Effect of glutamine on change in early postoperative intestinal permeability and its relation to systemic inflammatory response

AIM: To study the effects of glutamine (Gin) on the change of intestinal permeability and its relationship to systemic inflammatory response in early abdominal postoperative patients.METHODS: A prospective, randomized, double-blind and controlled trial was taken. Twenty patients undergoing abdominal surgery were randomized into Gin group (oral administration of glutamine, 30 g/d, for 7 d, n=10) and placebo group (oral administration of placebo, 30 g/d, for 7 d, n=-10). Temperatures and heart rates of all patients were daily recorded. White blood cell counts(WBC) and biochemical variables were measured before operation and 4 and 7 d alter drug administration. Serum concentrations of glutamine, endotoxin, diamine oxidase and malondialdehyde and urine lactulose/mannito (L/M) ratio were measured before and 7 d alter drug administration.RESULTS: The patients in the 2 groups were comparable prior to drug administration. Serum Gin concentration was significantly decreased in the placebo group and increased in the Gin group 7 d alter drug administration. Urine L/M ratio was significantly increased in the placebo group and decreased in the Gin group. The serum concentration of endotoxin, diamine oxidase and malondialdehyde was significantly decreased in the Gin group compared with those in the placebo group. Temperatures, heart rates and WBC counts were significantly lower in the Gin group than those in the placebo group.CONCLUSION: Gut is one of the sources of systemic inflammatory response in abdominal postoperative patients and glutamine can decrease intestinal permeability, maintain intestinal barrier and attenuate systemic inflammatory response in early postoperative patients.