HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Williams, E. A Articles by Lunn, P. G Search for Related Content PubMed PubMed Citation Articles by Williams, E. A Articles by Lunn, P. G Agricola Articles by Williams, E. A Articles by Lunn, P. G

A double-blind, placebo-controlled, glutamine-supplementation trial in growth-faltering Gambian infants^1,2,3

¹ From the Human Nutrition Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom, and the Medical Research Council, Keneba, The Gambia (EAW); the Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Southhampton, United Kingdom (ME); and the Department of Biological Anthropology, University of Cambridge, United Kingdom (PGL)

Background: Growth faltering during infancy is a characteristic of life in developing countries. Previous studies have shown that small-intestine mucosal enteropathy, accompanied by endotoxemia and a persistent systemic inflammatory response, accounts for up to 64% of the growth faltering in Gambian infants.

Objective: The objective was to test whether glutamine, with its putative trophic effects on enterocytes, immune cells, and intestinal integrity, can accelerate the repair of the intestine, lower immunostimulation, and reduce growth faltering.

Design: Ninety-three infants aged 4–10 mo from the West Kiang region of The Gambia were studied in a double-blind, double-placebo, controlled trial. Glutamine (0.25 mg/kg body wt) or a placebo that contained an isonitrogenous, isoenergetic mix of nonessential amino acids was orally administered twice daily throughout the 5-mo rainy season. Anthropometric measurements were made monthly during the supplementation period and for 6 mo after supplementation. Intestinal permeability was measured monthly (by determining the ratio of lactulose to mannitol), and finger-prick blood samples were collected for the analysis of plasma proteins on 3 occasions.

Results: Gambian infants showed a seasonal deterioration in growth and persistently elevated acute phase protein concentrations and intestinal permeability. Oral supplementation with glutamine did not improve growth ( ± SE: weight gain, 60 ± 19 and 69 ± 20 g/mo; length gain, 1.01 ± 0.05 and 0.95 ± 0.03 cm/mo) or intestinal permeability [lactulose:mannitol ratio: 0.29 (95% CI: 0.23, 0.35) and 0.26 (95% CI: 0.21, 0.32)] in the glutamine and placebo groups, respectively. It also had no effect on infant morbidity or on plasma concentrations of immunoglobulins or acute phase proteins.

Conclusion: Glutamine supplementation failed to improve growth or intestinal status in malnourished Gambian infants.

Key Words: Glutamine • growth • intestinal permeability • infants • malnutrition • immune response • randomized control trial • The Gambia

This article has been cited by other articles:

				H. E. Skillman and P. E. Wischmeyer Nutrition Therapy in Critically Ill Infants and Children JPEN J Parenter Enteral Nutr, September 1, 2008; 32(5): 520 - 534. [Abstract] [Full Text] [PDF]