Amino acid therapy in clinical practice
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Amino Acid Therapy in Clinical Practice: Applications and Evidence
Amino Acid Therapy in Cancer Treatment
Amino acid therapy is widely explored in cancer treatment, especially by targeting the unique metabolic needs of cancer cells. Cancer cells often depend on certain amino acids for growth and survival, making them vulnerable to therapies that restrict or deplete these nutrients. Clinically, asparaginase is used to deplete asparagine in acute lymphoblastic leukemia (ALL), leading to cancer cell death. Other strategies include using arginine deiminase and methioninase to target arginine and methionine dependencies, as well as glutaminase inhibitors to disrupt glutamine metabolism. These approaches have shown effectiveness in both preclinical and clinical settings, though challenges such as resistance, toxicity, and short drug half-lives remain. Ongoing research focuses on improving these therapies and identifying predictive markers to select patients who will benefit most from amino acid deprivation strategies 25610.
D-Amino Acids as Therapeutic Agents
D-amino acids (D-AAs) are gaining attention for their therapeutic potential beyond cancer. They have shown promise in treating neurological diseases, tissue and organ injuries, and reproductive dysfunction. D-AAs can also disrupt microbial biofilms, offering a novel approach to preventing infections. Additionally, D-AAs are being explored for their ability to inhibit cancer cell growth and improve drug stability and efficiency, which could enhance both therapy and diagnosis in clinical practice .
Amino Acid Therapy for Kidney Protection
Amino acid infusion is being studied for its potential to protect kidney function, particularly in critically ill patients and those undergoing cardiac surgery. In critically ill patients, intravenous amino acid supplementation increased estimated glomerular filtration rate (eGFR) and urine output, though it did not significantly reduce the duration of renal dysfunction. In cardiac surgery patients, especially those with chronic kidney disease, amino acid infusion significantly reduced the incidence and severity of acute kidney injury (AKI), with a notable reduction in severe AKI and a meaningful absolute risk reduction. These findings suggest that amino acid therapy may be especially beneficial for high-risk patients, such as those with pre-existing kidney disease 347.
Amino Acid Supplementation in Critical Illness
During critical illness, the body’s protein and amino acid metabolism is significantly altered due to stress and inflammation. Adequate protein and amino acid supplementation is considered important for improving clinical outcomes in these patients, potentially even more so than caloric supplementation. Ongoing clinical trials are investigating whether early intravenous amino acid supplementation can reduce mortality and improve recovery in critically ill patients with normal kidney function 89.
Conclusion
Amino acid therapy is an evolving area in clinical practice with applications in cancer treatment, kidney protection, and critical care. In oncology, targeting amino acid metabolism exploits cancer cell vulnerabilities and is already part of standard care for some cancers. D-amino acids offer new therapeutic possibilities for infections, neurological diseases, and cancer. In critical care and perioperative settings, amino acid supplementation may protect kidney function and improve patient outcomes, especially in those at high risk for kidney injury. As research continues, identifying the right patients and optimizing therapy protocols will be key to maximizing the benefits of amino acid therapy in clinical practice.
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