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Open Access Highly Accessed Research article

L-Glutamine therapy reduces endothelial adhesion of sickle red blood cells to human umbilical vein endothelial cells

Yutaka Niihara1*, Neil M Matsui3, Yamin M Shen4, Dean A Akiyama1, Cage S Johnson5, M Alenor Sunga1, John Magpayo1, Stephen H Embury3, Vijay K Kalra4, Seong Ho Cho2 and Kouichi R Tanaka1

Author Affiliations

1 Department of Medicine, Harbor-UCLA Medical Center, UCLA School of Medicine, Torrance, CA USA

2 Department of Pediatrics, Harbor-UCLA Medical Center, UCLA School of Medicine, Torrance, CA USA

3 Department of Medicine, San Francisco General Hospital, UCSF School of Medicine, San Francisco, CA USA

4 Department of Biochemistry, USC Keck School of Medicine, Los Angeles CA USA

5 Medicine/Hematology, USC Keck School of Medicine, Los Angeles CA USA

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BMC Blood Disorders 2005, 5:4  doi:10.1186/1471-2326-5-4

Published: 25 July 2005

Abstract

Background

We have previously demonstrated that therapy with orally administered L-glutamine improves nicotinamide adenosine dinucleotide (NAD) redox potential of sickle red blood cells (RBC). On further analysis of L-glutamine therapy for sickle cell anemia patients, the effect of L-glutamine on adhesion of sickle RBC to human umbilical vein endothelial cells (HUVEC) was examined.

Methods

The first part of the experiment was conducted with the blood samples of the 5 adult sickle cell anemia patients who had been on L-glutamine therapy for at least 4 weeks on a dosage of 30 grams per day compared to those of patient control group. In the second part of the experiment 6 patients with sickle cell anemia were studied longitudinally. Five of these patients were treated with oral L-glutamine 30 grams daily and one was observed without treatment as the control. t-test and paired t-test were used for determination of statistical significance in cross-sectional and longitudinal studies respectively.

Results

In the first study, the mean adhesion to endothelial cells with the autologous plasma incubated cells were 0.97 ± 0.45 for the treated group and 1.91 ± 0.53 for the nontreated group (p < 0.02). Similarly with lipopolysaccharide (LPS) incubated cells the mean adhesion to endothelial cells were 1.39 ± 0.33 for the treated group and 2.80 ± 0.47 for the untreated group (p < 0.001). With the longitudinal experiment, mean decrease in the adhesion to endothelial cells was 1.13 ± 0.21 (p < 0.001) for the 5 treated patients whereas the control patient had slight increase in the adhesion to endothelial cells.

Conclusion

In these studies, oral L-glutamine administration consistently resulted in improvement of sickle RBC adhesion to HUVEC. These data suggest positive physiological effects of L-glutamine in sickle cell disease.