L-글루타민 (장 수복)

The Effect of Amino Acids on Wound Healing: A Systematic Review and Meta-Analysis on Arginine and Glutamine.

1. Nutrients. 2021 Jul 22;13(8):2498. doi: 10.3390/nu13082498. The Effect of Amino Acids on Wound Healing: A Systematic Review and Meta-Analysis on Arginine and Glutamine. Arribas-López E(1), Zand N(1), Ojo O(2), Snowden MJ(1), Kochhar T(3). Author information: (1)School of Science, Medway Campu

[Role of new nitrogen substrates during peri-operative artificial nutrition in adults].

2. Ann Fr Anesth Reanim. 1995;14 Suppl 2:102-6. doi: 10.1016/s0750-7658(95)80108-1. [Role of new nitrogen substrates during peri-operative artificial nutrition in adults]. [Article in French] Cynober L(1). Author information: (1)Service de Biochimie A, Hôpital Saint-Antoine, Paris. Some amino

Combined infusion of glutamine and arginine: does it make sense?

3. Curr Opin Clin Nutr Metab Care. 2010 Jan;13(1):70-4. doi: 10.1097/MCO.0b013e328333c27f. Combined infusion of glutamine and arginine: does it make sense? Coëffier M(1), Déchelotte P. Author information: (1)Department of Nutrition, Rouen University Hospital and ADEN EA4311, Institute for Biome

Interactions between nutrients and peptide growth factors in intestinal growth, repair, and function.

4. JPEN J Parenter Enteral Nutr. 1999 Nov-Dec;23(6 Suppl):S174-83. doi: 10.1177/014860719902300602. Interactions between nutrients and peptide growth factors in intestinal growth, repair, and function. Ziegler TR(1), Estívariz CF, Jonas CR, Gu LH, Jones DP, Leader LM. Author information: (1)Dep

The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial.

1. Int J Prev Med. 2026 Feb 25;17:11. doi: 10.4103/ijpvm.ijpvm_114_23. eCollection 2026. The Effects of Calcium and Glutamine Co-supplementation on Body Composition and Bone Mineral Density in Young Female Athletes: A Randomized Clinical Trial. Goodarzizadeh N(1), Shahrjerdi A(2), Begum K(3), Amani R(4). Author information: (1)Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. (2)Razi Vaccine and Serum Research Institute (RVSRI), Agricultural Research, Education and Extension Organization (AREEO), Arak, Iran. (3)Department of Food Science and Nutrition, University of Mysore, Mysore, Karnataka, India. (4)Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran. BACKGROUND: Female athletes who experience menstrual disorders have an energy imbalance due to dietary restrictions and training. A significant problem arising from the daily training of such athletes is the imbalance between energy intake and energy expenditure, leading to fractures due to osteoporosis, amenorrhea, diabetes, and cardiovascular disease. The purpose of this study was to investigate and compare the complementary effect of calcium (Ca), Glutamine (Gln), and Ca+Gln supplements on bone mineral density (BMD), body composition, and physiological and biochemical symptoms of young female athletes with menstrual disorders during 90 days of the training program. METHODS: In this randomized clinical trial (RCT), participants were classified into four groups: Ca supplementation group (Ca), Gln supplementation group (Gln), Ca+Gln supplementation group, and placebo group. Ca supplement containing 500 mg elemental Ca was given to the recipient groups daily. Gln supplement was given at the dose of 10,000 mg. The control group received maltodextrin (similar to Gln powder) as a placebo. BMD, serum Ca and vitamin D3, mid-arm upper circumference (MUAC), weight, and body mass index (BMI) were recorded in the four groups pre and post intervention. RESULTS: Our study found that BMD differences in the three intervention groups were significant (P < 0.05). Results showed that Ca+Gln and Ca supplementation significantly improved BMD. This effect was observed in the Gln supplementation group too; however, it was lower than that of the Ca and Ca+Gln groups. Serum Ca was significantly elevated in the Ca group (P < 0.05). CONCLUSIONS: Ca+Glu supplement improves BMD in female athletes. Copyright: © 2026 International Journal of Preventive Medicine. DOI: 10.4103/ijpvm.ijpvm_114_23 PMCID: PMC13038277 PMID: 41924221 Conflict of interest statement: There are no conflicts of interest.

Comparative Analysis of Hypothalamic Responses to Stress and Glutamine Supplementation in Diet-Induced Obese Mice: A Study of Sex Differences.

2. Inflammation. 2026 Jan 10;49(1):37. doi: 10.1007/s10753-025-02428-9. Comparative Analysis of Hypothalamic Responses to Stress and Glutamine Supplementation in Diet-Induced Obese Mice: A Study of Sex Differences. Dreux V(1)(2), Lefebvre C(1)(2), Breemeersch CE(1)(2), Tiffay A(1)(2), Déchelotte P(1)(2)(3), Goichon A(1)(2), Langlois L(#)(1)(2), Coëffier M(#)(4)(5)(6). Author information: (1)Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", F-76000, Rouen, France. (2)Univ Rouen Normandie, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, F-76000, France. (3)CHU Rouen, Department of Nutrition and CIC-CRB1404, Rouen, F-76000, France. (4)Univ Rouen Normandie, INSERM, Normandie Univ, ADEN UMR1073 "Nutrition, Inflammation and Microbiota-Gut-Brain Axis", F-76000, Rouen, France. moise.coeffier@univ-rouen.fr. (5)Univ Rouen Normandie, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, F-76000, France. moise.coeffier@univ-rouen.fr. (6)CHU Rouen, Department of Nutrition and CIC-CRB1404, Rouen, F-76000, France. moise.coeffier@univ-rouen.fr. (#)Contributed equally Hypothalamic inflammation plays a key pathophysiological mechanism linking chronic consumption of a high fat diet (HFD) to the development of obesity and associated metabolic complications. Pilot studies report that oral glutamine (Gln) supplementation might reduce waist circumference and improve metabolic and inflammatory status in obesity patients. Although Gln metabolism plays a key role in intercellular communication in the central nervous system, its potential beneficial effects remain unexplored in these contexts. Here, we aimed to evaluate how stress and glutamine supplementation can modulate the hypothalamic response to HFD in mice using a chronic-restraint stress (CRS) model, which mimics IBS symptoms. From week 12 to week 14, mice received or not Gln diluted in drinking water (2 g/kg/day) and were placed in restraint tubes (2 h/day) for the last four consecutive days of protocol. Male and female obese mice showed a difference in vulnerability to CRS-induced effects. Moreover, mice responded to Gln supplementation in a sex-dependent manner, especially in stress conditions. Hypothalamic pathways regulating energy homeostasis were more impacted in male mice, whereas factors involved in neuroinflammation were more affected in female mice. Gln supplementation led to an increase in Mc4r and Bdnf mRNA levels and GFAP expression in male mice, while upregulated Iba1 and Il6 mRNA levels as well as signs of microgliosis were observed in stressed females. In conclusion, mice with obesity showed sex-specific hypothalamic response to glutamine supplementation and stress. Further investigations should be done to decipher underlying mechanisms. © 2026. The Author(s). DOI: 10.1007/s10753-025-02428-9 PMCID: PMC12858480 PMID: 41518541 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethical Approval and Consent to Participate: All experimental procedures were approved by the local ethical committee called CENOMEXA (APAFIS #29283‑2021012114574889 v5). Clinical Trial Number: Not applicable. Consent for Publication: All authors have read and agreed to the published version of the manuscript. Competing Interests: MC and PD collaborated with Laboratoire DIELEN. All other authors declare no competing interests.

Nutritional and Supplemental Interventions for Prevention and Treatment of Oral Mucositis in Pediatric Oncology.

3. Nutrients. 2025 Nov 11;17(22):3521. doi: 10.3390/nu17223521. Nutritional and Supplemental Interventions for Prevention and Treatment of Oral Mucositis in Pediatric Oncology. Horhat RM(1), Alexandru A(2), Ivan CS(2), Varga NI(2)(3), Suba MI(2)(4), Ciurariu E(5)(6), Susan M(7), Susan R(8), Cote A(9). Author information: (1)Department of Restorative Dentistry, Faculty of Dentistry, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania. (2)Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania. (3)Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania. (4)Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania. (5)Discipline of Physiology, Department of Functional Sciences III, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania. (6)Discipline of Immunology and Allergology, Biology, Department of Functional Sciences III, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania. (7)Department of Internal Medicine I, Centre for Preventive Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania. (8)Department of Family Medicine, Centre for Preventive Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania. (9)Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania. Background: Oral mucositis (OM) is a frequent complication of anticancer therapy which arises from cytotoxic injury, having significant clinical implications. Nutritional and supplement-based interventions have been proposed as adjunctive strategies to improve outcomes. Objectives: This systematic review aimed to identify and synthesize evidence from randomized controlled trials (RCTs) evaluating nutritional or natural supplement interventions for prevention or management of OM in pediatric oncology. Methods: We conducted a systematic search (17 August 2025) of Scopus, PubMed/MEDLINE, and Google Scholar (1 January 2000-1 June 2025) following PRISMA guidelines and registered in PROSPERO (CRD420251134454). The review included randomized controlled trials in pediatric cancer patients (≤18 years; up to 25 years for follow-up) receiving chemo-/radiotherapy, assessing nutritional, dietary, or natural product interventions for oral mucositis prevention or treatment. Non-randomized, adult, non-English, non-peer-reviewed, or inaccessible studies were excluded. Outcomes included incidence, severity, duration of OM, and mucositis-associated pain. Risk of bias was assessed using the NIH Study Quality Assessment Tools and the Cochrane RoB 2 tool. Results were qualitatively summarized. Results: Of 5870 records identified, 20 RCTs met inclusion criteria resulting in 1430 total included patients. Interventions tested included systemic supplements (e.g., glutamine, zinc, and bovine colostrum), topically applied agents (e.g., honey, vitamin E, Aloe vera, and olive oil), and nutrient-containing rinses (e.g., chamomile, Caphosol, and Traumeel S). Honey-based interventions showed promising outcomes. Discussion: Study designs and sample sizes varied considerably, and outcome measures were heterogeneous. Challenges with blinding, variable compliance, and inconsistent reporting reduce confidence and precision in the findings. Conclusions: Evidence from pediatric RCTs remains limited but highlights nutritional and natural products as promising supportive care options for OM. Findings suggest potential for practical, low-cost adjuncts to established oral care protocols, warranting further high-quality multicenter trials. DOI: 10.3390/nu17223521 PMCID: PMC12655015 PMID: 41305573 [Indexed for MEDLINE] Conflict of interest statement: The authors declare no conflicts of interest.

Anti-fatigue and antioxidative effects of amino acid (Leu, Gln, Cys)-EGCG complex via NRF2 and PGC-1α pathways: insights from cellular, animal, and pilot clinical studies.

4. Nutr Res Pract. 2025 Oct;19(5):664-681. doi: 10.4162/nrp.2025.19.5.664. Epub 2025 Apr 14. Anti-fatigue and antioxidative effects of amino acid (Leu, Gln, Cys)-EGCG complex via NRF2 and PGC-1α pathways: insights from cellular, animal, and pilot clinical studies. Kim SM(1)(2), Suh HJ(1)(2), Lee W(3), Kim B(3), Han SH(4)(5), Jung EY(6), Chang YB(1). Author information: (1)Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Korea. (2)Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul 02841, Korea. (3)LingTea, Seoul 06611, Korea. (4)Institute of Human Behavior & Genetics, Korea University, Seoul 02841, Korea. (5)Biomedical Research Center, Anam Hospital, Korea University, Seoul 02841, Korea. (6)Department of Home Economic Education, Jeonju University, Jeonju 55069, R Korea. BACKGROUND/OBJECTIVES: Fatigue is closely associated with an impaired mitochondrial function, oxidative stress, and inefficient energy metabolism, all contributing to reduced physical performance. Nutritional strategies targeting mitochondrial biogenesis and antioxidant defense may help alleviate fatigue and enhance endurance. This study examined the anti-fatigue and antioxidant effects of an amino acid (AA)-epigallocatechin gallate (EGCG) mixture comprised of 3 AAs (cysteine [Cys], glutamine [Gln], and leucine [Leu]) and EGCG on mitochondrial biogenesis, oxidative stress mitigation, and physical performance enhancement. MATERIALS/METHODS: C2C12 myoblasts were treated to assess mitochondrial biogenesis-related gene expression and oxidative stress markers. Animal studies measured the swimming endurance, glycogen, adenosine triphosphate (ATP), and serum parameters. A pilot clinical trial evaluated the blood glucose, lactate, and serum enzyme levels post-exercise. RESULTS: In cellular experiments, a 1:1:3 ratio of the AA mixture (Cys, Gln, and Leu) with EGCG enhanced mitochondrial biogenesis-related gene expression (AMP-activated protein kinase, sirtuin 1, and peroxisome proliferator-activated receptor gamma coactivator 1α [PGC-1α]) and reduced the oxidative stress markers (reactive oxygen species and malondialdehyde [MDA]). Animal studies revealed significant increases in swimming endurance, elevated glycogen and ATP levels, and reduced serum fatigue markers (creatine phosphokinase, lactate dehydrogenase, and blood nitrogen). Furthermore, nuclear factor erythroid 2-related factor 2 (NRF2) and PGC-1α expression was significantly upregulated in the gastrocnemius muscle, supporting enhanced mitochondrial function. In addition, the antioxidant effects were observed with reduced MDA levels in liver tissue. Clinical trial data showed improved blood lactate clearance and higher post-exercise blood glucose levels in the AA-EGCG group compared to the placebo group. CONCLUSION: The AA-EGCG mixture enhances mitochondrial biogenesis and antioxidant capacity by activating the NRF2 and PGC-1α pathways, improving physical performance and reducing fatigue. This study highlights its potential as a supplement for managing fatigue and enhancing endurance. ©2025 The Korean Nutrition Society and the Korean Society of Community Nutrition. DOI: 10.4162/nrp.2025.19.5.664 PMCID: PMC12518752 PMID: 41098404 Conflict of interest statement: Conflict of Interest: The authors declare no potential conflicts of interests.

Glutamine prevents diarrhea in colorectal cancer patients undergoing chemotherapy or chemoradiotherapy: a meta-analysis.

5. BMC Gastroenterol. 2025 Oct 6;25(1):697. doi: 10.1186/s12876-025-04308-w. Glutamine prevents diarrhea in colorectal cancer patients undergoing chemotherapy or chemoradiotherapy: a meta-analysis. Chen L(#)(1), Wang D(#)(2), Meng C(#)(1), Sun H(1), Li R(1), Miao G(3), Liu P(4). Author information: (1)Department of Emergency, Emergency General Hospital, Xibahe South Road 29, Beijing, 100028, PR China. (2)Department of General Medicine, Ordos School of Clinical Medicine, Ordos Central Hospital, Inner Mongolia Medical University, Ordos, 017000, PR China. (3)Department of Emergency, Emergency General Hospital, Xibahe South Road 29, Beijing, 100028, PR China. guobinpeking@163.com. (4)Department of Cardiology, Ordos School of Clinical Medicine, Ordos Central Hospital, Inner Mongolia Medical University, Inner Mongolia, 23 Yijin Huoluo West Street, Dongsheng District, Ordos, 017000, PR China. wanguyisu@163.com. (#)Contributed equally OBJECTIVE: To assess the efficacy of glutamine in preventing diarrhea associated with chemotherapy or chemoradiotherapy in colorectal cancer. METHODS: Randomized controlled trials of glutamine in the prevention of chemotherapy-associated diarrhea of colorectal cancer were retrieved from the Cochrane Library, Pubmed, EMBASE, CNKI, and Wanfang by computer up to August 1, 2024. Results were presented using relative risk (RR) or mean difference (MD) with a 95% confidence interval (CI). Publications were reviewed in accordance with the Cochrane Handbook and the guidelines of the Preferred Reporting Project for Systematic Review and Meta-Analysis (PRISMA2020). This study has been registered with INPLASY (registration number: INPLASY202490057). RESULTS: A total of 5 studies were included, and the total number of patients was 311. Meta-analysis showed that compared with the control group, glutamine supplementation significantly reduced the incidence of chemoradiation-induced diarrhea in colorectal cancer patients (RR = 0.72, 95%CI: 0.60-0.87, P < 0.01, I²=37%). Subgroup analysis found that glutamine was more effective in reducing diarrhea in patients receiving chemotherapy alone than in those undergoing chemoradiotherapy (RR = 0.65, 95%CI: 0.43-0.98, P < 0.05, I²=35%). By tumor location, glutamine reduced diarrhea in the colorectal cancer subgroup (RR = 0.65, 95%CI: 0.44-0.97, P < 0.05, I²=30%) but not in the rectal cancer subgroup (P > 0.05). D-xylose levels were significantly higher in the glutamine group (MD = 0.32, 95%CI: 0.14-0.51, P < 0.01, I²=0%), while C-reactive protein levels were significantly lower (MD = 0.52, 95%CI: 0.32-0.72, P < 0.01, I²=0%). The certainty of evidence for diarrhea was rated as low. CONCLUSION: Glutamine supplementation is associated with a reduced incidence of diarrhea in patients with colorectal cancer, with a more pronounced efficacy observed in those receiving chemotherapy alone. © 2025. The Author(s). DOI: 10.1186/s12876-025-04308-w PMCID: PMC12502349 PMID: 41053591 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All authors approved the final manuscript and the submission to this journal. Competing interests: The authors declare no competing interests.

Impact of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on inflammation in patients with cardiac surgery: A secondary analysis of a randomized controlled trial.

6. J Cardiol. 2025 Dec;86(6):561-567. doi: 10.1016/j.jjcc.2025.08.017. Epub 2025 Sep 4. Impact of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on inflammation in patients with cardiac surgery: A secondary analysis of a randomized controlled trial. Ogawa M(1), Satomi-Kobayashi S(2), Yoshida N(3), Komaki K(4), Hirabayashi T(4), Wakida K(5), Saitoh S(5), Inoue T(6), Yamashita T(7), Sakai Y(8), Takahashi M(5), Hirata KI(9). Author information: (1)Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan. (2)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. Electronic address: seimik@med.kobe-u.ac.jp. (3)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Cardiovascular Aging, National Cerebral and Cardiovascular Center, Osaka, Japan. (4)Division of Rehabilitation Medicine, Kobe University Hospital, Hyogo, Japan. (5)Department of Nutrition, Kobe University Hospital, Hyogo, Japan. (6)Department of Cardiac Surgery, Hyogo Prefectural Awaji Medical Center, Hyogo, Japan. (7)Department of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Hyogo, Japan. (8)Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. (9)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. BACKGROUND: Preoperative physical frailty is a significant predictor of adverse postoperative outcomes in older patients undergoing cardiac surgery. Inflammation plays a crucial role in the development of frailty and contributes to postoperative complications. This study investigated the effects of preoperative beta-hydroxy-beta-methylbutyrate (HMB), arginine, and glutamine supplementation on inflammatory markers, nutritional status, and renal function in older patients undergoing cardiac surgery. METHODS: This was a secondary analysis of a single-center, open-label, randomized controlled trial. Patients aged ≥65 years scheduled for elective cardiac surgery were randomized to receive either HMB supplementation (1200 mg HMB, 7000 mg l-glutamine, and 7000 mg L-arginine, twice daily) or routine care for at least two weeks before surgery. Serum levels of tumor necrosis factor-alpha (TNF-α), and other biochemical markers were measured at baseline, pre-surgery, and two weeks post-surgery. RESULTS: Forty-four patients (mean age 72.5 years, 36 % women) were analyzed. Preoperative HMB supplementation significantly reduced pre-surgery serum TNF-α levels compared to the control group (0.85 ± 0.28 pg/mL vs. 1.10 ± 0.44 pg/mL, p = 0.039). However, this difference was not observed two weeks post-surgery. No significant differences were observed in C-reactive protein levels or other nutritional markers between the two groups at any time point. CONCLUSIONS: Preoperative supplementation with a combination of HMB, glutamine, and arginine was effective in reducing preoperative TNF-α levels in older patients undergoing cardiac surgery, suggesting a potential anti-inflammatory effect. This anti-inflammatory effect suggests a potential mechanism for improving postoperative outcomes and warrants further investigation. Registration number of Clinical Trial: UMIN000030490 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034773). Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.jjcc.2025.08.017 PMID: 40914430 [Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors declare no conflicts of interest.

Role of B vitamins in modulating homocysteine and metabolic pathways linked to brain atrophy: Metabolomics insights from the VITACOG trial.

7. Alzheimers Dement. 2025 Jul;21(7):e70521. doi: 10.1002/alz.70521. Role of B vitamins in modulating homocysteine and metabolic pathways linked to brain atrophy: Metabolomics insights from the VITACOG trial. Kacerova T(1), Yates AG(1)(2), Dai J(1), Shepherd D(2), Pires E(1), de Jel S(3), Gong Q(3), Schiffer E(3), Jernerén F(4), Olsen T(5), De Jager Loots CA(6), Refsum H(2)(5), Smith AD(2), McCullagh JSO(1), Anthony DC(2), Probert F(1). Author information: (1)Department of Chemistry, Chemistry Research Laboratory, University of Oxford, Oxford, UK. (2)Department of Pharmacology, University of Oxford, Oxford, UK. (3)numares AG, Regensburg, Germany. (4)Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden. (5)Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. (6)The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, London, UK. INTRODUCTION: Elevated total homocysteine (tHcy) is a major predictor of brain atrophy, cognitive decline, and Alzheimer's disease (AD) progression. The VITACOG trial, a randomized, placebo-controlled study in mild cognitive impairment (MCI), previously showed that B vitamin supplementation lowered tHcy, slowing brain atrophy and cognitive decline; however, the underlying mechanisms remained unclear. METHODS: We used untargeted, multi-platform metabolomics, with nuclear magnetic resonance and liquid chromatography-mass spectrometry to analyze serum samples from 89 B vitamin-treated and 84 placebo-treated MCI participants over a 2 year follow-up period. RESULTS: Multivariate modeling distinguished treated from placebo groups with 91.2 ± 1.8% accuracy. B vitamin supplementation induced significant metabolic reprogramming, lowering quinolinic acid, α-ketoglutarate, α-ketobutyrate, glucose, and glutamate. DISCUSSION: These findings reveal that B vitamins influence metabolic pathways beyond tHcy reduction, particularly the tricarboxylic acid cycle and glutamine-glutamate cycling, critical for brain energy homeostasis and neurotransmission. This metabolic signature supports B vitamin supplementation as a strategy for slowing MCI progression. HIGHLIGHTS: Nuclear magnetic resonance and multi-platform liquid chromatography tandem mass spectrometry metabolomics were performed on serum samples from 89 B vitamin-treated and 84 placebo participants in the VITACOG trial. Multi-platform metabolomics revealed B vitamin-driven metabolic reprogramming, achieving 91% classification accuracy. B vitamin supplementation modulates key neuroprotective metabolic pathways. Regulation of energy metabolism and neurotransmission by B vitamins contributes to brain health in elderly individuals. B vitamins demonstrate potential as an adjunct therapy in mild cognitive impairment, potentially mitigating progression to Alzheimer's disease. © 2025 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association. DOI: 10.1002/alz.70521 PMCID: PMC12276071 PMID: 40684250 [Indexed for MEDLINE] Conflict of interest statement: A.D.S. and H.R. are named as inventors on two patents held by the University of Oxford on the use of B vitamins to treat cognitive disorders (US9364497 and US10966947). F.J. is named as an inventor on US10966947. These patents have been licensed to Elysium Health, NY. J.S.O.M. has a research contract and equipment loan from ThermoFisher Scientific, which manufactures IC‐MS systems. S. de J., Q. G., and E. S. are employees of Numares AG (Am Biopark 9, 93053 Regensburg‐Graß, Germany). All other authors report no conflicts of interest. Author disclosures are available in the supporting information.

L-arginine vs. L-glutamine oral suspensions for radiation-induced oral mucositis: a triple-blind randomized trial.

8. J Cancer Res Clin Oncol. 2025 Jul 3;151(7):198. doi: 10.1007/s00432-025-06213-x. L-arginine vs. L-glutamine oral suspensions for radiation-induced oral mucositis: a triple-blind randomized trial. Hassanein FEA(1), Mikhail C(2)(3), Elkot S(4), Abou-Bakr A(5). Author information: (1)Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, 11371, Egypt. fatma.hassanein@ksiu.edu.eg. (2)Oral Medicine, Periodontology, and Oral Diagnosis, Faculty of Dentistry, King Salman International University, El Tur, South Sinai, 11371, Egypt. (3)Oral Medicine and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt. (4)Oral Medicine and Periodontology, Faculty of Dentistry, Future University in Egypt, Cairo, Egypt. (5)Oral Medicine, Periodontology, and Oral Diagnosis Faculty of Dentistry, Galala University, Suez, Egypt. PURPOSE: Radiation-induced oral mucositis (RIOM) severely impacts patients with head and neck cancer (HNC) undergoing radiotherapy, often leading to pain and malnutrition. L-arginine and glutamine are immune-enhancing amino acids with potential benefits in wound healing and inflammation control. This study evaluated the efficacy of L-arginine versus L-glutamine oral suspensions in managing RIOM. METHODS: In this triple-blind, randomized controlled trial, 69 HNC patients with RIOM were allocated to three groups (n = 23 each): Group I (L-arginine 5 g + maltodextrin 5 g), Group II (glutamine 5 g + maltodextrin 5 g), or Group III (maltodextrin 10 g). Outcomes, assessed at weeks 2, 5, and 7 of radiotherapy, included the WHO oral mucositis scale, Pain Visual Analogue Scale (Pain-VAS), body mass index (BMI), and Oral Health Impact Profile (OHIP-14) questionnaire. RESULTS: By week 5, WHO scale scores differed significantly among groups (p < 0.001), with arginine and glutamine groups exhibiting lower mucositis severity than the maltodextrin group. Pain-VAS scores at weeks 5 and 7 were significantly lower in the arginine and glutamine groups compared to maltodextrin (p = 0.004 and p < 0.001, respectively). By 7th week of radiotherapy, BMI was significantly decreased in the maltodextrin group than in either the arginine (p = 0.028) or glutamine (p = 0.001) groups, indicative of treatment-mediated weight loss. In contrast, the BMI over time in the arginine (p = 0.87) and glutamine (p = 0.170) groups were almost constant. This indicates that compared to maltodextrin alone, both amino acid supplements prevented a decline in BMI during radiotherapy. OHIP-14 scores improved significantly in the arginine and glutamine groups at weeks 5 and 7 (p < 0.001), indicating better quality of life. CONCLUSIONS: Both L-arginine and glutamine significantly reduced RIOM severity, pain, and weight loss compared to maltodextrin, while improving quality of life in patients with head and neck cancer. Although no statistically significant difference was found between the two, a higher proportion of patients receiving L-arginine achieved complete healing by week 7, suggesting a potential late advantage. These findings support the use of both amino acids as viable options for symptom management during radiotherapy. TRIAL REGISTRATION: ClinicalTrials.gov (NCT06764420), registered 08/01/2024. © 2025. The Author(s). DOI: 10.1007/s00432-025-06213-x PMCID: PMC12222376 PMID: 40603739 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Ethics approval and consent to participate: The current study was conducted in compliance with the Helsinki Declaration for medical research involving human subjects as revised in 2013 as triple-blind, parallel arms, and randomized controlled clinical trial, with 1:1:1 allocation ratio. The study protocol was reviewed and approved by the University Research Ethics Committee (FUE.REC 2582024). All eligible individuals provided with written informed consent to participate in the current study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Effectiveness of amino acid supplementation in preventing acute kidney injury following cardiac surgery: A systematic review and meta-analysis of randomized controlled trials.

9. Acta Anaesthesiol Scand. 2025 Jul;69(6):e70037. doi: 10.1111/aas.70037. Effectiveness of amino acid supplementation in preventing acute kidney injury following cardiac surgery: A systematic review and meta-analysis of randomized controlled trials. Majeed MW(1), Finnegan E(2), Gallo Ruelas M(3), Lopes LM(4), Righetto BB(5), Salha I(6), Delgado D(7), Quirós MC(8), Tomo ATJ(9), Ahmad R(10), Andrabi S(11), Abujaber S(12). Author information: (1)Government Medical College Srinagar, VMMC and Safdarjung Hospital, New Delhi, India. (2)School of Medicine, Trinity College Dublin, Dublin, Ireland. (3)Department of Nutrition, Instituto de Investigación Nutricional (IIN), Lima, Peru. (4)Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. (5)Department of Medicine, Universidade Positivo, Curitiba, Brazil. (6)Department of Global Health, Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland. (7)Universidad Peruana de Ciencias Aplicadas, Lima District, Peru. (8)Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica. (9)Department of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique. (10)Department of Cardiology, Royal Brompton Hospital, London, UK. (11)Department of Nephrology, Columbia University Vagelos College of Physicians and Surgeons, NYC Health + Hospitals/Harlem, New York, New York, USA. (12)Department of Pulmonary and Critical Care, SUNY Downstate Medical Center, New York, New York, USA. INTRODUCTION: Acute kidney injury (AKI) is a frequent complication of cardiac surgery, contributing to increased morbidity, longer hospital stays, and higher mortality. Evidence suggests amino acid (AA) supplementation may enhance renal blood flow and glomerular filtration rate (GFR), potentially reducing AKI risk; however, findings remain inconclusive. This study evaluated the efficacy of perioperative AA supplementation in preventing AKI and related complications post-cardiac surgery. METHODS: PubMed, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs) comparing AA supplementation versus standard care in preventing cardiac surgery-associated AKI. Main outcomes included AKI incidence (defined by the Kidney Disease Improving Global Outcomes (KDIGO) criteria), 30-day mortality, and renal replacement therapy (RRT) requirement. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Statistical significance was set at p < 0.05. The certainty of the evidence (CoE) was assessed using the GRADE approach. RESULTS: Six RCTs involving 4501 cardiac surgery patients were included. AA mixture interventions significantly reduced the risk of AKI stage 1 (RR: 0.56; 95% CI: 0.77-0.96; p = .009; CoE: Moderate) and Stage 3 (RR: 0.53; 95% CI: 0.34-0.83; p = .005; CoE: Moderate), but not stage 2 (RR: 1.24; 95% CI: 0.60-2.55; p = .568; CoE: Low). Preliminary findings from glutamic acid and glutamine (single AA interventions) showed potential benefits in reducing AKI incidence (CoE: Very low) and improving surrogate biomarkers, respectively. No significant effects were observed on mortality or RRT incidence for any intervention. CONCLUSION: AA mixtures likely reduce AKI incidence following cardiac surgery but show limited effects on mortality and RRT. Further trials are needed to confirm the benefits of glutamic acid and glutamine supplementation. EDITORIAL COMMENT: Use of amino acid supplementation for the prevention of acute kidney injury after cardiac surgery may be effective, but more trial data and confidence in a beneficial effect is needed for this to be implemented in everyday clinical practice. © 2025 Acta Anaesthesiologica Scandinavica Foundation. DOI: 10.1111/aas.70037 PMID: 40411139 [Indexed for MEDLINE]

Effects of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on cardiac surgery: A randomized controlled trial.

10. Clin Nutr. 2025 Feb;45:91-100. doi: 10.1016/j.clnu.2024.12.030. Epub 2024 Dec 31. Effects of preoperative beta-hydroxy-beta-methylbutyrate, arginine, and glutamine supplementation on cardiac surgery: A randomized controlled trial. Ogawa M(1), Satomi-Kobayashi S(2), Yoshida N(3), Komaki K(4), Hirabayashi T(4), Wakida K(5), Saitoh S(5), Inoue T(6), Yamashita T(7), Sakai Y(8), Takahashi M(5), Okada K(9), Hirata KI(10). Author information: (1)Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Rehabilitation Science, Osaka Health Science University, Osaka, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan. (2)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. Electronic address: seimik@med.kobe-u.ac.jp. (3)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan; Department of Cardiovascular Aging, National Cerebral and Cardiovascular Center, Osaka, Japan. (4)Division of Rehabilitation Medicine, Kobe University Hospital, Hyogo, Japan. (5)Department of Nutrition, Kobe University Hospital, Hyogo, Japan. (6)Department of Cardiac Surgery, Hyogo Prefectural Awaji Medical Center, Hyogo, Japan. (7)Department of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Hyogo, Japan. (8)Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. (9)Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan. (10)Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan. BACKGROUND & AIMS: In older patients undergoing cardiac surgery, physical function is a critical determinant of postoperative outcomes. Beta-hydroxy-beta-methylbutyrate (HMB) supplementation has been shown to promote muscle protein anabolism and inhibit catabolism, thereby preventing muscle weakness. However, its efficacy in older patients undergoing cardiac surgery remains unknown. This study aimed to examine the effects of preoperative HMB supplementation on postoperative physical function and complications in this population. METHODS: In this single-center, open-label, randomized controlled trial, patients aged ≥65 years scheduled for cardiac surgery were randomized to receive HMB supplementation or no nutritional intervention. The HMB group received HMB 1200 mg, l-glutamine 7000 mg, and l-arginine 7000 mg, once or twice daily, for at least 2 weeks before surgery. Evaluations were performed at baseline and before and after surgery. The primary outcome was the 6-min walking distance (6MWD) before and after surgery. Secondary outcomes included the incidence of complications, muscle mass and strength, physical performance, and length of hospital stay. RESULTS: Forty-four patients with a mean age of 72.5 years (women, 38 %) were randomized to the HMB (n = 22) or control (n = 22) group. Compared with the control group, the HMB group demonstrated a statistically significant improvement in the 6MWD both at the pre-surgery (448.0 ± 73.5 m vs. 375.5 ± 58.8 m; P = 0.01) and post-surgery time points (428.9 ± 76.4 m vs. 304.5 ± 52.3 m; P = 0.001). Muscle strength and physical performance also showed significant improvements in the HMB group. However, no significant difference in muscle mass was observed between the groups at any time point. The HMB group had a shorter hospital length of stay compared with that of the control group (16.1 ± 3.8 days vs. 20.4 ± 7.6 days, P = 0.03), and no adverse events were observed with the intervention. CONCLUSIONS: Preoperative HMB supplementation in older adults undergoing cardiac surgery resulted in significant improvements in postoperative exercise capacity and physical function, along with a reduction in the length of hospital stay, without affecting muscle mass. REGISTRATION NUMBER OF CLINICAL TRIAL: UMIN000030490 (UMINhttps://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034773). Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.clnu.2024.12.030 PMID: 39765161 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest The authors declare no conflicts of interest.

The effect of Sarcomeal® oral supplementation plus vitamin D3 on muscle parameters and metabolic factors in diabetic sarcopenia patients: study protocol of a randomized controlled clinical trial.

11. Trials. 2024 Dec 23;25(1):848. doi: 10.1186/s13063-024-08700-x. The effect of Sarcomeal® oral supplementation plus vitamin D3 on muscle parameters and metabolic factors in diabetic sarcopenia patients: study protocol of a randomized controlled clinical trial. Abdi Dezfouli R(1), Zargar Balajam N(2), Shirazi S(3), Heshmat R(#)(4), Shafiee G(#)(5). Author information: (1)Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. (2)Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. (3)Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. (4)Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. rheshmat@tums.ac.ir. (5)Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. gshafiee.endocrine@gmail.com. (#)Contributed equally BACKGROUND: Diabetes is a significant risk factor for sarcopenia, a muscle dystrophy affecting older individuals. Sarcopenia management typically involves resistance exercise and oral supplements. Given the limitations of resistance training for many elderly individuals, oral supplements play a crucial role in treatment. This study is a protocol for evaluating the efficacy of the Sarcomeal® supplement, a mixture of whey protein, creatine, branch-chained amino acids (BCAAs), glutamine, and hydroxyl-methyl-butyrate (HMB) in diabetic people who also have sarcopenia. METHODS AND ANALYSIS: This study is a randomized clinical trial, in which sixty diabetic sarcopenia patients who meet the inclusion criteria will be randomly assigned to the control or the intervention group with a 1:1 allocation. The intervention group will receive one Sarcomeal® supplement sachet plus 1000 IU of vitamin D daily and both groups will be recommended to consume protein-rich food, be educated about the disease, and perform light exercises for 12 weeks. Anthropometric measurements, body composition analysis, muscle strength assessments, and blood tests will be conducted at the trial's start and end. DISCUSSION: It is hypothesized that the Sarcomeal® supplement plus vitamin D may be beneficial for the management of diabetic sarcopenia by reducing inflammation, oxidative stress, and glucose metabolism. The outcome of this trial will provide a basis for prescribing sarcomeal to patients with diabetic sarcopenia. ETHICS AND DISSEMINATION: This protocol is registered at the Iranian Registry of Clinical Trials (IRCT20230831059311N1) and also is approved by the ethics committee of Tehran University of Medical Sciences (September 2023, IR.TUMS.EMRI.REC.1402.071). TRIAL REGISTRATION: Iranian Registry of Clinical Trials (ID: IRCT20230831059311N1). © 2024. The Author(s). DOI: 10.1186/s13063-024-08700-x PMCID: PMC11667863 PMID: 39716287 [Indexed for MEDLINE] Conflict of interest statement: Declarations. Consent for publication: Not applicable. Competing interests: None of the authors of this study have any financial ties with Karen Company and do not receive a salary from them. In this study, Karen Company will only provide the product and will not pay any funds to the researchers.

Nutritional interventions in patients with burn injury: an umbrella review of systematic reviews and meta-analyses of randomised clinical trials.

12. Br J Nutr. 2024 Nov 28;132(10):1317-1324. doi: 10.1017/S0007114524002344. Epub 2024 Nov 6. Nutritional interventions in patients with burn injury: an umbrella review of systematic reviews and meta-analyses of randomised clinical trials. Naeini F(1), Zeraattalab-Motlagh S(2), Rahimlou M(3), Ranjbar M(1), Hemmati A(1), Habibi S(1), Moradi S(4), Mohammadi H(1). Author information: (1)Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. (2)Department of Health and Human Performance, University of Houston, Houston, TX, USA. (3)Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. (4)Department of Nutrition and Food Sciences, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran. Multiple reviews have examined the impact of nutritional interventions in patients with burn injuries; however, discrepancies among results cast doubt about their validity. We implemented this review to assess the impact of various nutritional interventions in adult patients with burn injuries. We conducted a thorough search of PubMed, Scopus and Web of Science databases until 1 August 2024, to identify relevant meta-analyses of intervention trials, examining the impact of nutritional interventions on burn patients. We adopted the random-effect models to determine the pooled effect sizes while employing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to examine evidence certainty. Thirty-three original intervention trials from eleven meta-analyses were entered in our review. Early enteral nutrition could substantially reduce overall mortality (relative risk (RR): 0·36, 95 % CI: 0·19, 0·68, GRADE = moderate certainty), hospital stay (mean difference (MD): -15·3, 95 % CI: -20·4, -10·2, GRADE = moderate certainty) and sepsis risk (RR: 0·23, 95 % CI: 0·11, 0·45, GRADE = moderate certainty). Glutamine showed a notable decrease in the length of hospital stay (MD: -6·23, 95 % CI: -9·53, -2·94, GRADE = low certainty). However, other nutritional interventions, including combined immunonutrition, branched-chain amino acids, fish oil, ornithine α-ketoglutarate and trace elements, did not significantly affect the assessed clinical outcomes. Early enteral nutrition might impose a beneficial effect on mortality, hospital stay length and incidence of sepsis with moderate evidence. Lower length of hospital stay was also seen in burn patients supplemented with glutamine, although the evidence was weak. DOI: 10.1017/S0007114524002344 PMID: 39501634 [Indexed for MEDLINE]

A systematic review and meta-analysis of clinical trials on the effects of glutamine supplementation on gut permeability in adults.

13. Amino Acids. 2024 Oct 13;56(1):60. doi: 10.1007/s00726-024-03420-7. A systematic review and meta-analysis of clinical trials on the effects of glutamine supplementation on gut permeability in adults. Abbasi F(1), Haghighat Lari MM(2), Khosravi GR(3), Mansouri E(4), Payandeh N(5), Milajerdi A(6). Author information: (1)Faculty of Physical Education and Sport Sciences, Tehran University, Tehran, Iran. (2)Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran. (3)Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran. (4)Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. (5)Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. (6)Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran. amkhv@yahoo.com. The gastrointestinal tract's epithelial barrier plays a crucial role in maintaining health. This study aims to investigate the impact of glutamine supplementation on intestinal permeability, considering its importance for immune function and nutrient absorption. The study adhered to the PRISMA protocol for systematic reviews and meta-analyses. A systematic search was performed in four databases (PubMed, Scopus, Web of Science, and Google Scholar) until April 2023 to identify clinical trials on glutamine supplementation and gastrointestinal permeability. Eligibility criteria included randomized placebo-controlled trials measuring gut permeability post-glutamine supplementation. Studies were included regardless of language or publication date. Data extraction involved study characteristics, intervention details, and outcomes. Quality assessment was performed using the Cochrane tool, and statistical analysis utilized mean differences and standard deviations with a random effects model. Subgroup analysis was conducted to explore heterogeneity. The systematic review and meta-analysis included 10 studies from 1998 to 2014 with 352 participants. A total of 216 patients were enrolled in the intervention group, and 212 in the control group. The mean participant age was 46.52 years. The participants had different types of diseases in terms of their health status. Overall, glutamine supplementation did not significantly affect intestinal permeability (WMD: -0.00, 95% CI -0.04, 0.03). Subgroup analysis showed a significant reduction in intestinal permeability with doses over 30g/day (WMD: -0.01, 95% CI -0.10, -0.08). The glutamine supplements were administered orally in all included studies. The meta-analysis demonstrated a significant reduction in intestinal permeability with glutamine supplementation exceeding 30 mg/day for durations of less than 2 weeks. Further investigations with varying dosages and patient populations are warranted to enhance understanding and recommendations regarding glutamine supplementation's effects on gut permeability. © 2024. The Author(s). DOI: 10.1007/s00726-024-03420-7 PMCID: PMC11471693 PMID: 39397201 [Indexed for MEDLINE] Conflict of interest statement: The authors do not declare any conflicts of interest.

A systematic review to assess the impact of amino acids or their derivatives on skeletal muscle wasting in critically ill patients.

14. Clin Nutr. 2024 Oct;43(10):2458-2472. doi: 10.1016/j.clnu.2024.09.025. Epub 2024 Sep 13. A systematic review to assess the impact of amino acids or their derivatives on skeletal muscle wasting in critically ill patients. Wittholz K(1), Bidgood E(2), Fetterplace K(3), McLean A(4), Rooyackers O(5), Deane AM(6), Karahalios A(4). Author information: (1)Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia. Electronic address: kym.wittholz@mh.org.au. (2)Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Australia. (3)Department of Allied Health (Clinical Nutrition), Royal Melbourne Hospital, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia. (4)Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia. (5)Division of Anesthesiology and Intensive Care, Department of Clinical Science, Technology and Intervention, Karolinska Institutet, Huddinge, Sweden. (6)Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia. BACKGROUND: It is plausible that supplementation with specific amino acids or metabolites could attenuate skeletal muscle wasting during critical illness. The aim of this systematic review was to explore if amino acids or their derivatives impact skeletal muscle wastage in critically ill adults. METHODS: Four databases were systematically searched to identify randomised control trials which delivered enteral supplemental amino acids, or their metabolites compared with placebo, standard care or no intervention, to critically ill patients and reported outcomes of skeletal muscle mass, plasma amino acids, nitrogen balance, or muscle strength. Two authors independently completed screening, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2 Tool. A meta-analysis was planned but heterogeneity in the type of intervention used and outcome assessment precluded this. Therefore, data were synthesised using vote counting. RESULTS: Thirty randomised control trials, comprising 1976 patients were included. The most frequently studied interventional amino acid or metabolite was glutamine (n = 12 trials), a combination (n = 9), arginine (n = 6), β-hydroxy β-methylbutyrate (HMB) (n = 2) or ornithine (n = 1). Six trials (including 284 participants) measured skeletal muscle following supplementation, four of which used HMB alone or in combination as the intervention. Of these, one trial observed an attenuation of muscle wasting with a combination of amino acids, one observed an exacerbation of muscle wasting with HMB, three trials observed no impact on muscle wasting with HMB or a combination of amino acids and one trial reported no information. CONCLUSION: Six trials have investigated the effect of enteral amino acid or amino acid metabolite supplementation on muscle mass in critically ill. Heterogeneity of interventions, outcome assessments and direction of effects limits the certainty regarding the effect of supplemental amino acids, or their metabolites, on skeletal muscle wasting during critical illness. The trial protocol is registered on PROSPERO (CRD42021275989). Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.clnu.2024.09.025 PMID: 39305756 [Indexed for MEDLINE] Conflict of interest statement: Conflict of interest None to declare.

Bifidobacterium regulates premature infant gut metabolites, reducing serum inflammatory factors: a randomised controlled trial.

15. Pediatr Res. 2025 Feb;97(3):1171-1182. doi: 10.1038/s41390-024-03552-2. Epub 2024 Sep 13. Bifidobacterium regulates premature infant gut metabolites, reducing serum inflammatory factors: a randomised controlled trial. Wang H(#)(1)(2), Chen D(#)(1)(2), Li H(1)(2), Fu C(1)(2), Fang L(1)(2), Wang R(1)(2), Xu J(3)(4). Author information: (1)The Graduate School of Fujian Medical University, Fuzhou, Fujian, China. (2)Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, Fujian Province, China. (3)The Graduate School of Fujian Medical University, Fuzhou, Fujian, China. lin3259627@163.com. (4)Department of Neonatology, Quanzhou Maternity and Children's Hospital, Quanzhou, Fujian Province, China. lin3259627@163.com. (#)Contributed equally BACKGROUND: Analyse the effects of Bifidobacterium BB-12 on intestinal metabolites and serum inflammatory factors in premature infants. METHODS: 71 premature infants at gestational age of ≤32 weeks were randomly divided into the probiotic (n = 36) and control (n = 35) groups. Faecal and blood samples were collected from the two groups of premature infants at the 2nd and 4th week of life for intestinal metabolite detection and assessment of the level of the serum inflammatory markers TLR4, NF- κ B, IL-1β, and TNF- α. RESULTS: Compared to the control group, the probiotic group contained more amino acids, these elements were enriched on multiple amino acid metabolic pathways, and the probiotic group showed significantly lower levels of the serum inflammatory markers TLR4, NF-κB, IL-1β, and TNF-α. Finally, the probiotic group showed a lower incidence of feeding intolerance. CONCLUSIONS: The administration of Bifidobacterium BB-12 is associated with increasing the levels of glutamine, glutamic acid, and kynurenine in the gut of premature infants, and associated with reducing the levels of TLR4 and NF-κB in the serum, further decreasing the secretion of the pro-inflammatory factors IL-1β and TNF-α, and alleviating systemic inflammatory reactions, thereby reducing the incidence of feeding intolerance. IMPACT: 1. The use of Bifidobacterium BB-12 in premature infants can increase the levels of amino acids in the intestine. 2. Increases in Bifidobacterium BB-12 may decrease the serum levels of TLR4, NF-κB, IL-1β, and TNF-α. 3. Kynurenine may improve the prognosis of preterm infants by reducing inflammation. 4. Bifidobacterium BB-12 may improve the feeding tolerance of premature infants, thus reducing the incidence of feeding intolerance. © 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc. DOI: 10.1038/s41390-024-03552-2 PMID: 39271904 [Indexed for MEDLINE] Conflict of interest statement: Competing interests: The authors declare no competing interests. Ethical approval and consent to participate: This study has been approved by the Ethics Committee of Quanzhou Children’s Hospital (Ethics No. 8, 2022), and all premature infants participating in the study have signed informed consent forms by their guardians.