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Am J Physiol Gastrointest Liver Physiol (December 27, 2007). doi:10.1152/ajpgi.00461.2007
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Submitted on October 5, 2007
Accepted on December 26, 2007

Corticosteroids increase glutamine utilization in human splanchnic bed

Ronan Thibault1, Susan Welch2, Nelly Mauras2, Brenda Sager2, Astride Altomare3, Morey W. Haymond4, and Dominique Darmaun5*

1 INRA, UMR 1280 Physiologie des Adaptations Nutritionnelles, Universite de Nantes, Centre de Recherche en Nutrition Humaine, Nantes, France; Department of Gastroenterology and Nutritional Support, CHU Hotel Dieu, Nantes, France
2 Nemours Children's Clinic, Jacksonville, Florida, United States
3 Jacksonville, Florida, United States; Nemours Children's Clinic, Jacksonville, Florida, United States
4 Department of Pediatrics - Nutrition, Baylor College of Medicine, Houston, Texas, United States
5 INRA, UMR 1280 Physiologie des Adaptations Nutritionnelles, Universite de Nantes, Centre de Recherche en Nutrition Humaine, Nantes, France; Nemours Children's Clinic, Jacksonville, Florida, United States; Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France

* To whom correspondence should be addressed. E-mail: ddarmaun{at}chu-nantes.fr.

Glutamine is the most abundant amino acid in the body and is extensively taken up in gut and liver in healthy humans. To determine whether glucocorticosteroids alter splanchnic glutamine metabolism, the effect of prednisone was assessed in healthy volunteers using isotope tracer methods. Two groups of healthy adults received 5-hr intravenous infusions of L-[1-14C]leucine and L-[2H5]glutamine, along with q. 20 min oral sips of tracer doses of L-[1-13C]glutamine in the fasting state, either: (a) at baseline (control group; n=6), or (b) after a 6-day course of 0.8 mg.kg-1.d-1 prednisone (prednisone group; n=8). Leucine and glutamine appearance rates (Ra) were determined from plasma [1-14C]-ketoisocaproate and [2H5]-glutamine, respectively; and leucine and glutamine oxidation from breath 14CO2 and 13CO2, respectively. Splanchnic glutamine extraction was estimated by the fraction of orally administered 13C-glutamine that failed to appear into systemic blood. Prednisone treatment: 1) did not affect leucine rate of appearance (Ra) or leucine oxidation; 2) increased plasma glutamine Ra, mostly due to enhanced glutamine de novo synthesis (median±IQ, 412±61 vs. 280±190 µmol.kg-1.h-1, P=0.003); and 3) increased the fraction of orally administered glutamine undergoing extraction in the splanchnic territory (64±6 vs. 42±12 %, P<0.05), without any change in the fraction of glutamine oxidized (mean±SE, 75±4 vs. 77±4 % %, NS). We conclude that high dose glucocorticosteriods increase in splanchnic bed the glutamine requirements. The role of such changes in patients receiving chronic corticoid treatment for inflammatory diseases or suffering from severe illness remain to be determined.







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