Glutamine supplementation in cancer patients

Nutrition. 2001 Sep;17(9):766-8. doi: 10.1016/s0899-9007(01)00629-3.


Objectives: Three series of studies investigated whether 1) glutamine deficiency occurs in tumor-bearing rats, 2) glutamine supplementation improves protein metabolism during chemotherapy in tumor-bearing rats, and 3) oral glutamine supplement improves systemic immune and gut-barrier function in patients with esophageal cancer receiving radiochemotherapy.

Methods: In the animal studies, AH109A hepatoma cells or Yoshida sarcoma cells were inoculated into male Donryu rats to induce tumors. Glutamine production was measured by U-14C-glutamine infusion and the conversion of arginine to glutamine was measured by infusion of U-14C-arginine. The effect of glutamine on protein metabolism was investigated by 1-14C-leucine infusion. In the clinical study, 13 patients with esophageal cancer were randomized into two groups, control and glutamine supplemented (30 g/d), for 4 wk.

Results: Glutamine levels in plasma and skeletal muscle were decreased in tumor-bearing rats, although glutamine production and the conversion of arginine to glutamine were increased. Glutamine-supplemented total parenteral nutrition reduced whole-body protein breakdown rate during chemotherapy in tumor-bearing rats. Oral supplementation of glutamine to the patients with esophageal cancer enhanced lymphocyte mitogenic function and reduced permeability of the gut during radiochemotherapy.

Conclusions: Glutamine depletion in host tissues occurs in tumor-bearing rats. Glutamine supplementation can attenuate loss of protein in the muscle in tumor-bearing animals and protect immune and gut-barrier function during radiochemotherapy in patients with advanced cancer.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cachexia / immunology
  • Cachexia / physiopathology
  • Cachexia / therapy*
  • Carbon Isotopes
  • Case-Control Studies
  • Combined Modality Therapy
  • Dietary Supplements
  • Disease Models, Animal
  • Esophageal Neoplasms / immunology
  • Esophageal Neoplasms / physiopathology
  • Esophageal Neoplasms / radiotherapy
  • Esophageal Neoplasms / therapy*
  • Glutamine / administration & dosage*
  • Glutamine / metabolism*
  • Glutamine / pharmacology
  • Humans
  • Male
  • Parenteral Nutrition, Total
  • Proteins / metabolism*
  • Rats


  • Carbon Isotopes
  • Proteins
  • Glutamine