Glutamine: essential for immune nutrition in the critically ill
Open accessAbstract
Critically ill patients on intensive care units are at an increased risk of sepsis, which is a major cause of mortality in these patients. Recent evidence suggests that impairment of the functioning of the immune system contributes to the development of sepsis in such patients. In particular, monocytes show reduced expression of HLA-DR antigen, associated with impaired antigen presenting capability and decreased phagocytic activity; lymphocytes show decreased proliferation in response to mitogens and T-helper cells show a shift in the Th1/Th2 ratio consistent with impaired immunity. The amino acid glutamine becomes conditionally essential in the critically ill, yet such patients frequently have a marked deficiency of glutamine; the reasons for this are still unclear. Glutamine is required by the cells of the immune system both as a primary fuel and as a carbon and nitrogen donor for nucleotide precursor synthesis. In vivo studies have demonstrated that glutamine is essential for optimal immune cell functioning for monocytes, lymphocytes and neutrophils. A number of trials of patients fed by the enteral or parenteral route have shown improved infectious morbidity when supplemented with glutamine. However, the exact mechanism of glutamine action in these patients remains to be determined.
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During cellular stress, blood glutamine levels are severely decreased.
“During cellular stress, such as nutrient starvation and catabolic stress after trauma, surgery, infection, sepsis, or cancer cachexia, blood glutamine levels are severely decreased144.”
From Glutamine reliance in cell metabolism (2020) · cites this paper as [144]
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- Authors
- Andrews, F. J., & Griffiths, R. D.
- Affiliations
- University of Liverpool (GB)
- Corresponding author
- Griffiths, Richard D.
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2002-01
- Volume
- 87
- Issue
- S1
- Pages
- S3-S8
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W2106515336
- Cited by
- 114
- References
- 54
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 10 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 3 · 2012: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Nutrition and Physiology
- Keywords
- glutamine, critically ill patients, sepsis, monocytes, HLA-DR, antigen presentation, lymphocyte proliferation, Th1/Th2 balance, glutamine deficiency, enteral nutrition, parenteral nutrition, infectious morbidity
- MeSH terms
- Glutamine, Humans, Immune Tolerance, Immunity, Cellular, Critical Illness, Sepsis
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