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(4/4) The role of glutamine in the treatment of oncological
Glutamine supplementation
Traditional diets typically contain less than 10g of glutamine day. During severe metabolic stress or catabolic
to maintain the balance may be necessary to supply from 20g to 40g glutamine (45). Recent studies have shown that glutamine is more effective when administered enteric route (46.47). Glutamine powder is the supplement of choice, because its cost is lower, it is easier to use, well absorbed, well tolerated and safe (3,44,48).
ROLE OF ANTIOXIDANTS
Much has been written about the problems emerging in
patients treated with anti-cancer properties. Characteristic feature of
cancer cachexia is severe weight loss which is the result of
deficiency of macronutrients (protein, fats, carbohydrates), negative
inefficient energy balance and metabolism. There are more and more
reports suggesting that micronutrients (vitamins, minerals,
trace elements), these patients are at an even greater deficit
(49). Antioxidants may be particularly important, because chemotherapy and
radiation, which damage the cells of both healthy and
cancer, are oxidative processes (50).
Because cancer cells can not absorb the antioxidants as
efficiently as normal cells, it is possible that the supply of antioxidants
can do more to support healthy cells, making the process
Oxidative more selectively toxic to cancer cells
(51). In conditions of deficiency of antioxidants lower amounts of oxidants
enough to make damage to the cells (52.53).
Supplied antioxidant ingredients and their precursors, such as:
Vitamins A, C, E, selenium, copper, zinc, and acetylcysteine, may therefore
protect healthy cells from oxidative damage and during
anticancer therapy (51.54).
Goring et al. report on the use of glutamine and vitamin E in the treatment of
veno-occlusive disease of liver (hepatic Veno-occlusive disease, VOD)
in patients after bone marrow transplantation. Liver injury in VOD
followed by the action of free radicals on endothelial cells
liver after radiation and chemotherapy (55). Previous studies have described
decreased levels of antioxidants in patients after bone marrow
marrow after chemotherapy treatment (56.57). Vitamin E along with vitamin
C and glutathione act at the cellular level by protecting membranes
protecting against cellular peroxidation (oxidation) of lipids.
Recent studies suggest a beneficial role of vitamin E
Protection against inflammation in the intestinal mucosa induced reduction
chemotherapy hair loss and restore to a certain degree of
precancerous (58 - 61).
Jaakkola et al. write in their publications on supplementation
antioxidants in patients with small cell lung cancer (50).
Patients were treated with chemotherapy and / or radiotherapy.They described that
replenishment of antioxidants, in addition to conventional therapy,
prolonged the survival in these patients compared to
standard therapy. An additional finding was better tolerance for
therapy in the group receiving antioxidants.
SUMMARY
The current state of scientific reports suggest that under stress
metabolic glutamine is a conditionally essential amino acid
used as fuel to support intracellular nitrogen balance and
protein synthesis.
It also protects the digestive system and improves the functioning of
immune. The role of glutamine as a driver of chemo-and
cancer radiotherapy is very promising. A simple process
glutamine supplementation may reduce side effects in patients
therapy such as gastrointestinal damage, inflammation
mucous membranes, stomach pain, neuro-muscular system.Glutamine in combination with
antioxidants may sensitize cancer cells, making therapy
conventional more efficient, with an additional positive effect on
terms of improved patient tolerance to the increased doses of medication.
In conclusion:
It should be emphasized that most of these reports indicate
potential benefits in addition to chemo - and radiotherapy.
In the case of self - glutamine in some
types of cancer can also accelerate their growth, since it is
important component of building block for cancer, a type of disorder
chemistry is different in different types of cancer.
I recommend that the possible use of glutamine has always separated the
During the supply of dietary carbohydrates. Cancer cells are replaced
then again and once the fuel timber, and not both of these components simultaneously.
Literature Cited:
45) Panigrahi P et al, Role of glutamine in bacterial transcytosis and
Epithelial cell injury, JPEN 21:75-80,1997
46) Kouznetsova L, et al, Glutamine reduces phorbol-12 0.13-dibutyrate
Macromolecular induced hyperpermeability in HT-29C1, 19A intestinal
cells, JPEN 23:136-139, 1999
47) Ziegler TR et al, Safety and metabolic effects of L-glutamine
administration in humans, JPEN 14:137 S-143S, 1990
48) Hoffman FA, micronutrient Requirements of Cancer Patients.Cancer
55:295-300, 1985
49) Jaakkola K et al, Treatment with antioxidant and Other Nutrients
in combination with chemotherapy and irradiation in Patients with
small cell lung cancer. Anticancer Res 12:599-606, 1992
50) P Quillen, Adjuvant nutrition in cancer treatment. Am J Nat Med
2 (5) :8-14, 1995
51) Demling RD, Glutamine and antioxidant replacement therapy after
Severe burn and trauma. Monograph
52) LaLonde C, et al, Antioxidants Prevent the cellular deficit
produced in response to burn injury. J Burn Care Rehab 17:379-383,
1996
53) Machlin L, Bendich A, Free radical tissue damage: protective role
of Antioxidant Nutrients. FASEB 7:441-445, 1987
54) AP Goring et al, Glutamine and vitamin E in the treatment of
hepatic Veno-occlusive Disease Following high dose chemotherapy. Bone
Marrow Transplantation 21:829-832, 1998
55) Durker M et al, deteriorating free radical trapping capacity and
plasma antioxidant status in bone marrow transplantation During.Bone
Marrow Transplantation 15:757-62, 1995
56) Clemens MR, supplementation with antioxidants is a bone marrow Priority
transplantation. Wien Klin Wochenschr 109:771-6, 1997
57) Wood L, Vitamin E in chemotherapy induced alopecia. N Engl J Med
312:16:1060, 198S
58) RG Wadleigh, Vitamin E and chemotherapy induced oral mucositis.
Amer J Med 92:481, 1992
59) Benner SE. Vitamin E and oral leukopeakia, JNCI 85:44-46, 1993
60) Singh VN, Gaby SK, Premalignant lesions: role of antioxidant
vitamins and betacarotene in risk reduction and prevention of
malignant transformation, Am J Clin Nutr 53:386-3905, 1991
tbc ...
MD Piotr Krzysztof Michalak
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