Cited by 114Clinical Nutrition and GastroenterologySepsis Diagnosis and TreatmentAnimal Nutrition and Physiology

Glutamine: essential for immune nutrition in the critically ill

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Andrews, Francis J., Griffiths, Richard D.·2002·British Journal of Nutrition

Abstract

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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  1. Askanazi J, Carpentier YA, Michelsen CB, Elwyn DH, Furst P, Kantrowitz LR, Gump FE & Kinney JM (1980) Muscle and plasma amino acids following injury. Annals of Surgery 192, 78 -85.

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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
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
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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