Glutamine for Amelioration of Radiation and Chemotherapy Associated Mucositis during Cancer Therapy

Nutrients. 2020 Jun 4;12(6):1675. doi: 10.3390/nu12061675.

Abstract

Glutamine is a major dietary amino acid that is both a fuel and nitrogen donor for healing tissues damaged by chemotherapy and radiation. Evidence supports the benefit of oral (enteral) glutamine to reduce symptoms and improve and/or maintain quality of life of cancer patients. Benefits include not only better nutrition, but also decreased mucosal damage (mucositis, stomatitis, pharyngitis, esophagitis, and enteritis). Glutamine supplementation in a high protein diet (10 grams/day) + disaccharides, such as sucrose and/or trehalose, is a combination that increases glutamine uptake by mucosal cells. This increased topical effect can reduce painful mucosal symptoms and ulceration associated with chemotherapy and radiation in the head and neck region, esophagus, stomach and small intestine. Topical and oral glutamine seem to be the preferred routes for this amino acid to promote mucosal healing during and after cancer treatment.

Keywords: amino acid supplementation in cancer; chemotherapy associated malnutrition; glutamine; glutathione; mucositis; radiation injury; trehalose.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Diet, High-Protein
  • Dietary Proteins / administration & dosage
  • Dietary Sucrose / administration & dosage
  • Dietary Supplements*
  • Glutamine / administration & dosage*
  • Glutamine / metabolism
  • Glutamine / pharmacology
  • Humans
  • Malnutrition / etiology
  • Mucositis / etiology*
  • Mucositis / physiopathology
  • Mucositis / prevention & control
  • Mucositis / therapy*
  • Mucous Membrane / metabolism
  • Neoplasms / drug therapy*
  • Neoplasms / radiotherapy*
  • Radiotherapy / adverse effects*
  • Trehalose / administration & dosage
  • Wound Healing / drug effects

Substances

  • Antineoplastic Agents
  • Dietary Proteins
  • Dietary Sucrose
  • Glutamine
  • Trehalose