Glutamine supplementation in cancer patients

Area of Science:

• Oncology
• Metabolic Research
• Nutritional Science

Background:

• Tumor-bearing states often lead to metabolic disturbances.
• Glutamine plays a crucial role in cellular metabolism and immune function.
• Chemotherapy and radiochemotherapy can exacerbate nutrient deficiencies and compromise gut integrity.

Purpose of the Study:

• To investigate glutamine deficiency in tumor-bearing rats.
• To assess the impact of glutamine supplementation on protein metabolism during chemotherapy in tumor-bearing rats.
• To evaluate the effect of oral glutamine on immune and gut-barrier function in esophageal cancer patients undergoing radiochemotherapy.

Main Methods:

• Animal studies involved inducing tumors in rats and measuring glutamine metabolism using isotopic tracers.
• Protein metabolism was assessed via 1-14C-leucine infusion.
• A clinical trial randomized esophageal cancer patients to receive either a control diet or glutamine supplementation (30 g/d) for 4 weeks.

Main Results:

• Tumor-bearing rats exhibited decreased plasma and skeletal muscle glutamine levels, despite increased glutamine production.
• Glutamine supplementation via total parenteral nutrition reduced whole-body protein breakdown in chemotherapy-treated tumor-bearing rats.
• Patients receiving oral glutamine showed enhanced lymphocyte function and reduced gut permeability during radiochemotherapy.

Conclusions:

• Glutamine depletion is a characteristic of the tumor-bearing state in rats.
• Glutamine supplementation can mitigate muscle protein loss in tumor-bearing animals.
• Oral glutamine protects immune and gut-barrier function in cancer patients undergoing radiochemotherapy.