L-alanyl-L-glutamine also known as alanylglutamine, is a dipeptide molecule, consisting of L-glutamine and L-alanine, two amino acids. L-alanyl-L-glutamine is sometimes supplemented for prolonged physical exercise as it can enhance electrolyte absorption and improve endurance and performance.Tests on rodents suggest L-alanyl-L-glutamine is more successful at increasing muscular glutamine levels after supplementation than glutamine itself. This is because glutamine is absorbed better via the liver and intestines after supplementation. Since L-alanyl-L-glutamine is a dipeptide molecule it means that it contains more than one amino acid for the intestines to absorb,allowing glutamine to reach the muscles.
Adding L-alanyl-L-glutamine to any rehydration solution will be significantly more effective at increasing water and electrolyte absorption than consuming either a glutamine or glucose-containing solution.Current studies on L-alanyl-L-glutamine use a dose of 1-3g a day. Over dosage of L-alanyl-L-glutamine may result in chills, nausea and vomiting.Precautions need to be taken with patients who suffer from severe hepatic impairment, severe metabolic acidosis as it may contradict the medication. There are no reported side effects of the drug.Following the prescribed dosage of approximately 231 and 266 mg of L-alanyl-L-glutamine per pound of body weight per day for men and women.
Under these conditions,L-glutamine becomes an essential amino acid and must be supplied to the body in order to prevent breakdown of muscle tissue, immune dysfunction and compromise of the gut mucosal barrier function with consequent bacterial translocation into the body. L-glutamine is arguably the most needed amino acid and, indeed,one of the most needed nutrients under these circumstances.
Until recently, L-glutamine was lacking from TPN. The reason for this is because L-glutamine is not very soluble in water 1 g dissolves in 20.8 mL of water at 30C and L-glutamine is unstable in solution. The problem has been solved by the synthesis of glutamine containing dipeptides, which are very soluble in water and stable in solution.
Two (2) synthetic glutamine-containing dipeptides that may be used in TPN areL-alanyl-L-glutamine (Ala-Gln) and glycyl-L-glutamine (Gly-Gln). The molecular weight of Ala-Gln is 217.24 daltons and L-glutamine comprises 67% of thedipeptide. L-glutamine comprises 72% of Gly-Gln and its molecular weight is203.22 daltons.
USES OF L-ALANYL-L-GLUTAMINE IN DETAILS
L-alanyl-L-glutamine is used as nutritional supplement to rebuild muscle tissue, improve intestinal health and immune system.
As part of an IV parenteral nutrition regimen
Adult: As solution containing L-alanyl-Lglutamine 200 mg in each ml. Usual dose: 0.3-0.4 g/kg/day.Dose depends on severity of the catabolic state and amino acid requirement; notto exceed 2 g amino acids/kg/day in parenteral nutrition; amount of amino acids supplied through L-alanyl-L-glutamine should not exceed 20% of the total supply. To be mixed with a compatible amino acid carrier solution or an amino acid containing infusion regimen before admin. Max treatment duration: 3 wk.
L-ALANYL-L-GLUTAMINE SIDE EFFECTS
There are rare reports of constipation and bloating with high-dose glutamine peptides in TPN.
Glutamine peptides are contra indicated in those hypersensitive to any component of L-alanyl-l-glutamine. L-alanyl-l-glutamine should not be administered to patient with severe renal [creatinine clearance (CrCl <25 mL/min)] and hepatic insufficiency, and severe metabolic acidosis.