Stein T Peter, Bolster Douglas R
University of Medicine and Dentistry of New Jersey - SOM, Stratford, New Jersey 08084, USA.
Curr Opin Clin Nutr Metab Care. 2006 Jul;9(4):395-402. doi: 10.1097/01.mco.0000232899.51544.69.
Muscle atrophy is a pervasive problem that occurs with disuse, aging, and a myriad of disease conditions. The purposes of this review are to describe recent advances in studying muscle atrophy that have elucidated pathways involved at the molecular level; to compare different types of atrophy--primary (e.g. bed rest, immobilization) and secondary (when the atrophy is related to pathology as well as disuse, e.g. injury, sepsis etc.) and their multiple common features; to review progress in studying the recovery process and clinical status.
Major advances have been made at the molecular level. There are two phenotypes for muscle atrophy--primary, which is mainly related to disuse (e.g. bed), and secondary, when the atrophy is related to pathology as well as disuse. It appears that the two forms have multiple elements in common. Studies on the recovery process reveal a very complex sequence of events that are not the simple reverse of the muscle loss process. In contrast to the progress at the molecular level, progress in treating muscle atrophy or accelerating recovery has been disappointing.
Although nutritional supplementation and pharmacological agents continue to have the potential to minimize muscle atrophy, given its minimal risks, exercise sets a very high standard for treatment options when medically appropriate. Identification of pathways and control points offers the potential for new approaches.
肌肉萎缩是一个普遍存在的问题，可发生于废用、衰老以及多种疾病状态。本综述的目的是描述肌肉萎缩研究的最新进展，这些进展阐明了分子水平上涉及的途径；比较不同类型的萎缩——原发性（如卧床休息、固定不动）和继发性（当萎缩与病理状态以及废用相关时，如损伤、脓毒症等）及其多个共同特征；回顾恢复过程和临床状况的研究进展。
在分子水平上取得了重大进展。肌肉萎缩有两种表型——原发性，主要与废用（如卧床）相关；继发性，当萎缩与病理状态以及废用都相关时。这两种形式似乎有多个共同要素。对恢复过程的研究揭示了一系列非常复杂的事件，并非肌肉丢失过程的简单逆转。与分子水平的进展相比，治疗肌肉萎缩或加速恢复方面的进展令人失望。
尽管营养补充和药物制剂仍有可能将肌肉萎缩降至最低，鉴于其风险极小，在医学上合适的情况下，运动为治疗选择设定了很高的标准。对途径和控制点的识别为新方法提供了潜力。
