Two amino acids, glutamine and arginine, appear to boost the immune system and may improve the outcomes of HIV-infected patients, burn victims, and those undergoing surgery. They may also be helpful for some cancer patients. These results, reported in the July issue of Medicine & Science in Sports & Exercise, beg the question of whether these important "immunonutrients" might help protect against getting a disease.
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Glutamine is required for three body systems, says Ronenn Roubenoff, MD, MHS. "The gut cell, kidney cells, and immune cells. Any situation where those are stressed, it makes sense to provide more," says Roubenoff, chief of exercise physiology at the Human Nutrition Research Center at Tufts University in Boston, who provided WebMD with an objective assessment of the study. However, does this translate to a healthy person needing to take supplements?
"Once you have a deficiency fixed, there is no linear extrapolation," Roubenoff says. In other words, stockpiling against a possible deficiency won't necessarily work. Also, since amino acids are protein, they could harm kidneys or, at the very least, produce very expensive urine.
Researchers from the University of Alberta in Edmonton reviewed many medical studies in which arginine and glutamine were used to treat various conditions and diseases. As a result of their review, they report that there may be a rationale for naming these amino acids "immunonutrients." They found that the nutrients might be considered "conditionally essential" in the treatment of those conditions in which the amino acids are depleted.
Some of the medical studies they reviewed showed that burn victims who were given glutamine and arginine supplements had fewer wound infections, shorter hospital stays, and fewer bacterial infections. Infection and hospital stays were also reduced in surgery and trauma patients. The researchers also found that production of lymphocytes and T cells -- types of immune cells that fight infection -- increased with supplementation. Other studies showed that patients who received supplements had fewer abdominal abscesses and less pneumonia.
The amino acids appear to play a role in cancer and HIV, although it's not as clear-cut as in other conditions. They appear to improve weight gain in HIV patients and prevent clinical infections and reduce hospital stays for cancer patients.
None of the studies reviewed, which included both human and animal studies, showed clear benefits of amino acid supplementation. Many of them, particularly those involving cancer and HIV, showed no effect of the nutrients at all.
Lewis Mehl-Medrano, MD, tells WebMD that research from Finland and Russia is showing strong evidence for using amino acids in malignant melanoma and other cancers, seizure disorders, and autism. He's applying a lot of this research to his own practice as director of family medicine at Beth Israel's Center for Health and Healing in New York City.
These nutrients function in both the immune system that is present from birth and the part of the immune system that is acquired. The acquired immune system is built up to guard against disease through exposure to various disease-bearing organisms. This is why we aren't likely to get a certain strain of flu if we've already had that particular strain before.
When the immune system is suppressed or compromised, both our natural and acquired immune systems get overwhelmed with infection. It is thought that these immunonutrients can bolster a system already beleaguered by infection, disease, or trauma.
"[Glutamine] and [arginine] are essential for optimal functioning of immune cells," the researchers write. "Clinical data support the dietary 'essentiality' of these two nutrients for improving immune response in most immunosuppressive states that are associated with high rates of infection."
"How this translates to ordinary people, I'm really not sure," Mehl-Medrano tells WebMD. "There's the argument that if it's good for someone with an illness, then it should be good for everyone to prevent that illness, but we don't know if that's true."
The researchers appear to agree, since their extensive review of the medical literature did not show that normal, healthy individuals taking these amino acids will gain an edge, or that the amino acids will prevent disease or infection. "However, for those who suffer from chronic or acute infections, there is considerable evidence that supplementation ... may be beneficial," they write.
The challenge for further research, the authors suggest, is to get a clear picture of how glutamine and arginine work and the conditions under which their immunonutrient value may be most beneficial.