Michie H R, Sherman M L, Spriggs D R, Rounds J, Christie M, Wilmore D W
Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115.
Ann Surg. 1989 Jan;209(1):19-24. doi: 10.1097/00000658-198901000-00002.
It has been proposed that many of the physiologic and metabolic changes that occur during critical illness and malignancy are mediated by the cytokine tumor necrosis factor alpha/cachectin (TNF). To test this hypothesis, a study of the metabolic responses that occurred during 5 days of continuous intravenous (I.V.) infusion of TNF both in rats and tumor-bearing humans was conducted. TNF administration was associated with anorexia, fluid retention, acute phase responses, and negative nitrogen balance. In both species, changes in nitrogen balance were related to the onset of anorexia and not to the development of hypermetabolism and accelerated net tissue breakdown. TNF may represent the primary afferent stimulus inducing many of the metabolic changes that occur during critical illness, but it is not solely responsible for the accelerated net proteolysis that occurs in these patients.
有人提出，危重病和恶性肿瘤期间发生的许多生理和代谢变化是由细胞因子肿瘤坏死因子α/恶病质素（TNF）介导的。为了验证这一假设，对大鼠和荷瘤人类连续5天静脉内（I.V.）输注TNF期间发生的代谢反应进行了一项研究。给予TNF与厌食、液体潴留、急性期反应和负氮平衡有关。在这两个物种中，氮平衡的变化与厌食的发生有关，而与高代谢的发展和净组织分解加速无关。TNF可能是诱导危重病期间发生的许多代谢变化的主要传入刺激，但它并非这些患者净蛋白水解加速的唯一原因。
