PRESS RELEASE
28 06 1996
Faster recovery with
glutamine-enriched
nutritional solutions

For the first time, researchers have been able to show that a nutrient, glutamine, has a therapeutic effect. Glutamine's important role in the healing process showed up in several clinical studies during the 90s.
The addition of glutamine to intravenous nutritional solutions reduces mortality rates, shortens time in hospital, and speeds recovery of seriously-ill patients.
Researchers have now been successful in keeping glutamine stable in substantial quantities in repetition solutions for parenteral nutrition.
In September, Pharmacia & Upjohn will be arranging a seminar in Geneva, Switzerland, to present a new glutamine-based product. The seminar will be held in association with ESPEN, the international conference for Europe's leading experts in clinical nutrition.

Intensive-care patients who are in stress situations after serious accidents, surgery, etc, enter a catabolic condition in which they should not or cannot eat, so that they need to be fed either enterally, or parenterally using TPN (total parenteral nutrition) solutions.
The catabolic condition causes changes in hormone levels, which leads to a transfer of glutamine from the skeletal musculature to other organs. Glutamine uptake in the bowel increases by 75%, and the glutamine requirement of kidneys, liver, and immune system also increases. The result is serious glutamine depletion, which cannot be met from the patient's own resources.
Several clinical studies carried out in recent years have shown that an exogenous glutamine supply allows the body to recover more rapidly.

Clinical study
In a comparative study, the British physician Richard D Griffiths discovered reductions in mortality among patients treated with glutamine in their intravenous nutritive supply. Within a six-month period, 67% of patients treated with conventional feeds had died, compared with only 43% of those treated with glutamine-enriched feeds.

Improved gut function
The reasons for reduced mortality have been elucidated in other studies. In one such study (van der Hulst et al, 1993), improved gut function and reduced susceptibility to infection were demonstrated. The length of gut-wall villi was unchanged in patients treated with glutamine, but reduced when standard solutions were used.
Among bone-marrow transplant patients, 43% of those given standard TPN solutions developed a clinical infection, compared with 12% of those using glutamine-enriched drips. The same study (Ziegler et al, 1992) also showed reduced time in hospital among patients given glutamine-enriched solutions - approximately 29 as opposed to 36 days.
Further clinical studies have shown that glutamine additions have a notable anabolic effect in patients with reduced muscle protein synthesis after surgery.
For the first time, studies have shown that nutrition also has a therapeutic effect.

Glutamine instability
Glutamine is unstable, and is not very soluble in the quantities required. When combined with TPN solutions, it forms a crystalline precipitate.
Now, researchers at Pharmacia & Upjohn have developed a method for supplying glutamine in the form of a dipeptide (glycyl - glutamine).
This means that, for the first time, a ready-made glutamine-containing nutritional solution, Glamin, is available for intravenous treatment of intensive-care patients.
‘Within five years, it is probable that glutamine, with its favourable medico-economic profile, will be incorporated into all nutritional solutions given to hospital patients', said Douglas W Wilmore, Professor of Surgery, at the 35th World Congress of Surgery in 1994./ins

Captions:
Fig 1 - diagram
Glutamine reduces duration of hospitalization.
Glutamine - enriched TPN reduces the risk of infection and duration of hospitalization after bone marrow transplantation compared with standard TPN.

Fig 2 - picture of product and molecule
Glutamine through dipeptide technology.
Pharmacia & Upjohn has developed the first balanced amino acid solution containing glutamine - Glamin.

For further information see attached list of contact addresses:

Austria
Pharmacia & Upjohn
Product Manager Silke Berger,
Oberlaaer Strasse 251
P.O. Box 297
A-1101 Vienna
Tel: +43 1 68 66 38 0
Fax: +43 1 68 66 38 330

Belgium
Pharmacia & Upjohn
Product Manager Ann Van den Broeck
Rue de la Fusée 62 b2
B-1130 Brussels
Tel: +32 2 72 74 41 1
Fax: +32 2 72 74 40 0

Germany
Pharmacia & Upjohn
Dr. Annemarie Diederich
91051 Erlangen
Tel: +49 91 31 801-471
Fax: +49 91 31 801-170

Italy
Pharmacia & Upjohn
Product Manager Enrico Falcioni,
Via Robert Koch, 1.2
I-20152 Milan
Tel: +39 2 48 38 1
Fax: +39 2 48 38 26 20

Netherlands
Pharmacia & Upjohn BV
Carl Janssen, Medisch Directeur
Postbus 17
3440 AA Woerden
Tel: 0348-494830
Fax: 0348-494950

Spain
Pharmacia & Upjohn
Prouduct Manager Angels Cañas
Pharmacia & Upjohn
Antonio López 109
E-28026 Madrid
Tel: +34 1 58 95 10 0
Fax: +34 1 47 65 79 8

Sweden
Staffan Bark, Int. Produktchef
Pharmacia & Upjohn
Hospital Care
S-112 87 Stockholm
Tel.: +46 8 695 80 00
Fax: +46 8 618 63 43

Switzerland
Pharmacia & Upjohn
Dr. Markus Hasenfratz
Product Manager
Lagerstrasse 14
CH-8600 Dübendorf

United Kingdom
Product Manager Steven Whitney
Pharmacia & Upjohn
Davy Avenue
Knowlhill
Milton Keynes MK5 8PH
Tel: +44 19 08 66 11 01
Fax: +44 19 08 60 30 55




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