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. 1994 Oct;70(4):732–735. doi: 10.1038/bjc.1994.385

5-fluorouracil and folinic acid-induced mucositis: no effect of oral glutamine supplementation.

S A Jebb 1, R J Osborne 1, T S Maughan 1, N Mohideen 1, P Mack 1, D Mort 1, M D Shelley 1, M Elia 1
PMCID: PMC2033386  PMID: 7917930

Abstract

In some clinical situations the endogenous production of glutamine may be insufficient to maintain optimal tissue structure and function such that glutamine becomes a conditionally essential amino acid. Studies in laboratory animals have demonstrated that glutamine supplementation can reduce the incidence and severity of cytotoxic-induced mucositis. This study examined the role of oral glutamine supplementation in the management of mucositis caused by 5-fluorouracil (5-FU) and folinic acid. Twenty-eight patients with gastrointestinal cancers were randomised to receive 16 g of glutamine per day for 8 days, or placebo, in a randomised double-blind trial before crossing over to the alternative supplement during the second treatment cycle. The supplement was well tolerated with no apparent adverse effects, but failed to have any significant effect on oral mucositis assessed by the patients or investigator. The possible reasons for this apparent lack of benefit are discussed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alfredsson G., Wiesel F. A., Lindberg M. Glutamate and glutamine in cerebrospinal fluid and serum from healthy volunteers--analytical aspects. J Chromatogr. 1988 Feb 26;424(2):378–384. doi: 10.1016/s0378-4347(00)81116-0. [DOI] [PubMed] [Google Scholar]
  2. Bergström J., Fürst P., Norée L. O., Vinnars E. Intracellular free amino acid concentration in human muscle tissue. J Appl Physiol. 1974 Jun;36(6):693–697. doi: 10.1152/jappl.1974.36.6.693. [DOI] [PubMed] [Google Scholar]
  3. Clark P. I., Slevin M. L. Allopurinol mouthwashes and 5-fluorouracil induced oral toxicity. Eur J Surg Oncol. 1985 Sep;11(3):267–268. [PubMed] [Google Scholar]
  4. Fox A. D., Kripke S. A., De Paula J., Berman J. M., Settle R. G., Rombeau J. L. Effect of a glutamine-supplemented enteral diet on methotrexate-induced enterocolitis. JPEN J Parenter Enteral Nutr. 1988 Jul-Aug;12(4):325–331. doi: 10.1177/0148607188012004325. [DOI] [PubMed] [Google Scholar]
  5. Klimberg V. S., Souba W. W., Salloum R. M., Plumley D. A., Cohen F. S., Dolson D. J., Bland K. I., Copeland E. M., 3rd Glutamine-enriched diets support muscle glutamine metabolism without stimulating tumor growth. J Surg Res. 1990 Apr;48(4):319–323. doi: 10.1016/0022-4804(90)90066-b. [DOI] [PubMed] [Google Scholar]
  6. Mahood D. J., Dose A. M., Loprinzi C. L., Veeder M. H., Athmann L. M., Therneau T. M., Sorensen J. M., Gainey D. K., Mailliard J. A., Gusa N. L. Inhibition of fluorouracil-induced stomatitis by oral cryotherapy. J Clin Oncol. 1991 Mar;9(3):449–452. doi: 10.1200/JCO.1991.9.3.449. [DOI] [PubMed] [Google Scholar]
  7. Poon M. A., O'Connell M. J., Moertel C. G., Wieand H. S., Cullinan S. A., Everson L. K., Krook J. E., Mailliard J. A., Laurie J. A., Tschetter L. K. Biochemical modulation of fluorouracil: evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma. J Clin Oncol. 1989 Oct;7(10):1407–1418. doi: 10.1200/JCO.1989.7.10.1407. [DOI] [PubMed] [Google Scholar]
  8. Schloerb P. R., Amare M. Total parenteral nutrition with glutamine in bone marrow transplantation and other clinical applications (a randomized, double-blind study) JPEN J Parenter Enteral Nutr. 1993 Sep-Oct;17(5):407–413. doi: 10.1177/0148607193017005407. [DOI] [PubMed] [Google Scholar]
  9. Windmueller H. G., Spaeth A. E. Uptake and metabolism of plasma glutamine by the small intestine. J Biol Chem. 1974 Aug 25;249(16):5070–5079. [PubMed] [Google Scholar]
  10. Ziegler T. R., Benfell K., Smith R. J., Young L. S., Brown E., Ferrari-Baliviera E., Lowe D. K., Wilmore D. W. Safety and metabolic effects of L-glutamine administration in humans. JPEN J Parenter Enteral Nutr. 1990 Jul-Aug;14(4 Suppl):137S–146S. doi: 10.1177/0148607190014004201. [DOI] [PubMed] [Google Scholar]
  11. Ziegler T. R., Young L. S., Benfell K., Scheltinga M., Hortos K., Bye R., Morrow F. D., Jacobs D. O., Smith R. J., Antin J. H. Clinical and metabolic efficacy of glutamine-supplemented parenteral nutrition after bone marrow transplantation. A randomized, double-blind, controlled study. Ann Intern Med. 1992 May 15;116(10):821–828. doi: 10.7326/0003-4819-116-10-821. [DOI] [PubMed] [Google Scholar]

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