Alanine and glutamine are the principal amino acid substrates for hepatic gluconeogenesis and ureagen-esis. Alanine is produced in peripheral tissues in transamination processes with glutamate, branched chain amino acids, and other amino acids; following its release in the systemic circulation, alanine is predominantly taken up by the liver and to a lesser extent by the kidney. Here, alanine can be deami-nated to yield pyruvate and an amino group, which can be used for transamination processes, ureagen-esis, or can be excreted in urine. Thus, the alanine released from peripheral tissues may be converted to glucose in the liver or kidney and eventually become a substrate for peripheral (mainly muscular) glycolysis. This so-called glucose-alanine cycle may be especially relevant during metabolic stress and critical illness when the endogenous alanine release from peripheral tissues is increased. Simultaneously, alanine serves as a nitrogen carrier in this manner. Alanine is often used as the second amino acid in glutamine dipeptides that are applied to increase solubility and stability of glutamine in nutritional solutions.
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