Glutamine Reduces Post-Burn Infections
Adults suffering from severe
burns may be able to reduce their risk of developing infections by taking oral
glutamine, according to a new study in Critical Care Medicine (2003;
31:2444-9). Lowering infection risk may lead to fewer deaths and shorter
hospital stays in burn victims.
In the new study, 41 adults under
the age of 65 years with severe burns covering between 20 and 80% of their skin
were assigned to receive standard nutrition through a feeding tube supplemented
with 4.3 grams of glutamine or supplemented with other amino acids (aspartic
acid, asparagine, and glycine) every four hours (up to 26 grams per day).
Treatment was continued until complete healing of the burns occurred. Time
spent in the hospital, incidence of blood infections, and the number of deaths
The incidence of blood infections
was three times higher in individuals receiving the control mixture than in
those getting supplemental glutamine in their feeding tube. No deaths occurred
in the group receiving glutamine among the 19 individuals who survived the
first 72 hours, compared with eight deaths among the 16 people in the control
group who survived the first 72 hours. Time spent in the hospital was also
significantly reduced in those receiving glutamine.
Glutamine is a non-essential
amino acid that is an important fuel source for cells of the immune system and
cells that line the inner wall of the intestines. It is the most abundant amino
acid found in the body and is involved in energy metabolism more than any
other. Studies show that severe burns deplete glutamine in the muscles and
blood; however, this is the first study to show a benefit of glutamine
supplementation following burn injuries. Although the amount of glutamine used
in this study was relatively large, similar doses have been used with apparent
safety in studies of individuals with HIV infection and in those receiving
cancer chemotherapy. It is possible that lower doses of glutamine would be
beneficial for people suffering less severe burns, but additional research is
needed to determine the optimal amount in such cases.
The mechanism by which glutamine
prevents post-burn infection is not clear. Some animal studies suggest
glutamine protects the gut wall barrier and prevents bacteria from crossing
into the bloodstream. Other animal studies suggest it stimulates the immune
system and improves immune function. Glutamine is an indirect precursor for a
compound called glutathione, which is a potent antioxidant and may have other
protective effects in the body. While more research is needed to clarify these
issues, glutamine is safe and is not associated with any toxic side effects,
even when taken in large amounts.
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