精氨酸
氨基酸
医学
谷氨酰胺
精氨酸酶
囊性纤维化
分解代谢
生物化学
内科学
新陈代谢
生物
作者
Claudia R. Morris,Jill Hamilton‐Reeves,Robert G. Martindale,Menaka Sarav,María Isabel Toulson Davisson Correia
标识
DOI:10.1177/0884533617691250
摘要
Nonessential amino acids are synthesized de novo and therefore not diet dependent. In contrast, essential amino acids must be obtained through nutrition since they cannot be synthesized internally. Several nonessential amino acids may become essential under conditions of stress and catabolic states when the capacity of endogenous amino acid synthesis is exceeded. Arginine and glutamine are 2 such conditionally essential amino acids and are the focus of this review. Low arginine bioavailability plays a pivotal role in the pathogenesis of a growing number of varied diseases, including sickle cell disease, thalassemia, malaria, acute asthma, cystic fibrosis, pulmonary hypertension, cardiovascular disease, certain cancers, and trauma, among others. Catabolism of arginine by arginase enzymes is the most common cause of an acquired arginine deficiency syndrome, frequently contributing to endothelial dysfunction and/or T‐cell dysfunction, depending on the clinical scenario and disease state. Glutamine, an arginine precursor, is one of the most abundant amino acids in the body and, like arginine, becomes deficient in several conditions of stress, including critical illness, trauma, infection, cancer, and gastrointestinal disorders. At‐risk populations are discussed together with therapeutic options that target these specific acquired amino acid deficiencies.
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