Glutamine for chemotherapy induced diarrhea: a meta-analysis

Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China.
Asia Pacific Journal of Clinical Nutrition (Impact Factor: 1.7). 06/2012; 21(3):380-5.
Source: PubMed


The clinical efficacy of glutamine in the control of chemotherapy-induced diarrhea remains controversial. We conducted a meta-analysis, including as many randomized control trails (RCTs) as possible, to clarify the effectiveness of prophylactic glutamine in patients requiring chemotherapy.
the Embase, MEDLINE, Cochrane Library, and BIOSIS databases were searched, and the included studies were RCTs that compared the use of prophylactic glutamine versus placebo in patients receiving chemotherapy. The main outcomes were diarrhea severity and duration.
a total of 298 patients in eight RCTs were reviewed (147 patients who received glutamine, and 151 patients who received placebo). There was a statistically significant difference in the duration of diarrhea (weighted mean difference (WMD), -1; 95% confidence interval (CI), -1.73, -0.26) between the two groups, but there was no significant difference in the severity of diarrhea (WMD, -0.49; 95% CI, -1.36, 0.39) between the groups.
we concluded that glutamine could reduce the duration of diarrhea but could not improve its severity.

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    ABSTRACT: Gastrointestinal mucositis is a major side effect of chemotherapy, leading to life quality reduction in patients and interrupting the therapy of cancer. Chimonanthus nitens var. salicifolius (CS) is a traditional Chinese herb for enteral disease. Considering the protective effect of CS on intestine, we hypothesize that the aqueous extract of CS could be benefcial to gastrointestinal mucositis. To verify this, a mouse mucositis model was induced by 5-Fluorouracil (5-Fu). Male Balb/C mice were treated with CS aqueous extract (5, 10, and 20 g/kg) or loperamide (0.2 mg/kg) intragastrically for 11 days, and the severity of mucositis was evaluated. Furthermore, the chemical compounds of CS aqueous extract were also analysed by high-performance liquid chromatography (HPLC). Our results demonstrated that CS aqueous extract improved mice body weight, diarrhoea, and faecal blood, maintained the liver function and intestinal length, alleviated villus shortening, and suppressed the apoptosis and inflammation in small intestine. We concluded that CS could protect mice against 5-Fu induced mucositis by inhibiting apoptosis and inflammation, and this protective effect might be associated with the 3 flavonoids (rutin, quercetin, and kaempferol) identified in CS aqueous extract.
    Evidence-based Complementary and Alternative Medicine 12/2013; 2013(4):789263. DOI:10.1155/2013/789263 · 1.88 Impact Factor


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