TY - JOUR
T1 - Acquired Amino Acid Deficiencies
T2 - A Focus on Arginine and Glutamine
AU - Morris, Claudia R.
AU - Hamilton-Reeves, Jill
AU - Martindale, Robert G.
AU - Sarav, Menaka
AU - Ochoa Gautier, Juan B.
N1 - Publisher Copyright:
© The American Society for Parenteral and Enteral Nutrition.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Nonessential amino acids are synthesized de novo and therefore not diet dependent. In contrast, essential amino acids must be obtained through nutrition since they cannot be synthesized internally. Several nonessential amino acids may become essential under conditions of stress and catabolic states when the capacity of endogenous amino acid synthesis is exceeded. Arginine and glutamine are 2 such conditionally essential amino acids and are the focus of this review. Low arginine bioavailability plays a pivotal role in the pathogenesis of a growing number of varied diseases, including sickle cell disease, thalassemia, malaria, acute asthma, cystic fibrosis, pulmonary hypertension, cardiovascular disease, certain cancers, and trauma, among others. Catabolism of arginine by arginase enzymes is the most common cause of an acquired arginine deficiency syndrome, frequently contributing to endothelial dysfunction and/or T-cell dysfunction, depending on the clinical scenario and disease state. Glutamine, an arginine precursor, is one of the most abundant amino acids in the body and, like arginine, becomes deficient in several conditions of stress, including critical illness, trauma, infection, cancer, and gastrointestinal disorders. At-risk populations are discussed together with therapeutic options that target these specific acquired amino acid deficiencies.
AB - Nonessential amino acids are synthesized de novo and therefore not diet dependent. In contrast, essential amino acids must be obtained through nutrition since they cannot be synthesized internally. Several nonessential amino acids may become essential under conditions of stress and catabolic states when the capacity of endogenous amino acid synthesis is exceeded. Arginine and glutamine are 2 such conditionally essential amino acids and are the focus of this review. Low arginine bioavailability plays a pivotal role in the pathogenesis of a growing number of varied diseases, including sickle cell disease, thalassemia, malaria, acute asthma, cystic fibrosis, pulmonary hypertension, cardiovascular disease, certain cancers, and trauma, among others. Catabolism of arginine by arginase enzymes is the most common cause of an acquired arginine deficiency syndrome, frequently contributing to endothelial dysfunction and/or T-cell dysfunction, depending on the clinical scenario and disease state. Glutamine, an arginine precursor, is one of the most abundant amino acids in the body and, like arginine, becomes deficient in several conditions of stress, including critical illness, trauma, infection, cancer, and gastrointestinal disorders. At-risk populations are discussed together with therapeutic options that target these specific acquired amino acid deficiencies.
KW - arginase
KW - arginine
KW - essential amino acids
KW - glutamine
KW - hemolysis
KW - myeloid-derived suppressor cells
KW - sickle cell disease
KW - trauma
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U2 - 10.1177/0884533617691250
DO - 10.1177/0884533617691250
M3 - Article
C2 - 28388380
AN - SCOPUS:85018767661
SN - 0884-5336
VL - 32
SP - 30S-47S
JO - Nutrition in Clinical Practice
JF - Nutrition in Clinical Practice
IS - 1_suppl
ER -