Glutamine

Glutamine comprises over one-third of the amino acids present free in tissues and the severity of illness is associated with significant losses from muscle and blood. Cells with rapid turnover (e.g. immune system, mucosa) avidly metabolize glutamine. The gut converts it to CO2, ammonia, and citrulline, which are precursors for liver urea synthesis, in proportion to the arterial concentration. The absence of glutamine in total parenteral nutrition solutions may lead to reduced cellularity in the intestine. There is also a growing suspicion that the ability of immune cells to respond to antigen challenge is impaired by low blood glutamine concentrations (e.g. 100-500 mol/l).

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