营养支持中补充谷氨酰胺的潜在作用

Potential role of glutamine supplementation in nutrition support

本支综述了谷氨酰胶、谷氨酰胺双肽及谷氨酰胺前体（鸟氨酰－α－酮戊酸和α－酮戊酸）在营养支持中的作用。结果表明，补充GLN或GLN前体的肠内或肠外营养能被很好耐受并且在许多病人群中证明了其有益作用。但机制仍不清楚，可能有多种相互有关的机制。如增加蛋白质合成和减少蛋白质分解反应而改善氮平衡；促进DNA和RNA的合成；改善膜屏障防御功能和维持组织抗氧化剂储存等。有必要对GLN作用的临床效能和分子基础作进一步的研究。

The paper reviewed the potential role of glutamine(GLN), GLN dipeptides or GLN precursors ornithine-alpha-ketoglutarate (OAK ) or alpha-ketoglutarate (AKG) in nutrition support. The available data suggested that enteral and parenteral feedings supplemented with GLN or GLN precursors had been well tolerated and beneficial effects have been documented in a number of patient groups. The mechanisms of GLN actions in nutrition were yet unclear and might be interrelated. Enhanced protein synthesis and reduced protein-catabolic responses resulting improved nitrogen retention, increased DNA and RNA synthesis, enhanced function of immune cells, maintenance of mucosal barrier defenses, and/or maintenance of tissue antioxidant stores etc. might contribute to its role. Further studies on the clinical efficacy and the molecular bases for GLN effects are neceasery.