Document Detail


L-alanyl-glutamine preoperative infusion in patients with critical limb ischemia subjected to distal revascularization reduces tissue damage and protects from oxidative stress.
MedLine Citation:
PMID:  20371164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Critical limb ischemia (CLI) is the most severe form of peripheral vascular disease where there is inadequate blood flow to a limb. Our aim was to examine the effects of preoperative infusion of l-alanyl-glutamine (l-Ala-Gln) during the ischemic period and during the first 30 minutes following blood reflow in patients with CLI who are undergoing distal femoral artery bypass surgery. METHODS: Thirty-two patients with CLI were alternately allocated to group 1 (saline) or group 2 (l-Ala-Gln). Saline (1000 mL) or L-Ala-Gln 250 mL plus 750 mL of saline were infused intravenously over a 3-hour period prior to surgery. Samples (muscle and blood) were collected at the beginning of the surgical procedure, at the end of ischemia, and at 15 and 30 minutes after reperfusion. RESULTS: l-Ala-Gln induced elevation in glutathione (GSH) muscle concentrations while promoting reduction in thiobarbituric acid reactive substance concentrations, demonstrating enhancement of antioxidant capacity and protection from lipid peroxidation. Decreases in LDH, lactate, and glucose blood concentrations in l-Ala-Gln-treated patients suggest increased glucose utilization by muscle and peripheral tissues. Reduction in creatine phosphokinase blood concentrations may reflect smaller muscle cell damage in l-Ala-Gln-treated patients. CONCLUSION: l-Ala-Gln pretreatment reduces muscle cell damage and enhances antioxidant capacity in patients with CLI.
Authors:
Wellington Forte Alves; Erika Elisa Aguiar; Sergio Botelho Guimarães; Antonio Ribeiro da Silva Filho; Petrúcia Maria Antero Pinheiro; Gabriel dos Santos Dias Soares; Paulo Roberto Leitão de Vasconcelos
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2010-04-03
Journal Detail:
Title:  Annals of vascular surgery     Volume:  24     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  461-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
General Hospital of Fortaleza, Fortaleza, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antioxidants / administration & dosage*
Biological Markers / blood
Blood Glucose / metabolism
Brazil
Creatine Kinase / blood
Critical Illness
Dipeptides / administration & dosage*
Drug Administration Schedule
Female
Glutathione / metabolism
Humans
Infusions, Intravenous
Ischemia / drug therapy*,  metabolism,  pathology,  physiopathology,  surgery
L-Lactate Dehydrogenase / blood
Lactic Acid / blood
Lipid Peroxidation / drug effects
Lower Extremity
Male
Middle Aged
Muscle, Skeletal / blood supply*,  drug effects*,  metabolism,  pathology
Oxidative Stress / drug effects*
Preoperative Care
Regional Blood Flow
Saphenous Vein / transplantation*
Thiobarbituric Acid Reactive Substances / metabolism
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antioxidants; 0/Biological Markers; 0/Blood Glucose; 0/Dipeptides; 0/Thiobarbituric Acid Reactive Substances; 39537-23-0/alanylglutamine; 50-21-5/Lactic Acid; 70-18-8/Glutathione; EC 1.1.1.27/L-Lactate Dehydrogenase; EC 2.7.3.2/Creatine Kinase

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