Oral glutamine accelerates healing of the small intestine and improves outcome after whole abdominal radiation
V. S. Klimberg, R. M. Salloum, M. Kasper, D. A. Plumley, D. J. Dolson, R. D. Hautamaki, W. R. Mendenhall, F. C. Bova, K. I. Bland, E. M. Copeland 3rd and al. et
Department of Surgery, University of Florida College of Medicine, Gainesville 32610.
The healing effects of glutamine given orally for 8 days as a single amino
acid nutrient after treatment with whole abdominal radiation (10 Gy) were
studied. Rats received isonitrogenous and isovolumic diets containing 3%
glutamine or 3% glycine. Control rats were not irradiated but were given
identical diets. In irradiated animals, survival was 100% in animals
receiving glutamine compared with 45% in animals receiving glycine.
Glutamine ingestion diminished bloody diarrhea and the incidence of bowel
perforation. Arterial glutamine level was higher in animals receiving
glutamine in the diet, as were gut glutamine extraction (35% +/- 8% vs 12%
+/- 7%) and intestinal glutaminase activity. These metabolic improvements
were associated with a marked increase in villous height, villous number,
and the number of mitoses per crypt in rats receiving glutamine. Glutamine
was not beneficial in control nonirradiated animals. The data demonstrated
that provision of oral glutamine after abdominal radiation supported gut
glutamine metabolism, improved mucosal morphometrics, and decreased the
morbidity and mortality associated with this abdominal radiation model.
