Skeletal Muscle Glutathione After Surgical Trauma

Luo, Jiali; Hammarqvist, Folke; Andersson, Kerstin; Wernerman, Jan

doi:10.1097/00000658-199604000-00011

Cited by 72 publications

(45 citation statements)

References 25 publications

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“…Glutathione depletion in skeletal muscle is pronounced following major trauma and sepsis in intensive care unit patients (Tischler and Fagan, 1982;Luo et al, 1996) Flaring et al (2003 have shown that intravenous glutamine supplementation attenuates glutathione depletion in skeletal muscle in humans following standardized surgical trauma.…”

Section: Cell Defense and Repairmentioning

confidence: 99%

Molecular mechanisms of glutamine action

Curi

Lagranha

Doi

et al. 2005

Journal Cellular Physiology

389

288

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Glutamine is the most abundant free amino acid in the body and is known to play a regulatory role in several cell specific processes including metabolism (e.g., oxidative fuel, gluconeogenic precursor, and lipogenic precursor), cell integrity (apoptosis, cell proliferation), protein synthesis, and degradation, contractile protein mass, redox potential, respiratory burst, insulin resistance, insulin secretion, and extracellular matrix (ECM) synthesis. Glutamine has been shown to regulate the expression of many genes related to metabolism, signal transduction, cell defense and repair, and to activate intracellular signaling pathways. Thus, the function of glutamine goes beyond that of a simple metabolic fuel or protein precursor as previously assumed. In this review, we have attempted to identify some of the common mechanisms underlying the regulation of glutamine dependent cellular functions.

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Section: Cell Defense and Repairmentioning

confidence: 99%

Molecular mechanisms of glutamine action

Curi

Lagranha

Doi

et al. 2005

Journal Cellular Physiology

389

288

View full text Add to dashboard Cite

show abstract

“…Furthermore, glutathione may have a more specific effect on the function of lymphocytes via the thioredoxin system (Dröge et al 1994). Unfortunately, surgery, a wide range of diseases which have an inflammatory component and ageing and protein-energy malnutrition decrease reduced glutathione concentrations in blood and other tissues (Luo et al 1996;Boya et al 1999;Loguercio et al 1999;Nuttall et al 1999;Reid et al 2000;Micke et al 2001). Within 24 h of elective abdominal surgery muscle glutathione content falls by over 30 %.…”

Section: Immunonutritionmentioning

confidence: 99%

Nutritional modulation of immune function

2001

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The inflammatory response to injury and infection, although an essential part of immune function, carries the risk of severe tissue depletion and immunosuppression. These outcomes increase morbidity and delay recovery. Evidence is accumulating that single-nucleotide polymorphisms in the genes controlling pro-inflammatory cytokine production adversely influence the response. Immunonutrition provides a means of modulating the inflammatory response to injury and infection, and thereby improves clinical outcome. n-3 Polyunsaturated fatty acids (n-3 PUFA), glutamine, arginine, S amino acids and nucleotides are important components of immunonutrient mixes. While animal model studies suggest that all these components may exert a beneficial effect in patients, the number of large randomized placebo-controlled trials utilizing immunonutrition is fairly limited and the observed effects are relatively small. Meta-analyses suggest that while immunonutrition may not reduce mortality rates, a reduction in hospital length of stay, decreased requirements for ventilation and lower infection rates are achieved by this mode of nutrition. The present paper discusses some underlying reasons for the difficulty in demonstrating the clinical efficacy of immunonutrition. Paramount among these reasons is the antioxidant status and genetic background of the patient. A number of studies suggest that there is an inverse relationship between inflammation and T-cell function. Immuno-enhancive effects have been shown in a number of studies in which n-3 PUFA, glutamine and N-acetyl cysteine have been employed. All these nutrients may exert their effects by suppressing inflammation; n-3 PUFA by direct suppression of the process and glutamine and N-acetyl cysteine by acting indirectly on antioxidant status. Glutamine and nucleotides exert a direct effect on lymphocyte proliferation. Preliminary data suggests that not all genotypes are equally sensitive to the effects of immunonutrition. When further studies have been conducted to discern the precise interaction between each individual's genotype of relevance to the response to injury and infection, and immunonutrients, the level of precision in the application of immunonutrition will undoubtedly improve.

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“…After surgical trauma, glutathione concentrations decrease in skeletal muscle [17], which might indicate ongoing oxidative stress with potential tissue injury [18]. Since the redox status of glutathione seems to be related to the degree of protein degradation, this may contribute to the protein catabolism associated with trauma [16].…”

Section: Introductionmentioning

confidence: 99%

Glutamine attenuates post-traumatic glutathione depletion in human muscle

Fläring¹,

Rooyackers²,

Wernerman³

et al. 2003

Clinical Science

111

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Glutathione is quantitatively the most important endogenous scavenger system. Glutathione depletion in skeletal muscle is pronounced following major trauma and sepsis in intensive care unit patients. Also, following elective surgery, glutathione depletion occurs in parallel with a progressive decline in muscle glutamine concentration. The present study was designed to test the hypothesis that glutamine supplementation may counteract glutathione depletion in a human trauma model. A homogeneous group of patients (n = 17) undergoing a standardized surgical procedure were prospectively randomly allocated to receive glutamine (0.56 g x day(-1) x kg(-1)) or placebo as part of isonitrogenous and isocaloric nutrition. Percutaneous muscle biopsies and blood samples were taken pre-operatively and at 24 and 72 h after surgery. The concentrations of muscle glutathione and related amino acids were determined in muscle tissue and plasma. In the control (unsupplemented) subjects, total muscle glutathione had decreased by 47+/-8% and 37+/-11% and reduced glutathione had decreased by 53+/-10% and 45+/-16% respectively at 24 and 72 h after surgery (P < 0.05). In contrast, in the glutamine-supplemented group, no significant post-operative decreases in total or reduced glutathione were seen following surgery. Muscle free glutamine had decreased at 72 h after surgery in both groups, by 41.4+/-14.8% (P < 0.05) in the glutamine-supplemented group and by 46.0+/-14.3% (P < 0.05) in the control group. In conclusion, the present study demonstrates that intravenous glutamine supplementation attenuates glutathione depletion in skeletal muscle in humans following standardized surgical trauma.

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Skeletal Muscle Glutathione After Surgical Trauma

Cited by 72 publications

References 25 publications

Molecular mechanisms of glutamine action

Molecular mechanisms of glutamine action

Nutritional modulation of immune function

Glutamine attenuates post-traumatic glutathione depletion in human muscle

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