Alanylglutamine

Immune/infection ↓

Glucose/stress ↓

Immune recovery + complications

Infections ↓, HLA-DR/TNF-α ↑

Infections -20%

Recovery 4 days

Barrier/leakiness ↓

Immune/absorption ↑

Wound healing/infections

N balance +

Glucose/insulin control

Nitrogen balance + survival

Protein sparing, less infection

Nitrogen balance +positive

Nitrogen/lean support

Immune/infection, shorter stay

Barrier ↑; glutamine +

GI symptoms ↓; mucositis -53%

Absorption/barrier + glutamine

Nitrogen balance/weight +

Energy/fatigue ↑

+26–83%

Recovery/inflammation ↓

Mucositis, feeding tubes -53%

Weight loss, steroids reduced