Effects of Intraperitoneal Glutamine in the Treatment of Experimental Sepsis

Abstract

Background: Sepsis is an important public health issue and is associated with high treatment costs and high mortality rates. Glutamine supplementation has proven to be beneficial to the functions of the immune system, acting beneficially in the evolution of patients in severe catabolic states. Aim: To evaluate the effect of glutamine supplementation via intraperitoneal in rats, induced sepsis, considering the following organs: intestines, liver, kidneys and lungs. Methods: Male Wistar rats subjected to sepsis by ligature and cecal puncture were divided into two groups: control C (n=6) and glutamine G (n=11), in which were administered dipeptiven 20% at a dose of 2 ml/kg/day (equivalent to 0.4g N(2)-L-alanyl-L-glutamine/kg) intraperitoneally 48 h prior to sepsis induction. After 48 h they were euthanized and intestine, liver, lung and kidney were removed for histological analysis. Results: Intestinal epithelial desquamation of the control group was more intense compared to the glutamine group (p=0.008). In the kidneys, degenerative tubular epithelial changes were less severe in the animals that received glutamine (p=0.029). Regarding to the liver, glutamine group showed lower levels of cell swelling than the control group (p=0.034). In the lung there were no results with statistical significance. Conclusion: Prior intraperitoneal supplementation with glutamine in experimental animals is able to reduce the damage to the intestinal mucosa, to the kidneys and liver’s histoarchitecture.

Research Progress on Natural Small-Molecule Compounds for the Prevention and Treatment of Sepsis

“…As a single nutrient supplement, a reasonable dose of glutamine is considered safe [ 97 ]. As shown in Figure 18 , glutamine supplementation in the abdominal cavity can reduce sepsis-induced damage to the intestinal mucosa, kidney, and liver tissues in CLP rat models [ 98 ]. Glutamine can inhibit the expression of SIRT5 to inhibit the desuccinylation of pyruvate dehydrogenase (PDH), which leads to an increase in oxidative phosphorylation, thereby promoting M2 polarization of macrophages to reduce burn sepsis in mice [ 99 ].…”

Aspectos Biológicos da L-Glutamina: Iimunomodulação e Hipertrofia Muscular – Estudo ao Longo do Tempo

“…Isso pode ser explicado pelo efeito que essa molécula tem em estimular o trofismo de células do intestino delgado e cólon. 26 Em 1998, a revista The Lancet (Vol 352, November 7, 1998) publicou a resposta dos autores referente ao questionamento do artigo Glutamine-enriched enteral nutrition in patients with multiple trauma, publicado por Alexander Houdijk e colegas (na publicação de Sept 5 p 772), 27 no qual a suplementação enteral com glutamina em pacientes com trauma múltiplo mostrou uma redução na incidência de pneumonia, sepse e bacteremia mas que naquele momento os resultados eram difíceis de interpretar.…”

Clinical profile of patients with sepsis admitted to an intensive care unit: a cross-cutting study / Perfil clínico de pacientes com sepse internados em unidade de terapia intensiva: um estudo transversal

“…1 According to epidemiological data, sepsis is the main cause of non-cardiological death in the Intensive Care Unit (ICU) and one of the main causes of late hospital mortality arising as a consequence of different types of pathologies involving different organ systems. 2 The risk factors described in the literature for the development and worsening of the clinical picture of sepsis are: aging, male gender, longer hospital stay, chronic diseases and use of invasive devices. 3 It is estimated that annually around 15 to 17 million people worldwide are affected with sepsis.…”