Glutaminin Kronik Hastalıklardaki Rolü

Abstract

Glutamin; arjinin, omega-3 yağ asitleri ve nükleotid gibi immünonütrisyon ürünleri arasında yer alan bir besin ögesidir. Aynı zamanda insan vücudunda en bol bulunan amino asit çeşidi olmakla birlikte stres, travma ve sepsis gibi katabolik koşullara bağlı olarak elzem hale gelmektedir. Dolaşımdaki glutamin salınımı ve bulunabilirliği bağırsak, karaciğer ve iskelet kasları gibi temel metabolik organlar tarafından kontrol edilmektedir. Glutaminin hücre içindeki başlıca görevleri arasında; nitrojen dengesinin sağlanması, mukozal immün yanıtın ve glukoz metabolizmasının düzenlenmesi, intestinal doku bütünlüğünün korunması ve asit baz dengesinin sağlanması yer almaktadır. Ayrıca glutaminin lenfosit ve enterositler için substrat görevi görme, glikoneogenezi ve protein sentezini düzenleme ve proinflamatuvar sitokin salınımını baskılama gibi görevleri de bulunmaktadır. Tüm bu özellikleri ile glutamin sağlık üzerindeki etkileri açısından oldukça önemlidir. Kritik hastalık durumunda meydana gelen metabolik değişiklikler nedeniyle, plazma ve iskelet kaslarındaki glutamin depoları tükenmektedir. Bu dönemlerde pozitif nitrojen dengesinin sağlanması adına glutamin takviyesinin yapılması önemlidir. Mevcut çalışmalarda glutamin destekleri oral, enteral ve/veya parenteral olmak üzere çeşitli yollarla yapılmış ve çalışmalarda farklı glutamin dozları kullanılmıştır. Literatürde, glutaminin hastalığa özgü dozu ve en etkin veriliş yolu için kesin bir öneri bulunmamaktadır. Bu derleme, güncel çalışmalardan elde edilen veriler ışığında glutaminin inflamatuvar bağırsak hastalıkları, kardiyovasküler hastalıklar, kanser, yara, yanık, stres, travma ve sepsis gibi çeşitli hastalıklar üzerindeki etkilerini incelemek amacıyla yazılmıştır.

Keywords

• Glutamin
• kronik hastalık
• beslenme tedavisi

The Role of Glutamine in Chronic Diseases

Abstract

Glutamine is a nutrient that is among the immunonutrition products such as arginine, omega-3 fatty acids and nucleotides. Besides being the most abundant amino acid in the human body, it becomes essential due to catabolic conditions such as stress, trauma, and sepsis. The release and availability of circulating glutamine is controlled by major metabolic organs such as the gut, liver, and skeletal muscles. Nitrogen balance, regulation of mucosal immune response, glucose metabolism, preservation of intestinal tissue integrity, and acid-base balance are included among the main functions of glutamine in the cell. In addition, glutamine has functions such as acting as a substrate for lymphocytes and enterocytes, regulating gluconeogenesis and protein synthesis, and suppressing proinflammatory cytokine release. With all these features, glutamine is very important in terms of its effects on health. Glutamine stores in plasma and skeletal muscles are depleted due to metabolic changes that occur in critical illness. It is important to supplement with glutamine to maintain a positive nitrogen balance during those periods. In the current studies, glutamine supplements were made in various ways, including oral, enteral, and/or parenteral, and different glutamine doses were used in the studies. In the literature, there is no definite recommendation for the disease-specific dose and for the most effective route of administration of glutamine. This review was written to examine the effects of glutamine on various diseases such as inflammatory bowel diseases, cardiovascular diseases, cancer, wounds, burns, stress, trauma, and sepsis in the light of data obtained from current studies.

Keywords

• Glutamine
• chronic disease
• nutrition therapy

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