Heberer M, Babst R, Juretic A, Gross T, Hörig H, Harder F, Spagnoli G C
Department of Surgery, University of Basel, Switzerland.
Nutrition. 1996 Nov-Dec;12(11-12 Suppl):S71-2. doi: 10.1016/s0899-9007(97)85203-3.
The dependence of human lymphocyte functions on the exogenous provision of glutamine (GLN) was evaluated in a series of in vitro experiments. The transcription of early activation markers (IL-2, IL-2-receptor, IL-4, IL-4, GM-CSF, IFN gamma) as evaluated by polymerase chain reaction was observed even in the absence of exogenous GLN. In contrast, later events of lymphocyte activation including cytokine production, proliferation of lymphocytes and lymphokine-activated killer cell activity were found to depend on exogenous GLN provision. These in vitro results are discussed in the context of established data on the reduction of peripheral blood GLN concentrations in critically ill patients and in view of recent studies reporting improved outcome of critically ill patients following GLN substitution. By and large, these data support the concept of GLN substitution in critical illness. However, the definition of indications and dose-response relationships clearly require further clinical studies.
在一系列体外实验中评估了人类淋巴细胞功能对外源性谷氨酰胺（GLN）供应的依赖性。通过聚合酶链反应评估，即使在没有外源性GLN的情况下，也观察到早期激活标志物（IL-2、IL-2受体、IL-4、GM-CSF、IFNγ）的转录。相比之下，发现淋巴细胞激活的后期事件，包括细胞因子产生、淋巴细胞增殖和淋巴因子激活的杀伤细胞活性，依赖于外源性GLN的供应。结合关于重症患者外周血GLN浓度降低的既定数据以及最近报道GLN替代后重症患者预后改善的研究，对这些体外实验结果进行了讨论。总体而言，这些数据支持在危重病中进行GLN替代的概念。然而，适应症的定义和剂量反应关系显然需要进一步的临床研究。
