Sobre las propiedades y los usos de la glutamina en la citorreducción tumoral

María Belén Andrade Hernández; Marcela Alejandra Chaug Solórzano; Francisco Xavier Andino Hernández; Dolores Rodríguez Veintimilla

Sobre las propiedades y los usos de la glutamina en la citorreducción tumoral

María Belén Andrade Hernández, Marcela Alejandra Chaug Solórzano, Francisco Xavier Andino Hernández, Dolores Rodríguez Veintimilla

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Resumen

La glutamina (Gln) participa en numerosas funciones biológicas que recorren desde el mantenimiento de la homeostasis del nitrógeno (N) corporal hasta la inmunocompetencia y la respuesta a la agresión. La Gln ha sido reconocida como el aminoácido condicionalmente esencial más abundante de la economía. Las concentraciones séricas de Gln se depletan rápidamente durante la agresión, la injuria y la sepsis. La célula cancerosa actúa como una trampa de N, y le disputa a la célula sana la disponibilidad y el acceso a nutrientes, la Gln entre ellos. La depleción tisular de Gln pudiera afectar la efectividad de las distintas modalidades de la citorreducción tumoral (CRT). Se ha propuesto la suplementación exógena de Gln para paliar las concentraciones tisulares disminuidas del aminoácido, restablecer las funciones biológicas afectadas, y asegurar la efectividad de los esquemas citorreductores. La suplementación exógena de Gln también podría servir para promover el arraigo y la proliferación de las subpoblaciones leucocitarias de neutrófilos tras el trasplante de médula ósea (TMO). Una tercera aplicación de la suplementación exógena con Gln sería la paliación de la mucositis, la diarrea, y otros efectos colaterales de la CRT. Se podrían beneficiar de la suplementación exógena con Gln aquellos enfermos en los que se anticiparía la interrupción de la CRT debido a la pérdida experimentada de peso, la reducción de la masa magra corporal, y el riesgo incrementado de infección y sepsis. Las indicaciones de la suplementación exógena con Gln deben extenderse a las necesarias consideraciones econométricas sobre la inclusión de esta modalidad de apoyo nutricional en la CRT.

Palabras clave

Glutamina; Citorreducción tumoral; Cáncer; Cirugía; Trasplante de médula ósea; Quimioterapia; Radioterapia

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