BASIC NUTRITIONAL INVESTIGATION
Effects of Parenteral Nutrition Supplemented With
Glutamine or Glutamine Dipeptides on Liver
Antioxidant and Detoxication Systems in Rats
Bele ´n Matilla, MD, Juan Ortı ´z, MD, Paquita Gonza ´lez, PhD,
Fructuoso Garcı ´a-Dı ´ez, MD, PhD, Francisco Jorquera, MD, PhD,
Jesu ´s M. Culebras, MD, PhD, Javier Gonza ´lez-Gallego, MD, PhD, and Marı ´a J. Tun ˜o ´n, PhD
From the Hospital of Leo ´n; and the Department of Physiology, University of Leo ´n,
Leo ´n, Spain
Our aim was to determine the effects of glutamine or alanyl glutamine parenteral supplementation on the
liver oxidant/antioxidant balance and on cytochrome-P450-mediated detoxication in rats. Animals were
infused for 5 d with standard total parenteral nutrition (TPN), glutamine-enriched TPN, or alanyl
glutamine-enriched TPN. The hepatic concentration of glutathione was reduced, and the levels of
thiobarbituric-acid-reactive substances (TBARS) were increased in animals receiving standard TPN. Both
glutamine and alanyl glutamine supplementation normalized glutathione, but thiobarbituric-acid-reactive
substance concentration was only decreased by alanyl glutamine. This effect was parallel to a partial
recovery of the activity of antioxidant enzymes. Cytochrome-P450 liver content, cytochrome-P450-
dependent monooxygenases, and antipyrine clearance were not modified by glutamine or alanyl glu-
tamine. Our data suggest a better protection against free radicals by alanyl glutamine supplementation and
an absence of effects of both glutamine and alanyl glutamine on liver oxidative metabolism. Nutrition
2000;16:125–128. ©Elsevier Science Inc. 2000
Key words: parenteral nutrition, glutamine, alanyl glutamine, antioxidant and detoxication systems, rats
INTRODUCTION
Glutamine is an amide amino acid, usually considered non-
essential because it can be synthetized from glutamic acid and
ammonia. Glutamine plays a role in multiple metabolic functions
by acting not only as a precursor for protein synthesis but also as
an important intermediary in a large number of metabolic
pathways.
It has been shown in both experimental and clinical settings
that in all situations with hypercatabolism (prolonged starvation,
surgery, burns, major injury) there is an intracellular deficiency of
glutamine with an accelerated muscle and lung glutamine efflux
and damage to the gut epithelium. Supplementation with glutamine
improves nitrogen balance, enhances the rate of protein synthesis,
and preserves the integrity of the mucosa.
1
If maintenance of
intracellular glutamine pools promotes conservation of muscle
protein and improves the regulation of amino acid homeostasis,
glutamine supplementation could be considered in the framework
of clinical nutrition.
2
Critical illness is associated with a depletion of the liver,
muscle, and plasma glutathione stores, resulting in reduced anti-
oxidant capacity and oxidative damage.
3
Glutamine is an efficient
precursor of glutathione and may contribute through changes in
glutathione levels to protect hepatic function. In addition, because
protein body reserve and diet amino-acid levels have a major role
in liver detoxication systems,
4,5
it is worthwhile to explore the
effects of glutamine supplementation on liver-oxidative metabo-
lism and on the activities of the cytochrome-P450-dependent
monooxygenases.
The purpose of our study was to investigate the effects of
glutamine parenteral supplementation on the liver oxidant/
antioxidant balance and on cytochrome-P450-mediated detoxica-
tion in rats. Because of the limitations that hamper the use of
glutamine in routine clinical settings,
1
both glutamine and alanyl
glutamine parenteral formulations were used.
MATERIALS AND METHODS
Animals and Experimental Procedures
Male Wistar rats (42 animals; Charles River, Barcelona, Spain)
weighing between 220 and 260 g were fed standard rat chow
(Purina Chow A03, Panlab Ltd, Barcelona, Spain) with free access
to tap water and kept in temperature- and humidity-controlled
animal quarters under a 12-h light-and-dark cycle. All the exper-
iments were performed according to European
6
and Spanish
7
reg-
ulations concerning animal experimentation, and we followed the
recommendations in the Guide for Care and Use of Laboratory
Animals.
8
Animals were anesthetized with sodium pentobarbital (45
mg/kg intraperitoneally). The right internal jugular vein was cath-
eterized with Silastic tubing (PE-50, Dow Corning Corp., Midland,
MI, USA). The catheters were exteriorized in the scapular region
and secured to the deep fascia with a stainless-steel button. After
the catheter was threaded through a flexible wire sheath, the
combined unit was attached to a swivel apparatus that allowed the
animals to move freely.
The animals were randomly assigned to one of the following
groups (n = 8 –12 animals/group): a) chow ad libitum and intra-
venous saline (control), b) standard total parenteral nutrition (TPN)
group, c) glutamine-enriched TPN, and d) alanyl glutamine-
enriched TPN. The animals receiving intravenous parenteral nu-
Correspondence to: Marı ´a J. Tun ˜o ´n, PhD, Departamento de Fisiologı ´a,
Universidad de Leo ´n, Campus Universitario, 24071 Leo ´n, Spain. E-mail:
dfimtg@unileon.es
Nutrition 16:125–128, 2000 0899-9007/00/$20.00
©Elsevier Science Inc., 2000. Printed in the United States. All rights reserved. PII S0899-9007(99)00265-8