Malnutrition is a risk factor for
infection, compromising immune response.
Glutamine (Gln) protects the lungs and distal organs in well-nourished septic and nonseptic conditions; however, no study to date has analyzed the effects of Gln in the presence of
sepsis and
malnutrition. In the present work, we tested the hypothesis that
early therapy with intravenous Gln prevents lung and distal organ damage in septic malnourished rats.
Protein-energy malnutrition was induced in male Wistar rats for 4 weeks. At the end of 4 weeks, malnourished animals were assigned to a
sepsis-inducing cecal
ligation and
puncture group or a
sham surgery group. One hour after surgery, animals were given saline (Sal) or L-alanyl-
L-glutamine (Gln) intravenously. In addition, a control group (C) was set up with rats fed ad libitum, not submitted to surgery or treatment. Forty-eight hours after surgery, in
malnutrition-
sham rats, Gln
therapy lessened neutrophil lung infiltration and apoptosis in lung and liver. In
malnutrition-cecal
ligation and
puncture rats, Gln
therapy yielded (a) reduced static lung elastance, alveolar collapse,
inflammation (neutrophil infiltration,
interleukin 6), and
collagen deposition; (b) repair of types I and II epithelial cells; (c) no significant changes in
heat shock protein 70 expression or heat shock factor 1 phosphorylation; (d) a greater number of M1 and M2 macrophages in lung tissue; and (e) less apoptosis in the lung, kidney, small intestine, and liver. In conclusion,
early therapy with intravenous Gln reduced
inflammation,
fibrosis, and apoptosis, minimizing lung and distal organ injury, in septic malnourished rats. These beneficial effects may be associated with macrophage activation in the lung.