longed exhaustive exercise, since there will be
increased activity of the immune system, and an
increased number of cells involved in pro-
liferation to carry out the necessary repair. The
question therefore arises as to whether extra glut-
amine should be provided after exhaustive
exercise.
Evidence that both parenteral and enteral glut-
amine feeding can have beneficial effects comes
from several clinical studies: of particular rele-
vance to this chapter is the evidence that gluta-
mine has a beneficial effect upon some cells of the
162 nutrition and exercise
immune system in the patients investigated
(Table 11.3).Exercise, infections and
immunodepression
Strenuous exercise and
upper respiratory tract infections
Upper respiratory tract infections (URTI) occur
frequently in athletes after prolonged, exhaus-
tive exercise compared with the normal seden-Table 11.3Some beneficial effects of glutamine feeding upon the immune system.
Recipients Clinical situation Method of feeding Beneficial effects Reference
Humans Bone marrow TPN (l-glutamine) Decreased number of positive Ziegler et al. 1992, 1998
transplant microbial cultures
Decreased number of clinical
infections
Enhanced recovery of
circulating lymphocytes,
total T-lymphocytes, CD4
helper, CD8 suppressor
Humans Colorectal cancer TPN (glycyl- Enhanced postoperative O’Riordain et al. 1994
glutamine dipeptide) T-lymphocyte DNA synthesis
Humans Severe, acute TPN (glycyl- Enhanced T-cell response, O’Riordain et al. 1996
pancreatitis glutamine dipeptide) decreased interleukin 8
production
Rats Healthy, suppressed TPN (l-glutamine) Increased biliary concentration Burke et al. 1989
biliary of immunoglobulin A
immunoglobulin A normally suppressed by TPN
Rats Tumour-bearing TPN (alanyl- Increased phagocytic activity Kweon et al. 1991
glutamine dipeptide) of alveolar macrophages
Rats Tumour-bearing Oral Increased mitogenic response Shewchuk et al. 1997
in splenocytes, increased NK
cell numbers in spleen but not
activity
Rats Sepsis TPN (alanyl- Increased rate of lymphocyte Yoshida et al. 1992
glutamine dipeptide) proliferation and increased
number of lymphocytes
Rats Chemotherapy Oral Decreased sepsis defined as Klimberg et al. 1992
decreased white blood cell
count plus decreased positive
blood cultures
TPN, total parenteral nutrition.