Department of Food and Nutrition, Brain Korea 21 Project, Yonsei University, Seoul, Korea.
Yonsei Med J. 2011 Nov;52(6):892-7. doi: 10.3349/ymj.2011.52.6.892.
Dietary supplementation with nutrients enhancing immune function is beneficial in patients with surgical and critical illness. Malnutrition and immune dysfunction are common features in hospitalized patients. Specific nutrients with immunological and pharmacological effects, when consumed in amounts above the daily requirement, are referred to as immune-enhancing nutrients or immunonutrients. Supplementation of immunonutrients is important especially for patients with immunodeficiency, virus or overwhelming infections accompanied by a state of malnutrition. Representative immunonutrients are arginine, omega-3 fatty acids, glutamine, nucleotides, beta-carotene, and/or branched-chain amino acids. Glutamine is the most abundant amino acid and performs multiple roles in human body. However, glutamine is depleted from muscle stores during severe metabolic stress including sepsis and major surgery. Therefore it is considered conditionally essential under these conditions. This review discusses the physiological role of glutamine, mode and dose for glutamine administration, as well as improvement of certain disease state after glutamine supplementation. Even though immunonutrition has not been widely assimilated by clinicians other than nutritionists, immunonutrients including glutamine may exert beneficial influence on diverse patient populations.
膳食补充增强免疫功能的营养素对手术和重症患者有益。营养不良和免疫功能障碍是住院患者的常见特征。当摄入的量超过日常需求时，具有免疫和药理作用的特定营养素被称为免疫增强营养素或免疫营养素。免疫营养素的补充对于免疫缺陷、病毒或压倒性感染伴营养不良的患者尤为重要。代表性的免疫营养素是精氨酸、ω-3 脂肪酸、谷氨酰胺、核苷酸、β-胡萝卜素和/或支链氨基酸。谷氨酰胺是最丰富的氨基酸，在人体中发挥多种作用。然而，谷氨酰胺在包括败血症和大手术在内的严重代谢应激期间从肌肉储存中耗尽。因此，在这些情况下，它被认为是条件必需的。本文综述了谷氨酰胺的生理作用、谷氨酰胺的给药方式和剂量，以及谷氨酰胺补充后对某些疾病状态的改善。尽管免疫营养除了营养师之外，尚未被临床医生广泛接受，但包括谷氨酰胺在内的免疫营养素可能对不同的患者群体产生有益的影响。
