Applications of glutamine in disease prevention and treatment

Sang Yuting; Yang Yanling; Sun Meng

doi:10.16689/j.cnki.cn11-9349/r.2026.03.002

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Electronic Journal of Metabolism and Nutrition of Cancer ›› 2026, Vol. 13 ›› Issue (3) : 342-347. DOI: 10.16689/j.cnki.cn11-9349/r.2026.03.002

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Applications of glutamine in disease prevention and treatment

¹Sang Yuting, ²Yang Yanling, ³Sun Meng

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Abstract

Glutamine is the most abundant and versatile free amino acid in the human body, playing various physiological effects in energy metabolism and the maintenance of health. Under normal physiological conditions, glutamine can be synthesized endogenously from glutamate and ammonia catalyzed by glutamine synthetase. However, in hypercatabolic states such as severe burns and major trauma, endogenous synthesis becomes insufficient, rendering glutamine a conditionally essential amino acid. As an important energy substrate for enterocytes and immune cells, glutamine plays a key role in protecting the integrity of the gastrointestinal mucosal barrier, modulating immune function, and mitigating oxidative stress. Glutamine is a key therapeutic nutrient for glutamine synthetase deficiency. For inherited metabolic disorders, such as mitochondrial diseases, glutamine demonstrates effective therapeutic effects. This article systematically explores the potential therapeutic value of glutamine in glutamine synthetase deficiency and rare diseases associated with mitochondrial dysfunction and reviews the evidence-based applications of glutamine in severe trauma and burns, radiotherapy-induced oral mucositis in head and neck cancer, the perioperative period of elective gastrointestinal surgery, sickle cell disease, and short bowel syndrome, aiming to provide updated and comprehensive evidence-based references for clinical practice.

Key words

Glutamine / Inherited metabolic disorders / Rare diseases / Amino acid / Severe burn / Radiotherapy-induced mucositis / Sickle cell disease / Intestinal barrier

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Sang Yuting, Yang Yanling, Sun Meng. Applications of glutamine in disease prevention and treatment[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(3): 342-347 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.03.002

References

[1] 杨艳玲,张尧.代谢加减法: 营养干预与防病治病之道[M].马未萌,张婧韬,孙芳,等. 维持生命的氨基酸及其代谢异常. 北京:中国人口与健康出版社, 2026:173-188.
[2] CRUZAT V, MACEDO ROGERO M, NOEL KEANE K, et al. Glutamine: metabolism and immune function, supplementation and clinical translation[J]. Nutrients,2018,10(11): 1564.
[3] EELEN G, DUBOIS C, CANTELMO A R, et al. Role of glutamine synthetase in angiogenesis beyond glutamine synthesis[J]. Nature,2018, 561(7721): 63-69.
[4] PARRY-BILLINGS M, EVANS J, CALDER P C, et al. Does glutamine contribute to immunosuppression after major burns[J]. Lancet,1990,336(8714):523-525.
[5] OUDEMANS-VAN STRAATEN H M, BOSMAN R J, TRESKES M, et al. Plasma glutamine depletion and patient outcome in acute ICU admissions[J]. Intensive Care Med, 2001,27(1): 84-90.
[6] 周业平,蒋朱明,孙永华,等. 谷氨酰胺双肽改善烧伤患者切痂术后肠粘膜通透性、内毒素血症和预后的研究[J]. 中国临床营养杂志,2003,11(1):14-18.
[7] HÄBERLE J, GÖRG B, RUTSCH F, et al. Congenital glutamine deficiency with glutamine synthetase mutations[J]. N Engl J Med,2005,353(18):1926-1933.
[8] HÄBERLE J, SHAHBECK N, IBRAHIM K, et al. Natural course of glutamine synthetase deficiency in a 3 year old patient[J]. Mol Genet Metab, 2011,103(1): 89-91.
[9] HÄBERLE J, SHAHBECK N, IBRAHIM K, et al. Glutamine supplementation in a child with inherited GS deficiency improves the clinical status and partially corrects the peripheral and central amino acid imbalance[J]. Orphanet J Rare Dis, 2012,7: 48.
[10] GUERRERO-MOLINA M P, MORALES-CONEJO M, DELMIRO A, et al. High-dose oral glutamine supplementation reduces elevated glutamate levels in cerebrospinal fluid in patients with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes syndrome[J]. Eur J Neurol, 2023, 30(2):538-547.
[11] DIQUIGIOVANNI C, RIZZARDI N, CATALDI-STAGETTI E, et al. Glutamine supplementation as a novel metabolic therapeutic strategy for LIG3-dependent chronic intestinal pseudo-obstruction[J]. Gastroenterology, 2025,168(1): 68-83.
[12] GARREL D, PATENAUDE J, NEDELEC B, et al. Decreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: a prospective, controlled, randomized clinical trial[J]. Crit Care Med, 2003,31(10): 2444-2449.
[13] 中华医学会肠外肠内营养学分会. 中国成人患者肠外肠内营养临床应用指南(2023版)[J]. 中华医学杂志,2023,103(13):946-974.
[14] 肠外肠内营养学分会指南与规范编委会. 成人烧伤与临床营养支持[J]. 中国临床营养杂志,2007,15(6): 337-339.
[15] 朱明炜,杨桦,陈伟,等. 静脉用丙氨酰-谷氨酰胺双肽临床应用专家共识(2021)[J]. 中华临床营养杂志,2021,29(4):193-200.
[16] SINGER P, BLASER A R, BERGER M M, et al. ESPEN guideline on clinical nutrition in the intensive care unit[J]. Clin Nutr, 2019,38(1): 48-79.
[17] 卫彬彬,肖苗,孙哲,等.鼻咽癌放射治疗联合化学治疗所致口腔黏膜炎的防治[J]. 国际口腔医学杂志,2019,46 (5): 558-564.
[18] ELAD S, CHENG K K F, LALLA R V, et al. Guidelines leadership group of the multinational association of supportive care in cancer and international society of oral oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy[J]. Cancer, 2020,126(19): 4423-4431.
[19] YOSHIDA S, MATSUI M, SHIROUZU Y, et al. Effects of glutamine supplements and radiochemotherapy on systemic immune and gut barrier function in patients with advanced esophageal cancer[J]. Ann Surg, 1998,227(4): 485-491.
[20] PACHÓN IBÁÑEZ J, PEREIRA CUNILL J L, OSORIO GÓMEZ G F, et al. Prevention of oral mucositis secondary to antineoplastic treatments in head and neck cancer by supplementation with oral glutamine[J]. Nutr Hosp,2018,35(2):428-433.
[21] RUBIO I, SUVA L J, TODOROVA V, et al. Oral glutamine reduces radiation morbidity in breast conservation surgery[J]. JPEN J Parenter Enteral Nutr, 2013,37(5): 623-630.
[22] MUSCARITOLI M, ARENDS J, BACHMANN P, et al. ESPEN practical guideline: Clinical Nutrition in cancer[J]. Clin Nutr, 2021,40(5): 2898-2913.
[23] 中华医学会肠外肠内营养学分会. 肿瘤患者营养支持指南[J]. 中华外科杂志,2017,55(11):801-829.
[24] HU J, SHI Y, WANG C, et al. Role of intestinal trefoil factor in protecting intestinal epithelial cells from burn-induced injury[J]. Erratum in: Sci Rep, 2020,10(1):12741.
[25] KANG K, SHU X L, ZHANG Y S, et al. Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials[J]. Chin Med J (Engl), 2015,128(2): 245-251.
[26] HUANG Y, YANG X Z, QIN S H, et al;. Effect of perioperative glutamine-enriched nutritional support on patients with colorectal cancer: a systematic review and meta-analysis[J]. World J Gastrointest Surg, 2025,17(12): 112256.
[27] 中国加速康复外科专家组. 中国加速康复外科围手术期营养支持专家共识(2022版)[J]. 中华胃肠外科杂志, 2022,25(6): 461-468.
[28] 唐夏玉. 谷氨酰胺对肠梗阻患者围术期的营养作用研究[J]. 中国实用医刊,2014,41(14):96-97.
[29] JAFRI F, SEONG G, JANG T, et al. L-glutamine for sickle cell disease: more than reducing redox[J]. Ann Hematol, 2022,101(8): 1645-1654.
[30] NIIHARA Y, MILLER S T, KANTER J, et al. Investigators of the phase 3 trial of l-glutamine in sickle cell disease. a phase 3 trial of l-glutamine in sickle cell disease[J]. N Engl J Med, 2018,379(3): 226-235.
[31] WALES P W, NASR A, DE SILVA N, et al. Human growth hormone and glutamine for patients with short bowel syndrome[J]. Cochrane Database Syst Rev, 2010(6): CD006321.
[32] DAWSON S L, TODD E, WARD A C. The interplay of nutrition, the gut microbiota and immunity and its contribution to human disease[J]. Biomedicines, 2025,13(2): 329.
[33] GONG Z Y, YUAN Z Q, DONG Z W, et al. Glutamine with probiotics attenuates intestinal inflammation and oxidative stress in a rat burn injury model through altered iNOS gene aberrant methylation[J]. Am J Transl Res, 2017,9(5):2535-2547.
[34] 中华医学会老年医学分会,中国医师协会老年医学科医师分会,《中华老年医学杂志》编辑委员会. 中国老年危重患者营养支持治疗指南(2023)[J]. 中华老年医学杂志,2023,42(9):1009-1028.
[35] 孙珂岱,董志伟,陈婧,等. 严重烧伤患者早期口服混合肠内营养剂对肠黏膜屏障的作用[J]. 中华烧伤杂志,2015,31(1):25-29.
[36] 李宇飞,赵挺威,乐文涛,等. 谷氨酰胺与肠道损伤的关系及相关机制的研究进展[J]. 国际外科学杂志,2024,51(5):354-360.
[37] ALTMAN B J, STINE Z E, DANG C V. From Krebs to clinic: glutamine metabolism to cancer therapy[J]. Erratum in: Nat Rev Cancer, 2016, 16(11):749.
[38] 汪红艳,吕银. 放化疗所致口腔黏膜炎的干预治疗[J]. 国际肿瘤学杂志,2008,35(6):428-431.
[39] TSUJIMOTO T, YAMAMOTO Y, WASA M, et al. L-glutamine decreases the severity of mucositis induced by chemoradiotherapy in patients with locally advanced head and neck cancer: a double-blind, randomized, placebo-controlled trial[J]. Oncol Rep, 2015,33(1):33-39.
[40] ACHAMRAH N, DÉCHELOTTE P, COËFFIER M. Glutamine and the regulation of intestinal permeability: from bench to bedside[J]. Curr Opin Clin Nutr Metab Care, 2017,20(1):86-91.
[41] ZHANG S, LI X, YUAN T, et al. Glutamine inhibits inflammation, oxidative stress, and apoptosis and ameliorates hyperoxic lung injury[J]. J Physiol Biochem, 2023,79(3):613-623.