The oral glutamine challenge in liver cirrhosis

Abstract

Oral glutamine challenge is a test which aims to measure increase in blood ammonia after glutamine intake, what is similar to the situation that occurs after a protein meal. Oral glutamine challenge induces an increase in blood ammonia in patients with cirrhosis but not in healthy control or transplanted subjects. A pathological response curve for glutamine tolerance is defined as an ammonia rise to 128 mg/dl at 60 min after the glutamine ingestion. No serious adverse effects have been described in the different published studies. Oral glutamine challenge is able to predict minimal hepatic encephalopathy, as well as is associated with a poor survival. On the other hand, ammonia is mainly produced by glutaminase. Therefore, glutaminase enzyme is an excellent target to develop new drugs that reduced its activity.