1. L-Alanyl-L-Glutamine and craniocerebral injury
Gln can promote protein synthesis, improve nutritional status, protect the barrier function of intestinal mucosa, stimulate the immune system, and enhance the immune function of patients with traumatic brain injury. And it can effectively improve the nutritional status of patients with craniocerebral injury, and promote prognosis and rehabilitation.
Formulas containing glutamine are recommended for patients with traumatic brain injury.
2. L-Alanyl-L-Glutamine and critical illness
Early administration of Gln-enhanced enteral nutrition can prevent intestinal infection and reduce the risk of pneumonia and sepsis in trauma patients. Reduce the hospitalization time of patients and reduce hospitalization costs. For patients with severe trauma, glutamine (0.2-0.3 g/kg/d) was supplemented through the intestines 5 days before enteral nutrition support treatment. During the healing of complex wounds, the use of glutamine can be appropriately extended for 10-15 days.
L-Alanyl-L-Glutamine can reduce the activity of plasma DAO after severe burns, reduce the degree of intestinal mucosal damage, and promote intestinal mucosal repair. For patients with burns whose body surface area is greater than 20%, glutamine (0.3-0.5 g/kg/d) should be supplemented through the intestines during enteral nutrition support for 10-15 days.
Except for burn and trauma patients, additional glutamine supplementation is not recommended for other critically ill patients.
3. L-Alanyl-L-Glutamine and surgery
For postoperative patients with insufficient enteral nutrition supply and parenteral nutrition supplementation, 0.5 g/kg/d of glutamine can be supplemented parenterally. However, routine oral glutamine-rich formulas are not recommended for postoperative patients.
Oral administration of formula containing glutamine in adult patients with parenteral fistula can promote fistula closure and reduce mortality. Oral administration of glutamine/glutamine-containing formulations alone in patients with pressure ulcers promotes wound healing.
4. L-Alanyl-L-Glutamine and acute pancreatitis
Nutritional support rich in Gln has a better curative effect on the traditional treatment of acute severe pancreatitis, and parenteral Gln supplementation can increase plasma albumin levels and reduce plasma C-reactive protein levels and the incidence of infection compared with enteral Gln supplementation.
For acute pancreatitis (supplementation with alanyl-glutamine dipeptide injection in the form of parenteral nutrition, >0.30 g/kg/d), adding glutamine to enteral nutrition is not recommended.
5. L-Alanyl-L-Glutamine and Tumor
Gln can reduce the severity of chemotherapy-induced mucositis in patients with esophageal cancer, and can reduce the mucositis caused by radiotherapy and chemotherapy in patients with head and neck cancer. Oral administration of Gln can effectively prevent lymphopenia and reduce intestinal permeability in patients with esophageal cancer during radiotherapy. For malnourished patients undergoing major tumor surgery, it is recommended to use oral nutritional preparations containing four main immunonutrients (glutamine, arginine, nucleic acids, and essential fatty acids) in addition to conventional nutritional therapy.