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Glycyl-L-Glutamine-Enriched Total Parenteral Nutrition Maintains Small Intestine Gut-Associated Lymphoid Tissue and Upper Respiratory Tract Immunity

Department of Surgery, The University of Tennessee at Memphis

Brock K. King, MD

Department of Surgery, The University of Tennessee at Memphis

Peter G. Janu, MD

Department of Surgery, The University of Tennessee at Memphis

Kathryn B. Renegar, DVM, PHD

Department of Surgery, The University of Tennessee at Memphis

Kenneth A. Kudsk, MD

Department of Surgery, The University of Tennessee at Memphis

Background: IV administration of a total parenteral nutrition (TPN) solution results in small intestinal gut-associated lymphoid tissue (GALT) atrophy, lowers small intestinal immunoglobulin A (IgA) levels, and impairs upper respiratory tract secretory IgA-mediated mucosal immunity; isonitrogenous supplementation of TPN with 2% glutamine attenuates these changes. This experiment examines whether a 2% glycyl-L-glutamine-enriched TPN solution reverses IV TPN-induced changes as effectively as L-glutamine. Methods: Male Institute of Cancer Research (ICR) mice underwent intranasal inoculation with H1N1 influenza virus to establish immunity. After 3 weeks, mice were randomized to chow, IV feeding of a TPN solution, glutamine-enriched TPN, or glycyl-L-glutamine-enriched TPN. After 4 days of feeding, mice were challenged intranasally with influenza virus and killed at 40 hours to determine viral shedding from the respiratory tract; normal convalescent mice do not shed virus because they possess intact IgA-mediated mechanisms. Lymphocytes were isolated from Peyer's patches, the intraepithelial layer, and lamina propria to determine cell yields. Results: Total lymphocyte yield in the Peyer's patches, the intraepithelial layer, and lamina propria decreased with TPN but remained normal with glutamine and glycyl-L-glutamine. Upon challenge, 70% of the mice in the TPN group shed virus in nasal secretions, whereas only 20% of the glutamine-treated group, 18% of glycyl-L-glutamine group and none of the Chow group were virus positive. Conclusions: L-Glutamine and glycyl-L-glutamine have similar effects on IV administered TPN-associated (GALT) atrophy and decreased upper respiratory tract immunity. (Journal of Parenteral and Enteral Nutrition 22:31-36, 1998)

Journal of Parenteral and Enteral Nutrition, Vol. 22, No. 1, 31-36 (1998)
DOI: 10.1177/014860719802200131


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