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Review
. 2020 Jun 4;12(6):1675.
doi: 10.3390/nu12061675.

Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy

Peter M Anderson  1 , Rajesh V Lalla  2
Affiliations
Review

Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy

Peter M Anderson et al. Nutrients. .

Abstract

Glutamine is a major dietary amino acid that is both a fuel and nitrogen donor for healing tissues damaged by chemotherapy and radiation. Evidence supports the benefit of oral (enteral) glutamine to reduce symptoms and improve and/or maintain quality of life of cancer patients. Benefits include not only better nutrition, but also decreased mucosal damage (mucositis, stomatitis, pharyngitis, esophagitis, and enteritis). Glutamine supplementation in a high protein diet (10 grams/day) + disaccharides, such as sucrose and/or trehalose, is a combination that increases glutamine uptake by mucosal cells. This increased topical effect can reduce painful mucosal symptoms and ulceration associated with chemotherapy and radiation in the head and neck region, esophagus, stomach and small intestine. Topical and oral glutamine seem to be the preferred routes for this amino acid to promote mucosal healing during and after cancer treatment.

Keywords: amino acid supplementation in cancer; chemotherapy associated malnutrition; glutamine; glutathione; mucositis; radiation injury; trehalose.

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Conflict of interest statement

Peter Anderson has a patent “glutamine and trehalose compositions” (US2015/0080331) and is on the scientific advisory board of Enlivity. Rajesh Lalla served as a consultant for Enlivity.

Figures

Figure 1
Figure 1
Physical damage and amino acid malnutrition can both contribute to slow healing and worse mucosal injury from cancer chemotherapy and/or radiation. Dietary glutamine may ameliorate some of these side effects of cancer therapy.
Figure 2
Figure 2
Pivotal role of glutamine stored in muscle (glutamine “bank”), normal high glutamine concentration in plasma, and liver amino acid metabolism (switch hitter) to facilitate steady state glutamine for mucosal health in (A) healthy anabolic state versus (B) during catabolic states including injury from cancer therapy, malnutrition, and tissue damage. In the catabolic state of mucositis from cancer therapy injury, topical glutamine + disaccharide can be helpful.
See this image and copyright information in PMC

References

    1. Souba W.W., Smith R.J., Wilmore D.W. Glutamine metabolism by the intestinal tract. J. Parenter. Enter. Nutr. 1985;9:608–617. doi: 10.1177/0148607185009005608. - DOI - PubMed
    1. Souba W.W., Klimberg V.S., Plumley D.A., Salloum R.M., Flynn T.C., Bland K.I., Copeland E.M., 3rd The role of glutamine in maintaining a healthy gut and supporting the metabolic response to injury and infection. J. Surg. Res. 1990;48:383–391. doi: 10.1016/0022-4804(90)90080-L. - DOI - PubMed
    1. Klimberg V.S., McClellan J.L., Organ C.H., Jr. Honorary Lectureship. Glutamine, cancer, and its therapy. Am. J. Surg. 1996;172:418–424. doi: 10.1016/S0002-9610(96)00217-6. - DOI - PubMed
    1. Klimberg V.S., Souba W.W., Salloum R.M., Plumley D.A., Cohen F.S., Dolson D.J., Bland K.I., Copeland E.M., 3rd Glutamine-enriched diets support muscle glutamine metabolism without stimulating tumor growth. J. Surg. Res. 1990;48:319–323. doi: 10.1016/0022-4804(90)90066-B. - DOI - PubMed
    1. Smith R.J., Wilmore D.W. Glutamine nutrition and requirements. J. Parenter. Enter. Nutr. 1990;14:94S–99S. doi: 10.1177/014860719001400412. - DOI - PubMed

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