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Influence of enteral glutamine on inflammatory and hormonal response in patients with rectal cancer during preoperative radiochemotherapy

European Journal of Clinical Nutrition volume 71, pages 671–673 (2017)Cite this article

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Abstract

We conducted a randomized double-blind placebo-controlled study evaluating the influence of 5 weeks’ duration of 30 g enteral glutamine supplementation on inflammatory and hormonal responses in 73 patients with rectal cancer undergoing preoperative radiochemotherapy. Plasma levels of inflammatory and hormonal parameters were controlled at the beginning and at the end of supplementation. Enteral glutamine resulted in modulation of inflammatory and hormonal responses as shown by a decreased plasma interleukin 6 and cortisol levels in glutamine compared with placebo group: 5.5±3.8 versus 11.1±19.9 ng/l (P=0.02) for IL-6 and 386±168.4 to 312.7±111.7 nmol/l (P=0.03) for cortisol. We conclude that enteral glutamine exhibits some anti-inflammatory activity and, consequently, leads to a lower hormonal stress response during radiochemotherapy in patients with rectal cancer.

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References

  1. Hohenberger W, Lahmer G, Fietkau R, Croner RS, Merkel S, Göhl J et al. Neoadjuvant radiochemotherapy for rectal cancer. Chirurg 2009; 80: 294–302.

    Article  CAS  Google Scholar 

  2. Kuhn KS, Muscaritoli M, Wischmeyer P, Stehle P . Glutamine as indispensable nutrient in oncology: experimental and clinical evidence. Eur J Nutr 2010; 49: 197–210.

    Article  CAS  Google Scholar 

  3. Yoshida S, Matsui M, Shirouzu Y, Fujita H, Yamana H, Shirouzu K . Effect of glutamine supplements and radiochemotherapy on systemic immune and gut barrier function in patients with advanced oesophageal cancer. Ann Surg 1998; 227: 485–491.

    Article  CAS  Google Scholar 

  4. Topkan E, Yavuz MN, Onal C, Yavuz AA . Prevention of acute radiation-induced esophagitis with glutamine in non-small cell lung cancer patients treated with radiotherapy: evaluation of clinical and dosimetric parameters. Lung Cancer 2009; 63: 393–399.

    Article  Google Scholar 

  5. Algara M1, Rodríguez N, Viñals P, Lacruz M, Foro P, Reig A et al. Prevention of radiochemotherapy-induced esophagitis with glutamine: results of a pilot study. Int J Radiat Oncol Biol Phys 2007; 69: 342–349.

    Article  CAS  Google Scholar 

  6. Belabed L, Darmon P, Pichard C . Dichotomic actions of glutamine in host versus tumour: an emerging concept. Curr Opin Clin Nutr Metab Care 2009; 12: 372–377.

    Article  CAS  Google Scholar 

  7. Lu CY, Shih YL, Sun LC, Chuang JF, Ma CJ, Chen FM et al. The inflammatory modulation effect of glutamine-enriched total parenteral nutrition in postoperative gastrointestinal cancer patients. Am Surg 2011; 77: 59–64.

    PubMed  Google Scholar 

  8. Marton S, Ghosh S, Papp A, Bogar L, Koszegi T, Juhasz V et al. Effect of glutamine in patients with esophagus resection. Dis Esophagus 2010; 2: 106–111.

    Article  Google Scholar 

  9. Kozelsky TF, Meyers GE, Sloan JA, Shanahan TG, Dick SJ, Moore RL et al. Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy. J Clin Oncol 2003; 21: 1669–1674.

    Article  CAS  Google Scholar 

  10. Vidal-Casariego A, Hernando-Martín M, Calleja-Fernández A, Cano-Rodríguez I, Cordido F, Ballesteros-Pomar MD . Tissue effects of glutamine in rectal cancer patients treated with preoperative chemoradiotherapy. Nutr Hosp 2015; 31: 1689–1692.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Oncology, Zaloška 2, Ljubljana, Ljubljana, Slovenia

    N Rotovnik Kozjek, L Kompan & T Žagar

  2. Department of Gastroenterology, Worthing Hospital WSHT, Worthing, UK

    Ž Mrevlje

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  1. N Rotovnik Kozjek
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  2. L Kompan
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  3. T Žagar
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  4. Ž Mrevlje
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Correspondence to L Kompan.

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Rotovnik Kozjek, N., Kompan, L., Žagar, T. et al. Influence of enteral glutamine on inflammatory and hormonal response in patients with rectal cancer during preoperative radiochemotherapy. Eur J Clin Nutr 71, 671–673 (2017). https://doi.org/10.1038/ejcn.2017.11

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