Glutamine analogues as adjunctive therapy for infectious diarrhea

BA Carneiro-Filho, OY Bushen, GAC Brito… - Current Infectious …, 2003 - Springer
Current Infectious Disease Reports, 2003Springer
Glutamine is the major fuel for the gut as well as for many cells in the immune system that
becomes conditionally essential during catabolic states. Glutamine supplementation
improves intestinal mucosal repair and function. Glutamine, even at high doses, is without
side effects and is well tolerated. Though unstable in solution, this is overcome by creating
stable dipeptides such as alanyl-glutamine. In HIVpositive patients with wasting, glutamine
enhances intestinal absorptive function and weight gain. Glutamine enhances sodium and …
Abstract
Glutamine is the major fuel for the gut as well as for many cells in the immune system that becomes conditionally essential during catabolic states. Glutamine supplementation improves intestinal mucosal repair and function. Glutamine, even at high doses, is without side effects and is well tolerated. Though unstable in solution, this is overcome by creating stable dipeptides such as alanyl-glutamine. In HIVpositive patients with wasting, glutamine enhances intestinal absorptive function and weight gain. Glutamine enhances sodium and water absorption in a rabbit model of cholera and Cryptosporidium-infected piglet intestine. Both glutamine and alanyl-glutamine have recently proven effective in a bovine model of Cryptosporidium as well. Finally, a rat model of cholera toxin-induced diarrhea also showed that alanyl-glutamine enhanced water and electrolyte intestinal absorption even better than the traditional glucose solutions. Clearly glutamine and its stabler derivatives hold promise for enhancing repair of mucosal injury by a wide range of infections or toxic agents, and hence have great potential as a new oral rehydration and nutrition therapy for patients with enteric infection, malnutrition, or chemotherapy- or radiationinduced enteritis.
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