Glutamine‐Enriched Enteral Diet Enhances Bacterial Clearance in Protracted Bacterial Peritonitis, Regardless of Glutamine Form‡

Furukawa, Satoshi; Saito, H.; Inaba, Tomoki; Lin∥, Ming–Tsan; Inoue, T.; Naka, Shuhei; Fukatsu, Kazuhiko; Hashiguchi, Yojiro; Han, Ilsoo; Matsuda, Takeshi; Ikeda, Shigeo; Muto, Tetsuichiro

doi:10.1177/0148607197021004208

Cited by 30 publications

(12 citation statements)

References 18 publications

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“…28 These findings explain the fact that glutamine enhances the bactericidal function of neutrophils from normal patients and those suffering from burns. [1][2][3] Recently, we have found that glutamine delays the onset of apoptosis in rat and human neutrophils. [28][29] Since glutamine metabolism provides NADPH/NADH to maintain the redox state of the cells and to ensure the production of ATP and intermediates for the synthesis of macromolecules such as nucleic acids and lipids, 30 a high glutamine consumption could be a metabolic attempt to preserve the integrity and function of the cells.…”

Section: Resultsmentioning

confidence: 99%

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Glucose and glutamine utilization by rat lymphocytes, monocytes and neutrophils in culture: a comparative study

Pithon-Curi

Melo

Curi

2004

Cell Biochemistry & Function

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Glucose and glutamine utilization and production of glutamate and lactate were determined for up to 48 h in lymphocytes, monocytes and neutrophils cultured in medium rich in metabolites and vitamins. Glucose was utilized by the three cell types in culture in the following order: neutrophils > monocytes > lymphocytes, whereas lactate was produced in the order: monocytes > neutrophils > lymphocytes. The consumption of glucose followed the activity of glucose-6-phosphate dehydrogenase but it was not related to hexokinase activity. Glutamine was consumed by the three leukocyte types in culture as follows: neutrophils > lymphocytes > or = monocytes. The consumption of glutamine was not fully related to the activity of phosphate-dependent glutaminase. The production of glutamate was not remarkably different among the three cell types. For comparison, glutamine and glucose utilization and glutamate and lactate production were also evaluated using 1-h incubated leukocytes. Under this condition, only glucose or glutamine was added to the medium. Glucose was utilized as follows: neutrophils > monocytes > lymphocytes, whereas lactate was produced in the following order: monocytes > or = neutrophils > lymphocytes. Glutamine was consumed as follows: neutrophils > lymphocytes > monocytes, whereas glutamate was produced as follows: neutrophils > or = monocytes = lymphocytes. The ratio of the amount of glucose/glutamine consumed by 1-h incubated cells was 0.5 for neutrophils, 1.5 for monocytes, and 0.3 for lymphocytes. However, the three cell types cultured for 48 h utilized glucose to a much higher degree than glutamine. The ratio of the amount of glucose/glutamine utilized by the cultured cells was 8.9 for neutrophils, 16.4 for monocytes, and 6.7 for lymphocytes. These observations support the proposition that glutamine is required in much higher amounts than glucose to accomplish the total metabolic requirement of leukocytes. Under conditions closer to physiological when the availability of a variety of metabolites and vitamins is not restricted, glucose is the preferred substrate for lymphocytes, monocytes and neutrophils.

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Section: Resultsmentioning

confidence: 99%

“…[1][2][3] The pioneering work of Newsholme's laboratory in the early to mid-1980s established that immune cells such as lymphocytes and macrophages could utilize glutamine at high rates in addition to glucose. 4,5 In 1997, Pithon-Curi et al showed that the rate of glutamine utilization by neutrophils is higher than that of glucose.…”

Section: Introductionmentioning

confidence: 99%

Glucose and glutamine utilization by rat lymphocytes, monocytes and neutrophils in culture: a comparative study

Pithon-Curi

Melo

Curi

2004

Cell Biochemistry & Function

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“…This system is of fundamental importance not only in preventing or limiting infection, but also in the overall process of repair and recovery from injury. It is therefore important in clinical conditions of trauma, sepsis, burns and recovery from surgery (1,2). The significance of the cellular immune system in overcoming infection has been recently highlighted by the high mortality rate associated with simple immune challenges in acquired immune deficiency syndrome.…”

Section: Introductionmentioning

confidence: 99%

Metabolic fate of glutamine in lymphocytes, macrophages and neutrophils

Curi

Newsholme

Pithon-Curi

et al. 1999

Braz J Med Biol Res

106

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Eric Newsholmes laboratory was the first to show glutamine utilization by lymphocytes and macrophages. Recently, we have found that neutrophils also utilize glutamine. This amino acid has been shown to play a role in lymphocyte proliferation, cytokine production by lymphocytes and macrophages and phagocytosis and superoxide production by macrophages and neutrophils. Knowledge of the metabolic fate of glutamine in these cells is important for the understanding of the role and function of this amino acid in the maintenance of the proliferative, phagocytic and secretory capacities of these cells. Glutamine and glucose are poorly oxidized by these cells and might produce important precursors for DNA, RNA, protein and lipid synthesis. The high rate of glutamine utilization and its importance in such cells have raised the question as to the source of this glutamine, which, according to current evidence, appears to be muscle.

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“…The association led many to hypothesize that administering exogenous glutamine, parenterally or enterally, to restore glutamine to Bnormal^levels during critical illness may improve clinical outcomes [15,17]. Indeed, animal models of hemorrhagic shock demonstrate that glutamine supplementation can attenuate the impairment of intestinal blood flow, potentially preserving mucosal integrity [18], while peritonitis models have shown that glutamine enhances peritoneal bacterial clearance [19] as well as neutrophil function through increased production of reactive oxygen intermediates [20]. Based on encouraging observational studies and meta-analyses of smaller randomized trials [21], two large, well-designed and adequate powered multicenter trials have recently been conducted.…”

Section: Glutaminementioning

confidence: 99%

Immune-Enhancing Diets: What is the Final Answer?

Yeh

Heyland

2016

Curr Trauma Rep

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Supplementation of certain micronutrients to standard nutrition therapy in pharmacological doses can modulate the host immunologic response. The three most extensively studied: arginine, glutamine, and omega-3 fatty acids (Bfish oils^). While animal studies are encouraging, human clinical trials arrive at conflicting conclusions for multiple reasons, mainly related to heterogeneity in patient selection, concentration and combination of agents, dose, route, and timing and administration. Glutamine should not be given to patients with multi-organ (especially renal) failure and arginine should be avoided in septic shock. Enteral glutamine may be beneficial in burn and trauma patients. Larger, higher-quality studies are required before strong recommendations can be made.

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Glutamine‐Enriched Enteral Diet Enhances Bacterial Clearance in Protracted Bacterial Peritonitis, Regardless of Glutamine Form‡

Abstract: Supplemental Gln enhances peritoneal and hepatic bacterial clearance, regardless of Gln form. Gln-enriched may be more beneficial than Gln-depleted enteral diets in peritonitis.

Cited by 30 publications

References 18 publications

Glucose and glutamine utilization by rat lymphocytes, monocytes and neutrophils in culture: a comparative study

Glucose and glutamine utilization by rat lymphocytes, monocytes and neutrophils in culture: a comparative study

Metabolic fate of glutamine in lymphocytes, macrophages and neutrophils

Immune-Enhancing Diets: What is the Final Answer?

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