Glutamine Reduces Post-Burn Infections

Adults suffering from severe burns may be able to reduce their risk of developing infections by taking oral glutamine, according to a new study in Critical Care Medicine (2003; 31:2444–9). Lowering infection risk may lead to fewer deaths and shorter hospital stays in burn victims.

In the new study, 41 adults under the age of 65 years with severe burns covering between 20 and 80% of their skin were assigned to receive standard nutrition through a feeding tube supplemented with 4.3 grams of glutamine or supplemented with other amino acids (aspartic acid, asparagine, and glycine) every four hours (up to 26 grams per day). Treatment was continued until complete healing of the burns occurred. Time spent in the hospital, incidence of blood infections, and the number of deaths were recorded.

The incidence of blood infections was three times higher in individuals receiving the control mixture than in those getting supplemental glutamine in their feeding tube. No deaths occurred in the group receiving glutamine among the 19 individuals who survived the first 72 hours, compared with eight deaths among the 16 people in the control group who survived the first 72 hours. Time spent in the hospital was also significantly reduced in those receiving glutamine.

Glutamine is a non-essential amino acid that is an important fuel source for cells of the immune system and cells that line the inner wall of the intestines. It is the most abundant amino acid found in the body and is involved in energy metabolism more than any other. Studies show that severe burns deplete glutamine in the muscles and blood; however, this is the first study to show a benefit of glutamine supplementation following burn injuries. Although the amount of glutamine used in this study was relatively large, similar doses have been used with apparent safety in studies of individuals with HIV infection and in those receiving cancer chemotherapy. It is possible that lower doses of glutamine would be beneficial for people suffering less severe burns, but additional research is needed to determine the optimal amount in such cases.

The mechanism by which glutamine prevents post-burn infection is not clear. Some animal studies suggest glutamine protects the gut wall barrier and prevents bacteria from crossing into the bloodstream. Other animal studies suggest it stimulates the immune system and improves immune function. Glutamine is an indirect precursor for a compound called glutathione, which is a potent antioxidant and may have other protective effects in the body. While more research is needed to clarify these issues, glutamine is safe and is not associated with any toxic side effects, even when taken in large amounts.