Document Detail


Selective uptake of glutamine in the gastrointestinal tract: confirmation in a human study.
MedLine Citation:
PMID:  1903318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent animal data suggest that the gut plays a far more important metabolic role than previously thought. During critical illness, disruption in bowel barrier function may result in a chronic hypermetabolic state and contribute to multiorgan failure. Animal studies have demonstrated that enterocytes of the gastrointestinal tract use glutamine as a respiratory fuel and during critical illness the consumption of glutamine by the gut significantly increases. The selective uptake of glutamine by the gut, to date, has not been confirmed in humans. Seven patients who sustained multisystem trauma necessitating laparotomy underwent portal venous catheterization. This was done by carefully reopening the obliterated umbilical vein and facilitating access to the left branch of the portal vein using a standard central venous catheter. Portal venous and systemic blood samples were recorded for 5 days after operation. Amino acid levels in both circulations were recorded at 48 h and 5 days. Using Student's t test for related samples, the differences between individual amino acids in portal and systemic circulations were compared. At 48 h, mean(s.d.) portal venous glutamine was 85(5) per cent of the systemic levels (253(80) compared with 296(90) mumol/ml, P less than 0.002). At 5 days, portal glutamine was 87(3) per cent of the systemic levels (255(69) compared with 292(83) mumol/ml, P less than 0.003). Levels of citrulline, a breakdown product of glutamine metabolism, were elevated in the portal venous circulation at 48 h (20(4) compared with 16(3) mumol/ml, P less than 0.005) and at 5 days (21(5) compared with 14(3) mumol/ml, P less than 0.002). No significant differences between any of the other amino acids analysed were identified. This study confirms, for the first time in humans, that selective uptake of glutamine occurs in the gut. In stressed states, glutamine deficiency is associated with gut mucosal atrophy. This has significant implications as glutamine is not provided in most commercially available parenteral and enteral nutrition formulations.
Authors:
O J McAnena; F A Moore; E E Moore; T N Jones; P Parsons
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  78     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-06-26     Completed Date:  1991-06-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  480-2     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Denver General Hospital, Colorado.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amino Acids / blood
Catheterization
Catheters, Indwelling
Digestive System / metabolism*
Enteral Nutrition
Female
Glutamine / blood,  metabolism*
Humans
Male
Middle Aged
Multiple Trauma / metabolism*,  therapy
Parenteral Nutrition
Portal Vein
Chemical
Reg. No./Substance:
0/Amino Acids; 56-85-9/Glutamine
Comments/Corrections
Comment In:
Br J Surg. 1992 Mar;79(3):280   [PMID:  1555103 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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