![]() ![]() It plays a role in the modulation of intracellular free calcium concentration, and although it is one of the few amino acids not incorporated into proteins, taurine is one of the most abundant amino acids in the brain, retina, muscle tissue, and organs throughout the body. However, under situations of extreme stress, endogenous supply is not enough and a conditional deficiency develops it is therefore ‘conditionally essential’ 8.Taurine is an organic osmolyte involved in cell volume regulation, and provides a substrate for the formation of bile salts. In most situations, glutamine is readily synthesized hence, it has been classified as a dietary nonessential amino acid. ![]() Glutamine is produced by the lung and the brain, but the skeletal muscle is the most important glutamine store, which, together with its ability to synthesize glutamine de novo, makes it the most important source of glutamine for the bloodstream. The ability of the liver to consume or release glutamine, along with opposite fluxes of glutamine and alanine in the splanchnic bed, has recently been suggested as evidence for an efficient N-sparing mechanism 7. Glutamine regulates DNA synthesis, a significant contributor to gluconeogenesis and a precursor for glucosamine, glutathione, and arginine synthesis. Glutamine appears to be most important for the integrity and function of metabolically active tissues 6. Thereafter, circulating glutamine is preferentially taken up by the liver, kidneys, gut mucosa, central nervous system, and immune cells 5. Under physiological conditions, ∼90 g of glutamine appears in the bloodstream daily only 10 g are derived from oral intake and the rest from the body muscles. The nutritional importance of glutamine is that it is synthesized by the cytosolic glutamine synthetase in many tissues. The first proper decryption of glutamine was carried out by Schulze and Bosshard in their historical paper ‘Uber das Glutamin’ (On Glutamine) in 1883: ‘beetroots contain an amide of glutamic acid which decomposes during heating in the presence of acid, to ammonia and glutamic acid’ 4. Glutamine was first discovered in a letter to the editor of the Journal fur praktische Chemie ( The Journal of Applied Chemistry ), Ritthausen, in 1866 that reported on a newly discovered substance found in the proteins from lupine and almond: ‘The new body which is formed during boiling of gluten in the presence of sulphuric acid, apart from tyrosine and leucine, is a monobasic nitrogen-containing acid’ 3. Glutamine, which is considered one of the immunonutrients, is the most abundant amino acid in the extracellular and intracellular compartments, contributing toward more than 50% of the body’s free amino acid pool. The term ‘immunonutriton’, and later ‘immunomodulators’, is applied for specific nutrients that modulate the inflammatory or the immune response and affect clinical outcomes 2. ![]() Their presence in the regimen decreases the incidence of sepsis and improves the overall function of the immune system.Įarly death in the intensive care unit (ICU) is usually because of a primary organ insult, but later death occurs because of multiple organ failure and is ‘associated’ with the development of secondary infections 1. ![]() Glutamine and taurine are considered to be conditioned essential amino acids in the management of critically ill patients. The art and science of nutrition has evolved over the past decade, and amino acids play an important role in the nutritional aspect in intensive care units. ![]()
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