In contrast, Peppermint tea recipe non-diabetic rats did not exhibit increased levels of the Gluatmine protein Gljtamine Gln supplementation. Therapeutic benefits of glutamine: an umbrella review of meta-analyses. Dong Y, Pan JS, Zhang L. CD8 T cells are involved in skeletal muscle regeneration through facilitating MCP-1 secretion and Gr1 high macrophage infiltration.

Glutamine and muscle wasting -

No study has discussed whether glutamine mitigates oxidative damage on RBC or enhances the regeneration of RBC after exhaustive exercise. We found that the RBC level increase and accordingly glutamine might enhance the regeneration of RBC upon oral intake after exercise Figure 2.

The differences between the prevention and treatment groups were not only with respect to RBC concentration, but also regarding tissue damage for histological examinations. The treatment group showed more considerable damage reduction in the cardiac muscle and kidneys than the prevention group showed.

Figures 3G, H The primary cause for this difference in damage reduction might be the maldigestion of glutamine during exercise. Eating before exhaustive exercise often causes maldigestion; furthermore, body temperature increases during exercise until rest. Research has demonstrated that in a hot environment, intestinal permeability is reduced by glutamine supplementation Pugh et al.

Therefore, glutamine intake is more beneficial after rather than before exhaustive exercise. Relative to the prevention group, the treatment group had a more considerable reduction in the damage to their cardiac muscles and kidneys. Our results revealed that the timing of glutamine oral intake influences outcomes, such as improved organs protection and elevated RBC concentration in blood.

Although the conditions of sports practice in humans are far different from those that can be applied in laboratory rats, these results might suggest athletes take supplements at the proper timing after exhaustive exercise. Daily supplementation of L-glutamine can reduce the skeletal muscle damage caused by exhaustive exercise and that the timing of the oral intake affects the reduction.

Glutamine as a treatment more considerably reduced damage than it had as a prophylactic. We also observed that the oral intake of glutamine could elevate RBC, HCT, and PLT only after exhaustive exercise.

It seems like the proper timing for taking glutamine supplements is after exercise. However, the further clinical trial is needed in the future study. The animal study was reviewed and approved by the Institutional Animal Care and Use Committee of Tzu Chi University IACUC No: C-CL: Conceptualization, and prepared the original draft.

C-YK: Designed the animal study, analyzed the data, and wrote the original draft. W-TW: Performed the histological examination, supervised the study and data collection. R-PL: Conceptualization, supervised the study, completed the final manuscript.

All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Citation: Lu C-C, Ke C-Y, Wu W-T and Lee R-P L-Glutamine is better for treatment than prevention in exhaustive exercise. doi: Received: 23 February ; Accepted: 18 April ; Published: 28 April Copyright © Lu, Ke, Wu and Lee.

This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.

No use, distribution or reproduction is permitted which does not comply with these terms. Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.

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Sections Sections. About journal About journal. Article types Author guidelines Editor guidelines Publishing fees Submission checklist Contact editorial office. ORIGINAL RESEARCH article Front. L-Glutamine is better for treatment than prevention in exhaustive exercise.

Introduction Acute muscle damage often occurs after exhaustive exercise and also causes levels of lactatic acid, creatine kinase CK , aspartate aminotransferase AST , alanine aminotransferase ALT , and lactate dehydrogenase in serum to increase Baumert et al.

Methods In this study, animal experimentation was conducted to explore the difference in the effect of L-glutamine supplementation at different times i.

Experiment protocol Experimental rats, with body weights between and g, were ordered from LASCO animal center Taipei, Taiwan. Blood cell counts and level of skeletal muscle-specific creatine kinase in blood The blood samples were collected before exercise, 12 h and 24 h after exercise. Histological examination Euthanasia was conducted 24 h after treatments.

After approval by the Nemours Children's Clinic Research Committee and the Baptist Medical Center Institutional Review Committee, written informed consent was obtained from a parent or guardian of each child with DMD.

The protocol was explained to the children, and their assent was obtained. Whole body leucine and glutamine metabolism was assessed in six prepubertal Tanner stage I children with DMD age 9.

Subjects were studied on two consecutive days in the postabsorptive state after 14 h of fasting. Leucine and glutamine kinetics were measured during oral administration of flavored water Kool-Aid® only, the first study day, and glutamine dissolved in the same flavored water, the second study day.

The night before each study day, each child was asked to eat dinner between and h and then remain fasting with the exception of ad libitum water until completion of the infusion study at h on the day of study. On the day of study at h, two short i.

catheters were placed: one in a forearm vein for isotope infusion, and the other one in a superficial vein of the contralateral hand. During the sampling period, the hand was placed in heating pad 60°C to obtain arterialized venous blood samples. At h, baseline blood and expired air samples were obtained.

To collect breath samples, children were asked to breathe through a mouthpiece mounted with a one-way valve and connected to a 5-L rubber bag. At h children received a primed, continuous i. infusion of L-[1- 13 C]leucine 3 μmol·kg -1 , 3μmol·kg -1 ·h -1 , and L-[2- 15 N]glutamine 8 μmol·kg -1 , 8 μmol·kg -1 ·h -1 for 5 h using a calibrated syringe-pump.

The second study day, 0. Plasma amino acid concentrations were measured at the end of each study day from an arterialized blood sample. Analytical methods. E p ,KIC , E p ,gln , and plasma KIC concentrations were measured by gas chromatography-mass spectrometry 15 , E 13 CO 2 was measured using gas chromatography-isotopic ratio mass spectrometry V.

Isogas, Ipswich, UK. Plasma amino acid concentrations were measured using an amino acid analyzer Beckman, High Performance Analyzer, System Plasma insulin concentrations were determined by RIA Endocrine Science, Calabasas Hills, CA. Leucine oxidation Ox leu inμmol·kg -1 ·h -1 was calculated as:Equation where VCO 2 is the rate of CO 2 production in mL·min -1 measured by indirect calorimetry, 60 converts min to h, k CO 2 is the fractional recovery of CO 2 in expired air 0.

NOLD in μmol·kg -1 ·h -1 , an index of protein synthesis, was calculated as: Equation. infusate, and i [ 15 N] g ln is the tracer infusion rate μmol·kg -1 ·h -1 18 , During glutamine oral administration, endogenous glutamine rate of appearance in plasma Endo R a ,gln was calculated as:Equation where Inf gln is the rate of oral delivery of L-glutamine i.

Glutamine arising from protein breakdown B gln was calculated as 19 : Equation where 0. Glutamine de novo synthesis D gln was calculated as 19 : Equation. Data are means ± SEM. Comparisons between study days were performed using paired t test.

Substrate concentrations. On the control day, blood urea nitrogen decreased by 0. During glutamine oral administration, blood urea nitrogen increased by 1.

Leucine kinetics. Plasma [ 13 C]KIC enrichments, 13 CO 2 enrichments in expired air, and plasma KIC concentrations were at steady state on both study days. Effect of oral glutamine on whole body leucine kinetics. Results are mean ± SEM; solid bars , oral glutamine administration; open bars , flavored water administration; Ra,leu , leucine release from protein breakdown; Ox,leu , leucine oxidation rate; NOLD , index of whole body protein synthesis; significance of observed differences by paired t test.

Glutamine kinetics. Plasma [ 15 N]glutamine enrichments Fig. Glutamine enrichments in plasma. Each value represents the mean ± 1 SEM of patients measured at each time point.

To our knowledge, the present study is first to demonstrate that oral glutamine administration is associated with an acute decrease in leucine release from protein breakdown in children with DMD. This suggests that oral glutamine might have a protein-sparing effect in DMD.

In addition, oral glutamine administration was associated with a decrease in estimates of glutamine de novo synthesis, suggesting that exogenous glutamine might preserve muscle amino acid stores in DMD.

In boys suffering from DMD, oral glutamine administration was associated with an acute decrease in leucine release from protein breakdown and leucine oxidation rate resulting in no change in nonoxidative leucine disposal, an index of protein synthesis.

The inhibition of protein breakdown observed using stable isotope methodology is strengthened by the concomitant decrease in plasma leucine, lysine, and phenylalanine concentrations, three essential amino acids whose only source in the postabsorptive state is protein degradation.

In the present study as in healthy adults receiving the same dose of enteral glutamine 7 , plasma insulin concentration did not rise significantly, therefore suggesting that decreased protein degradation is not due to insulin.

An inhibitory effect of glutamine on protein breakdown was shown in perfused rat skeletal muscle To date mechanisms involved in the inhibition of protein breakdown in DMD remain unclear. We did not perform leucine kinetics measurements with an isonitrogenous control because at the beginning of the study we did not know whether or not glutamine would have any effect on protein metabolism in DMD.

This kind of experiment is rather cumbersome for children, and including more patients to test the specificity of glutamine's effect on protein metabolism was ethically questionable.

Recent studies on nitric oxide synthesis in muscle wasting 21 and onα-tocopherol administration in mdx mice 4 , an animal model of DMD, might provide clues to help in understanding glutamine's effect on protein metabolism in DMD.

Although still debated 22 , an increase in muscle protein breakdown might be the main process leading to muscle mass loss in DMD 23 , The present study as well as animal studies 23 , 25 suggest that protein degradation might be accessible to therapeutic modulation in DMD. CO 2 recovery values are instrumental for calculating the leucine oxidation rate and nonoxidative leucine disposal calculations.

However, CO 2 recovery would not affect the effect of glutamine on whole body protein degradation. In the present study, we used the values measured previously in healthy adults by our group 7.

Similar CO 2 recovery values were obtained in premature infants Therefore, age might not affect CO 2 recovery. To date, CO 2 recovery has not been measured in patients with DMD. Measuring CO 2 recovery involves a 2-d study with NaHCO 3 i. infusion while giving glutamine or saline enterally.

We have shown in a previous study that glutamine does not alter 13 CO 2 recovery in healthy adults 7. For ethical reasons we did not perform this experiment that would require more patients in a pediatric population.

Unlike in healthy adults 7 , acute oral glutamine administration failed to stimulate protein synthesis in children with DMD. A few hypotheses can be proposed to explain this discrepancy: 1 an increase in muscle protein synthesis may be more difficult to detect in DMD patients than in healthy subjects because of the dramatic reduction in muscle mass that reduces the relative contribution of muscle to whole body protein synthesis 27 ; 2 muscle protein synthesis might be at or near its maximum in DMD and not be further stimulable 25 ; 3 previous study reported low intramuscular glutamine concentration in DMD 10 , 11 , and it might take longer to increase it sufficiently to stimulate protein synthesis; and 4 finally, muscle protein synthesis per se , might be defective.

Specific patterns of protein metabolism have been reported in other studies in DMD patients; unlike in healthy volunteers 28 , 29 prednisone does not increase protein degradation and does improve muscle mass indices and muscle function in DMD Further studies exploring muscle protein metabolism and the adjacent connective tissue that might have a key role in muscle degeneration in DMD 30 are required to help in understanding the present results.

The response of whole body glutamine exchange in plasma in the postabsorptive state and during oral glutamine administration had not been evaluated in DMD.

As in healthy humans 18 , glutamine appearance rate and plasma glutamine concentration doubled during oral glutamine administration. These data thus suggest that oral glutamine is bioavailable in children with DMD.

In addition, oral glutamine administration inhibits endogenous glutamine production through a decrease in estimates of both glutamine de novo synthesis and glutamine release from protein breakdown.

Although the glutamine de novo synthesis rate should be taken with caution because it is a calculated value, these results suggest that glutamine synthetase might be an important regulatory step in glutamine homeostasis.

Such a role for glutamine synthetase is also suggested in vitro 31 and in humans 32 , Because glutamine is synthesized from other amino acids, e. branched chain amino acids 34 , the decrease in glutamine de novo synthesis may be considered a protein-saving mechanism because it saves precursor amino acid stores.

This might, in turn, help decrease protein degradation. In summary, acute oral glutamine administration might have an acute protein-sparing effect in DMD resulting from a decrease in protein degradation.

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J Nutr : —

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