Effects of glutamine supplementation on inflammatory bowel disease: A systematic review of clinical trials

Juliana Soares Severo; Vilk Janne da Silva Barros; Alda Cássia Alves da Silva; José Miguel Luz Parente; Murilo Moura Lima; Aldo Ângelo Moreira Lima; Armênio Aguiar Dos Santos; Emídio Marques Matos Neto; Moisés Tolentino Bento da Silva

doi:10.1016/j.clnesp.2020.12.023

Effects of glutamine supplementation on inflammatory bowel disease: A systematic review of clinical trials

Clin Nutr ESPEN. 2021 Apr:42:53-60. doi: 10.1016/j.clnesp.2020.12.023. Epub 2021 Jan 21.

Authors

Juliana Soares Severo¹, Vilk Janne da Silva Barros¹, Alda Cássia Alves da Silva², José Miguel Luz Parente³, Murilo Moura Lima³, Aldo Ângelo Moreira Lima⁴, Armênio Aguiar Dos Santos⁴, Emídio Marques Matos Neto⁵, Moisés Tolentino Bento da Silva⁶

Affiliations

¹ Graduate Program in Food and Nutrition, Federal University of Piauí, Teresina, PI, Brazil.
² Graduate Program in Pharmacology, Federal University of Piauí, Teresina, PI, Brazil.
³ University Hospital, Federal University of Piauí, Teresina, PI, Brazil.
⁴ Department of Physiology and Pharmacology, School of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
⁵ Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil.
⁶ Graduate Program in Food and Nutrition, Graduate Program in Pharmacology, Laboratory of Exercise and Gastrointestinal Tract, Department of Physical Education, Federal University of Piauí, Teresina, PI, Brazil. Electronic address: tolentino@ufpi.edu.br.

PMID: 33745622
DOI: 10.1016/j.clnesp.2020.12.023

Abstract

Context: Glutamine supplementation has been applied clinical practice to treat inflammatory bowel disease (IBD). However, scientific evidence about this is still controversial.

Objective: In this review, we systematically evaluated the effects of glutamine supplementation on IBD, based on evidence from randomized clinical trials.

Data source: This review was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We used the PubMed and SciVerse Scopus databases. The Cochrane collaboration tool was used to assess the risk of bias in clinical trials.

Data extraction: The review was carried out by two independent researchers according to the established inclusion criteria. The PICO (patient, intervention, comparison, and outcomes) strategy was used, with the descriptors: "glutamine," "supplementation," "inflammatory bowel diseases," "Crohn's disease," and "ulcerative colitis".

Data synthesis: Seven research articles were selected for this systematic review. In these studies, glutamine was administered to the participants through oral (21-30g or 0.5g per kg of participant's body weight), enteral (7.87g-8.3 g/100g of the enteral formula), and/or parenteral (0.3 g/kg of the participant's body weight) routes. No changes in anthropometry or biochemical parameters were observed. However, in one study reduced intestinal permeability and morphometry were reported. In two other studies, a slight effect of glutamine on inflammation and oxidative stress was observed. Additionally, two other studies reported an effect of glutamine supplementation on disease activity.

Conclusions: The findings obtained through this systematic review indicate that glutamine supplementation has no effect on disease course, anthropometric measurements, intestinal permeability and morphology, disease activity, intestinal symptoms, biochemical parameters, oxidative stress and inflammation markers in patients with IBD, regardless of the route of administration, either treated at a hospital or as outpatients.

Keywords: Crohn's disease; Glutamine; Inflammatory bowel disease; Supplementation; Ulcerative colitis.

Publication types

Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Clinical Trials as Topic
Colitis, Ulcerative*
Crohn Disease*
Dietary Supplements
Glutamine
Humans
Inflammatory Bowel Diseases* / drug therapy

Substances

Glutamine