Glutamine: Metabolism and Immune Function, Supplementation and Clinical Translation

Figure 2: Intertissue glutamine production and utilisation in health and catabolic/hypercatabolic situations. Filled arrows indicate tissues that exhibit GS activity and thus produce glutamine; white arrows indicate tissues that exhibit GLS activity, and thus consume glutamine. In health and/or fed states, glutamine stores are in equilibrium in plasma/bloodstream and tissues, and are maintained constantly mainly by the liver and skeletal muscles, two major stores of glutamine in the body. On the other hand, cells of the immune system are extremely dependent on glucose and glutamine in situation (A), and even more in situation (B). Although the gut is a major site of glutamine consumption, in situation (B), there is a dramatic increase in glutamine consumption from both the luminal and basolateral membrane, when compared to situation (A). In addition, the liver switches the role of a major producer to a major glutamine consumer to maintain gluconeogenesis, and the whole body relies on the skeletal muscle’s ability/stores to maintain glutamine levels. However, this process is usually accompanied by a dramatic increase in muscle proteolysis, atrophy, and cachexia. The lungs and adipose tissue exhibit both GS and GLS enzymes, and hence can produce and consume glutamine in situations (A) and (B). The brain and the kidneys do not exhibit GS, only GLS, and hence are mainly dependent on plasma glutamine availability in situations (A) and (B).