Aminosäuren in der klinischen Ernährung - Entwicklungen der letzten zwei Jahrzehnte

Zusammenfassung

In den letzten zwei Jahrzehnten erfolgte eine generelle Neubewertung von Aminosäuren als Bestandteil einer optimalen Ernährungstherapie in verschiedenen Krankheitssituationen. Grundlegende physiologische Studien belegen eindrucksvoll, dass einige früher als „nicht essenziell” eingeordnete Aminosäuren (z. B. Glutamin, Arginin, Cystein) aufgrund eines erhöhten Bedarfs und/oder einer nicht mehr genügenden körpereigenen Synthese als bedingt unentbehrliche Nährstoffe einzustufen sind. Unabhängig von ihrem nutritiven Wert, besitzen verschiedene Aminosäuren zudem zusätzliche „pharmakologische” Eigenschaften, wodurch die Integrität und Funktion von Organen/Geweben beeinflusst und die Immunantwort moduliert wird. Die vorliegende Übersicht fasst neue Aspekte des Aminosäurenstoffwechsels in pathophysiologischen Situationen zusammen, beschreibt die Konsequenzen einer nicht adäquaten Zufuhr und beleuchtet optimale Ernährungsstrategien zur Unterstützung des Heilungsprozesses und des outcome.

Abstract

Within the last two decades, the role of amino acids in the frame of optimum nutrition support of various patient groups has been generally revised. Basic physiological studies clearly indicate that certain amino acids (e.g. glutamine, arginine, cysteine) formerly valued as „non-essential”, have to be considered as conditionally indispensable substrates in diseased state due to increased needs and/or no more sufficient endogenous synthesis. Apart from their nutritive value, various amino acids possess additional „pharmacological” functions influencing integrity and function of organs/tissues as well as modulating the immune response. The present review summarizes the actual knowledge of selected amino acid metabolism in diseased states, describes the consequence of inadequate nutrition support and highlights optimum nutrition strategies to support patient recovery and outcome.

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