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Sci Adv 2020;6:eaaz7492

4.3 Glutamine Glutamine (Gln) is mainly converted through GLS/glutamate dehydrogenase (GLUD)-related reactions to generate -KG, which enters the TCA cycle and provides anaplerotic substrates for oxidative metabolism, while also influencing polarization-related epigenetic regulatory processes through metabolic ratios such as -KG/succinate ( Glutamine (Gln) metabolism in macrophage polarization is mainly manifested as a composite regulatory axis of TCA cycle anaplerosis-mitochondrial metabolism-epigenetic coupling. Its role is usually not reflected by the output of a single effector molecule, but rather by the coordinated shaping of polarization-related transcriptional programs through metabolic flux and key intermediates, particularly -KG ( -KG is considered a key hub linking Gln metabolism to phenotypic remodeling ( It should be noted that the effects of Gln metabolism on polarization direction are markedly context-dependent

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TRIUMPH-CVOT: cardiovascular outcomes trial, approximately 10,000 participants with established CVD, primary endpoint major adverse cardiovascular events (MACE), timeline 3 to 4 years