Plasma glutathione of HIV⁺ patients responded positively and differently to dietary supplementation with cysteine or glutamine.

Maria Dorotéia Borges-Santos, Fernando Moreto, Paulo Câmara Marques Pereira, Yong Ming-Yu, Roberto Carlos Burini

Journal: Nutrition (Burbank, Los Angeles County, Calif.) 2012;28(7-8):753-6

PMID: 22261571

Plain Language Summary

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HIV patients have low concentrations of antioxidant nutrients including glutathione, which may contribute to disease progression. The aim of the study was to investigate the response of glutathione synthesis to cysteine and glutamine supplements in HIV patients compared with healthy controls. 12 HIV patients and 20 healthy controls were randomly assigned to 7 days of dietary supplements containing either 1g N-acetylcysteine (NAC) or 20g glutamine, whilst eating their usual diet. Blood levels of sulphur-containing amino acids, glutathione and its precursors were measured at the start and end of the study period. NAC supplementation increased levels of sulphur-containing amino acids and glutathione in the HIV patients. Glutamine supplementation resulted in increased glutathione, glutamine and glycine to levels that were equal to those in the healthy subjects. The authors concluded that glutathione may be increased by NAC or glutamine supplementation, with NAC acting by increasing cysteine levels and glutamine likely acting by replenishing the glycine pool.

Abstract

OBJECTIVE

Patients with positivity for the human immunodeficiency virus (HIV⁺) present low concentrations of antioxidant nutrients, including total glutathione (GSH) and its precursors. We investigated the responses of the sulfur-containing amino acid pathway to cysteine and glutamine (Gln) dietary supplements in patients with HIV⁺ compared with healthy controls.

METHODS

Twelve treated patients (six men and six women, 22-45 y old) and 20 healthy controls (10 men and 10 women, 20-59 y old) were randomly assigned to 7-d dietary supplements containing N-acetylcysteine (NAC; 1 g/d) or Gln (20 g/d), with a 7-d washout period ingesting their usual diet. Blood samples were drawn after an overnight fast. High-performance liquid chromatographic plasma analysis of sulfur-containing amino acids (methionine, homocysteine, cysteine, and taurine), GSH, oxidized GSH, and serine, glycine, glutamic acid, and Gln was carried out moments before and after 7-d supplementations. Statistical comparisons were undertaken between groups and between dietary supplements (P < 0.05).

RESULTS

Patients with HIV⁺ showed higher oxidized GSH and lower concentrations of GSH and all amino acids except homocysteine. The HIV⁺ group responded to the NAC by increased levels of sulfur-containing amino acids and GSH and equalized taurine and GSH levels in the control group. The Gln supplements also equalized the levels of GSH, Gln, and glycine in the control group.

CONCLUSION

An increase in GSH may be attained by NAC or Gln supplementation, with NAC acting by increasing cysteine levels and Gln likely acting by replenishing the glycine pool (trial registered at http://www.clinicaltrials.gov, identifier NCT00910442).

Copyright © 2012 Elsevier Inc. All rights reserved.

Address: Department of Public Health, Botucatu Medical School, UNESP-São Paulo State University, Botucatu, São Paulo, Brazil.

Patient Centred Factor

Clinical Imbalances

Laboratory Testing

Modifiable Lifestyle Factors

Jadad Score

Allocation Concealment

Nutrition Evidence Keywords

Bioactive Substances

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