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Related Experiment Videos

Parenteral glutamine protects hepatic function during bone marrow transplantation

S A Brown1, A Goringe, C Fegan

  • 1Department of Haematology, University Hospital of Wales, Cardiff, UK.

Bone Marrow Transplantation
|August 28, 1998
PubMed
Summary

Glutamine supplementation may protect liver function in patients undergoing bone marrow transplantation (BMT). This study found glutamine helped preserve protein C and albumin levels, crucial for preventing hepatic veno-occlusive disease (VOD).

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Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Nutritional Biochemistry

Background:

  • Hepatic veno-occlusive disease (VOD) is a frequent complication after bone marrow transplantation (BMT) due to high-dose chemotherapy.
  • Reduced glutathione (GSH) levels post-chemotherapy are linked to liver injury, specifically in centrilobular hepatocytes and endothelium.
  • Animal studies indicate glutamine can maintain GSH levels and offer protection against cellular damage.

Purpose of the Study:

  • To prospectively evaluate the effect of glutamine supplementation on liver function markers in patients undergoing BMT.
  • To determine if glutamine preserves key proteins like protein C and albumin, which are known to decrease post-BMT and predict VOD severity.
  • To assess glutamine's impact on markers of coagulation and fibrinolysis activation.

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Main Methods:

  • A randomized controlled trial involving 34 patients undergoing BMT.
  • Patients received either glycyl-L-glutamine or an isonitrogenous mixture of non-essential amino acids.
  • Liver function markers, including protein C, albumin, and markers of thrombin and plasmin generation, were measured at specified time points.

Main Results:

  • Glutamine supplementation significantly preserved protein C levels at days +4 and +7 (P < 0.05).
  • Albumin levels were also significantly preserved in the glutamine group at days 0 and +4 (P < 0.02).
  • No significant differences were observed between groups in markers of thrombin or plasmin generation.

Conclusions:

  • Glutamine supplementation appears to preserve hepatic function during BMT, evidenced by maintained protein C and albumin levels.
  • While glutamine supports hepatic function, it does not appear to significantly alter thrombin or plasmin generation.
  • These findings suggest a potential role for glutamine in mitigating VOD risk by protecting liver function post-BMT.