The effect of glutamine on the heat shock protein content of muscle in cell culture and during critical illness

• Main Author: Bongers, Thomas Aloys
• Published: University of Liverpool 2012
• Subjects: 616.028
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.629450

Despite significant developments, critical care mortality remains high at - 20-30%. Muscle wasting with protein breakdown is frequently seen in critically ill patients with increased amino acids release from muscle tissue, of which alanine and glutamine compose a large proportion. Plasma glutamine is rapidly utilized and circulating plasma glutamine declines rapidly. Low plasma glutamine concentrations correlate with mortality in critical illness and intravenous glutamine supplementation improves survival of the critically ill patient. The precise mechanism whereby this protection is afforded remains uncertain, although evidence suggests that glutamine plays an important role in the ability of cells to respond to stress. The expression of stress or heat shock proteins (HSPs) is one of the most highly conserved mechanisms of cellular protection. Increased intracellular HSP content is associated with a striking preservation of muscle mass and function and low muscle and serum HSP 70 content in severe trauma correlate with increased mortality. Glutamine infusions facilitate increased HSP expression. Further, glutamine infusions enhance HSP content in multiple organs of the rat with a significant protection of these organs from damage during sepsis and a mortality advantage. This has resulted in the hypothesis that glutamine deficiency leads to a modified HSP content of muscle cells and a diminished ability to mount a stress response. Administration of glutamine will have a direct and beneficial effect on the HSP content of muscle in cell culture and during critical illness.