Glutamine as A Therapeutic Strategy in Inflammatory Bowel Diseases: A Systematic Review

Abstract

Introduction: Glutamine is a non-essential L-α-amino acid – a polar compound due to the presence of amide groups. It is involved in maintaining the intestinal mucosal barrier, acting on gene expression, cell proliferation, differentiation, apoptosis, oxidative action, and regulation of the immune system. Due to its importance to the endothelium, glutamine has been the subject of studies for the protection and preservation of the intestinal mucosa against atrophy, which is caused by inflammatory bowel disease. Objective: To verify the efficacy of glutamine in inflammatory bowel disease based on a systematic review. Methods: The most relevant studies in the MedLine databases were reviewed by including randomized controlled trials only. The search strategy used the following keyword combinations: “glutamine”; “inflammatory bowel disease”. To identify study designs, the following terms were used: “randomized controlled trial”, “humans”. Results: The scope of this review included six articles with controversies regarding the efficacy of glutamine in the treatment of inflammatory bowel disease. Each study used different dosages, methods of administration and duration of administration. Conclusion: According to the results, we concluded that glutamine supplementation in inflammatory bowel diseases does not cause patients any harm. Additionally, both intestinal permeability and modulation of immune and inflammatory response were improved, thus confirming the efficacy of glutamine in inflammatory bowel disease. Although these strategies are very promising and appear to be useful in some contexts, further clinical studies are needed to firmly establish the relevance of glutamine supplementation in inflammatory bowel disease. Thus, further research is needed to determine the optimal dosage, duration, route and method of administration for better use of this amino acid by the enterocytes and for maintaining homeostasis.