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Does glutamine-enriched parenteral nutrition really affect intestinal morphology and gut permeability?
Karel W E Hulsewé1, Bernadette A C van Acker, Wim Hameeteman
1Department of General Surgery, University Hospital Maastricht, The Netherlands. k.hulsewe@ah.unimaas.nl
Background:
Nutritional depletion has been related to low glutamine levels in plasma and gut mucosa. This study was set up to investigate the effects of glutamine-enriched total parenteral nutrition on intestinal morphology and permeability.
Methods:
Twenty-three depleted patients were randomized and after stabilization baseline measurements were performed. Plasma glutamine concentrations, gut morphology (including proliferation and lymphocyte markers) and intestinal permeability were measured. After administration during 8-10 days of a glutamine enriched total parenteral nutrition or an isonitrogenous control solution the measurements were repeated.
Results:
No significant changes in glutamine concentrations, intestinal permeability, mucosal morphology or gut mucosal inflammation were observed between groups.
Conclusions:
Glutamine enriched total parenteral nutrition in a depleted patient population does not result in improvements in gut morphology and gut barrier function.