Experimental data on cell culture extensively reported that glutamine has protective effect on cells by inducing the production of heat shock proteins (HSPs), which protect cells against toxic agents or pathologic insults (Wischmeyer 2002, 2007). Indeed, glutamine enhanced HSP expression in human peripheral blood mononuclear cells (Wischmeyer et al. 2003) in intestinal epithelial cell lines (Chow and Zhang 1998; Wischmeyer et al. 1997) and in several organs in rats (Wischmeyer et al. 2001). In endotoxemic rats, beneficial effects of intravenous glutamine on inflammatory, apop- totic, and antioxidant responses were related to HSP32 induction (Uehara et al. 2005).

In healthy volunteers, glutamine enhanced HSP32 expression in the intestinal mucosa (Coeffier et al. 2002). In critically ill patients receiving intravenous glutamine, plasma HSP70 concentration was increased (Ziegler et al. 2005) and a correlation between higher plasma HSP70 and better clinical outcomes was observed, suggesting that beneficial effects of glutamine may be related to HSP induction.

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