THE EFFECT OF GLUTAMINE SUPPLEMENTATION ON
THE DURATION OF DIARRHEA AND ON THE LEVEL OF INTERLEUKIN-8 AND SECRETORY
IMMUNOGLOBULIN A IN CHILDREN WITH ACUTE DIARRHEA
Yalçın SS,
Yurdakök K, Tezcan I, Öner L, Coşkun T
Hacettepe University Institute of Child Health, Ankara,
Turkey
Objective: Glutamine, as an immunonutrient, is the primary fuel
for rapidly dividing cells such as enterocytes and lymphocytes. Exogenous
glutamine supplementation in catabolic states preserves intestinal mucosal
structure and function, decreases bacterial translocation, supports normal
immunologic responses. This study was planed to determine the effect of
glutamine supplementation on the duration and severity of diarrhea and,
also the immunomodulatory effects with the levels of serum IL-8 and sIgA in
children with acute diarrhea.
Methods: In this placebo controlled, double blinded and
randomized trial, 6
to 24 month-old children who were admitted to Diarrheal Diseases
Training and Treatment Center with acute diarrhea randomly assigned
either to a group receiving 0.3g/kg/day of glutamine (n=63) or placebo
(n=65) for seven days. All the cases were followed until the diarrheal
episode ended. Then the cases were evaluated for anthropometric parameters
and the presence of infectious diseases monthly for three months. Serum
IL-8 and sIgA levels were determined both on admission and 7 days later.
Results: Both the mean duration
of diarrhea after treatment and the total duration of diarrhea were
significantly shorter in glutamine group than that in placebo group
(p<0.05). No differences in serum IL-8 and sIgA levels were found
between groups both on admission and one week later. The mean weight gain
and the incidence of infectious diseases were similar in the groups in the
monthly follow-up.
Conclusion: Although glutamine
supplementation was decreased the duration of diarrhea, it didn’t have any
effect on either serum IL-8 or sIgA levels in this group of children with
acute diarrhea. Further studies are necessary to detect the effect of glutamine
supplementation in children with persistent diarrhea.