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Glutamine Structure and Function: A Starter Pack

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Glutamine in Clinical Nutrition

Part of the book series: Nutrition and Health ((NH))

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Abstract

Glutamine is a substrate central in metabolism. Its carbon skeleton can act as an anaplerotic substrate by introduction as α-oxoglutarate in the Krebs-cycle. At other sites of the cycle intermediates can branch off producing carbon chains of purines, pyrimidines, haem, proline, aspartate, non-essential amino acids, sterols, phospholipids. Its nitrogen serves in a similar manner to synthesize bases, the amino groups of non-essential amino acids and other products. A third role consists of the production of reducing equivalents essential in several functions including the maintenance of redox balance. This explains why in cell culture optimal cell proliferation only occurs when glutamine (and glucose) are added to the incubation medium.

In vivo new glutamine production is increased in trauma, inflammatory states and in conditions of growth. Peripheral (muscle) tissues yield amino acids which are used in close collaboration with the liver to produce glutamine, glycine, proline, alanine and glucose. Other amino acids derived from net protein breakdown are also released in lesser amounts. In malnourished states and in chronic inflammatory illness glutamine production has been claimed to be insufficient but studies convincingly demonstrating deficient peripheral production have not been performed. In disease states (trauma, sepsis) the maximal amount of new glutamine produced amounts to 30 g in adults. Low glutamine levels are unreliable indicators of glutamine deficiency. Very high glutamine levels have been found in patients with liver (and renal) failure and are contraindications for supplementation with glutamine.

In long term inflammatory conditions and trauma benefit has been demonstrated from glutamine supplementation, decreasing infectious complications, mortality and intestinal permeability.

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Authors and Affiliations

  1. Maastricht University Medical Center, Lanaken, Belgium

    Peter B. Soeters M.D., Ph.D.

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  1. Peter B. Soeters M.D., Ph.D.
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Correspondence to Peter B. Soeters M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Intensive Care, Barnet and Chase Farm Hospitals, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition and Dietetics, Diabetes and Nutritional Sciences, School of Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Soeters, P.B. (2015). Glutamine Structure and Function: A Starter Pack. In: Rajendram, R., Preedy, V., Patel, V. (eds) Glutamine in Clinical Nutrition. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1932-1_1

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  • DOI: https://doi.org/10.1007/978-1-4939-1932-1_1

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