promotes cardiovascular health by serving as an l-arginine precursor to optimize nitric oxide synthesis. Importantly, Gln mitigates numerous risk factors for cardiovascular disease, such as hypertension, hyperlipidemia, glucose intolerance, obesity, and diabetes. Many studies demonstrate that Gln supplementation protects against cardiometabolic disease, ischemia-reperfusion injury, sickle cell disease, cardiac injury by inimical stimuli, and may be beneficial in patients with heart failure. However, excessive shunting of Gln to the Krebs cycle can precipitate aberrant angiogenic responses and the development of pulmonary arterial hypertension. In these instances, therapeutic targeting of the enzymes involved in glutaminolysis such as glutaminase-1, Gln synthetase, glutamate dehydrogenase, and amino acid transaminase has shown promise in preclinical models. Future translation studies employing Gln delivery approaches and/or glutaminolysis inhibitors will determine the success of targeting Gln in cardiovascular disease.

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Section: L-glutamine and Cardiometabolic Diseasementioning

confidence: 99%

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

Durante

2019

Nutrients

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“…Chavez-Tostado et al também demonstraram menor morbidade, menor uso de medicamento vasoativo, menor incidência de infarto agudo do miocárdio, menor taxa de infecção, menor hemorragia e menor necessidade de nova intervenção cirúrgica no grupo que recebeu a intervenção estudada. 15,25 Ao se comparar estes últimos achados com a literatura atual, vemos que o uso de glutamina já é bem documentado como substrato para síntese de DNA, ATP (molécula de adenosina trifosfato) e proteínas, sendo importante para proliferação vascular, migração e apoptose cardíaca. Desta maneira, é eficaz para diminuir injúria após infarto agudo do miocárdio ou após parada cardiorrespiratória.…”

Section: Discussionunclassified

Efeitos e segurança do uso pré-operatório de glutamina ou Whey Protein: Uma revisão sistemática

Naspitz

Konstantyner

2020

International Journal of Nutrology

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Resumo Contexto e Objetivo Jejum prolongado aumenta a resistência insulínica pós-operatória, dificultando a convalescência cirúrgica. Oferecer solução com carboidratos 2 horas antes da cirurgia reduz desfechos clínicos desfavoráveis. Adicionar glutamina ou whey protein a esta solução seria seguro e poderia implicar benefícios ainda maiores? Métodos Revisão sistemática da literatura realizada em dois bancos de dados com descritores de saúde preoperative care ou preoperative period associado a whey e depois a glutamine. Um total de 160 artigos foram encontrados. Após aplicação de filtros de busca e de critérios de exclusão e de inclusão, 16 artigos foram incluídos na presente revisão. Resultados Todos os artigos selecionados são ensaios clínicos randomizados. Daqueles que avaliaram segurança, nenhum encontrou eventos adversos ou aumento do risco anestésico quando utilizados glutamina ou whey protein. Dos artigos que investigaram eficácia, demonstrou-se redução da resistência insulínica e dos mediadores inflamatórios e aumento das proteínas séricas e da capacidade antioxidante total naqueles que utilizaram a solução proteica. Poucos autores conseguiram relacionar esses achados laboratoriais com otimização de desfechos clínicos, com exceção de dois que utilizaram a glutamina em pré-operatório de cirurgia cardíaca. Conclusão Uso de glutamina ou whey protein pré-operatório demonstra-se seguro e com benefícios laboratoriais no pós-operatório. Estudos ainda carecem de conseguir demonstrar melhor recuperação clínica do paciente quando realizado uso de proteína pré-operatória.

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“…For mice on a high-fat diet, studies show that glutamine intake helps lower body weight, decreases hyperglycemia, and improves insulin sensitivity [57]. In patients with coronary artery diseases, glutamine supplementation enhances myocardial repair and prevents damage to the cardiovascular system during surgical interventions or cardiac injuries [9,58,59]. The protective role of glutamine in ischemia-reperfusion injury is especially well investigated [60][61][62][63][64].…”

Section: Glutamine Supplementation Is Implemented For Treatment Of Cancer and A Variety Of Cardiovascular Diseasesmentioning

confidence: 99%

“…As the fight against these fatal diseases continues, it is crucial that we continue our investigation and broaden our understanding of cancer and cardiovascular diseases to innovate our prognostic and treatment approaches. Even though cardiovascular diseases and cancer are usually studied independently [2][3][4][5][6][7][8][9][10][11][12], there are some striking overlaps between their metabolic behaviors and therapeutic targets, suggesting the potential application of cardiovascular disease treatments for cancer therapy. More specifically, both cancer and many cardiovascular diseases have an upregulated glutaminolysis pathway, resulting in low glutamine and high glutamate circulating levels.…”

Section: Introductionmentioning

confidence: 99%

Metabolic Intersection of Cancer and Cardiovascular Diseases: Opportunities for Cancer Therapy

Hoang

Nguyen

2021

The Heterogeneity of Cancer Metabolism

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According to data from the World Health Organization, cardiovascular diseases and cancer are the two leading causes of mortality in the world [1]. Despite the immense effort to study these diseases and the constant innovation in treatment modalities, the number of deaths associated with cardiovascular diseases and cancer is predicted to increase in the coming decades [1]. From 2008 to 2030, due to population growth and population aging in many parts of the world, the number of deaths caused by cancer globally is projected to increase by 45%, corresponding to an annual increase of around four million people [1]. For cardiovascular diseases, this number is six million people [1]. In the United States, treatments for these two diseases are among the most costly and result in a disproportionate impact on low- and middleincome people. As the fight against these fatal diseases continues, it is crucial that we continue our investigation and broaden our understanding of cancer and cardiovascular diseases to innovate our prognostic and treatment approaches. Even though cardiovascular diseases and cancer are usually studied independently [2–12], there are some striking overlaps between their metabolic behaviors and therapeutic targets, suggesting the potential application of cardiovascular disease treatments for cancer therapy. More specifically, both cancer and many cardiovascular diseases have an upregulated glutaminolysis pathway, resulting in low glutamine and high glutamate circulating levels. Similar treatment modalities, such as glutaminase (GLS) inhibition and glutamine supplementation, have been identified to target glutamine metabolism in both cancer and some cardiovascular diseases. Studies have also found similarities in lipid metabolism, specifically fatty acid oxidation (FAO) and synthesis. Pharmacological inhibition of FAO and fatty acid synthesis have proven effective against many cancer types as well as specific cardiovascular conditions. Many of these treatments have been tested in clinical trials, and some have been medically prescribed to patients to treat certain diseases, such as angina pectoris [13, 14]. Other metabolic pathways, such as tryptophan catabolism and pyruvate metabolism, were also dysregulated in both diseases, making them promising treatment targets. Understanding the overlapping traits exhibited by both cancer metabolism and cardiovascular disease metabolism can give us a more holistic view of how important metabolic dysregulation is in the progression of diseases. Using established links between these illnesses, researchers can take advantage of the discoveries from one field and potentially apply them to the other. In this chapter, we highlight some promising therapeutic discoveries that can support our fight against cancer, based on common metabolic traits displayed in both cancer and cardiovascular diseases.

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Oral glutamine reduces myocardial damage after coronary revascularization under cardiopulmonary bypass. A randomized clinical trial

Abstract: Preoperative oral glutamine standardized at a dose of 0.5 g/kg/day in our study group showed a significant reduction in postoperative myocardial damage. Lower cardiac injury markers levels, morbidity and mortality were observed in patients receiving glutamine.

Cited by 13 publications

References 0 publications

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

The Emerging Role of l-Glutamine in Cardiovascular Health and Disease

Efeitos e segurança do uso pré-operatório de glutamina ou Whey Protein: Uma revisão sistemática

Metabolic Intersection of Cancer and Cardiovascular Diseases: Opportunities for Cancer Therapy

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