GLUTAMINE - IS IT A CONDITIONALLY REQUIRED NUTRIENT FOR THE HUMAN GASTROINTESTINAL SYSTEM

Glutamine is a nonessential amino acid which can be synthesized from g lutamate and glutamic acid by glutamine synthetase. It is the preferre d fuel for the rat small intestine. Animal studies have suggested both glutamine-supplemented parenteral nutrition and enteral diets may pre vent bacterial translocation. This effect is thought to be modulated v ia the preservation and augmentation of small bowel villus morphology, intestinal permeability and intestinal immune function. The existing data are less compelling in humans. It remains unclear what, if any, i ntestinal deficits actually occur in humans during provision of exclus ive parenteral nutrition. Furthermore, the clinical significance of th ese changes is largely undefined in humans. The existing data on the u se of parenteral and enteral glutamine for the purpose of preserving i ntestinal morphology and function, and the prevention of bacterial tra nslocation in humans are reviewed. Pertinent animal data are also desc ribed.