Orellana Renan A, O'Connor Pamela M J, Nguyen Hanh V, Bush Jill A, Suryawan Agus, Thivierge M Carole, Fiorotto Marta L, Davis Teresa A
United States Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center and Sections of Critical Care and Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
Am J Physiol Endocrinol Metab. 2002 Nov;283(5):E909-16. doi: 10.1152/ajpendo.00220.2002.
Protein synthesis in skeletal muscle is reduced by as much as 50% as early as 4 h after a septic challenge in adults. However, the effect of sepsis on muscle protein synthesis has not been determined in neonates, a highly anabolic population whose muscle protein synthesis rates are elevated and uniquely sensitive to insulin and amino acid stimulation. Neonatal piglets (n = 10/group) were infused for 8 h with endotoxin [lipopolysaccharide (LPS), 0 and 10 microg. kg(-1). h(-1)]. Plasma amino acid and glucose concentrations were kept at the fed level by infusion of dextrose and a balanced amino acid mixture. Fractional protein synthesis rates were determined by use of a flooding dose of [(3)H]phenylalanine. LPS infusion produced a septic-like state, as indicated by an early and sustained elevation in body temperature, heart rate, and plasma tumor necrosis factor-alpha, interleukin-1, cortisol, and lactate concentrations. Plasma levels of insulin increased, whereas glucose and amino acids decreased, suggesting the absence of insulin resistance. LPS significantly reduced protein synthesis in longissimus dorsi muscle by only 11% and in gastrocnemius by only 15%, but it had no significant effect in masseter and cardiac muscles. LPS increased protein synthesis in the liver (22%), spleen (28%), kidney (53%), jejunum (19%), diaphragm (21%), lung (50%), and skin (13%), but not in the stomach, pancreas, or brain. These findings suggest that, when substrate supply is maintained, skeletal muscle protein synthesis in neonates compared with adults is relatively resistant to the catabolic effects of sepsis.
在成年人中,脓毒症激发后最早4小时,骨骼肌中的蛋白质合成就会减少多达50%。然而,脓毒症对肌肉蛋白质合成的影响在新生儿中尚未确定,新生儿是一个合成代谢旺盛的群体,其肌肉蛋白质合成率升高,且对胰岛素和氨基酸刺激具有独特的敏感性。将新生仔猪(每组n = 10)用内毒素[脂多糖(LPS),0和10微克·千克⁻¹·小时⁻¹]输注8小时。通过输注葡萄糖和平衡氨基酸混合物,将血浆氨基酸和葡萄糖浓度维持在进食水平。使用过量的[³H]苯丙氨酸来测定蛋白质合成率。LPS输注产生了类似脓毒症的状态,表现为体温、心率以及血浆肿瘤坏死因子-α、白细胞介素-1、皮质醇和乳酸浓度早期且持续升高。血浆胰岛素水平升高,而葡萄糖和氨基酸水平降低,表明不存在胰岛素抵抗。LPS使背最长肌的蛋白质合成仅显著降低11%,腓肠肌仅降低15%,但对咬肌和心肌没有显著影响。LPS使肝脏(22%)、脾脏(28%)、肾脏(53%)、空肠(19%)、膈肌(21%)、肺(50%)和皮肤(13%)的蛋白质合成增加,但对胃、胰腺或脑没有影响。这些发现表明,当维持底物供应时,与成年人相比,新生儿的骨骼肌蛋白质合成对脓毒症的分解代谢作用相对具有抗性。