Reduction of muscle protein degradation by leupeptin in acutely uremic rats.

Enhanced muscle protein breakdown has been demonstrated in acutely uremic rats by numerous authors. These findings have been used to explain the clinical signs of muscle wasting and enhanced urea-N appearance, frequently observed in patients suffering from uremia. In order to investigate whether inhibition of skeletal muscle proteinases would have a favourable effect on the extent of muscle protein degradation, leupeptin, a low-molecular-weight proteinase inhibitor, was administered intraperitoneally to acutely uremic rats. 24 h after bilateral nephrectomy, leupeptin-treated animals displayed significantly lowered serum urea levels (-32%), and hence decreased urea-N appearances (-39%) as compared to untreated uremic rats. As a sign of muscle protein breakdown, plasma levels of Nt-methylhistidine, an indicator of myofibrillar protein degradation, were also decreased (-35%) in the uremic animals treated with leupeptin as compared to untreated uremic rats. Finally, leupeptin treatment resulted in a significant inhibition of the myofibrillar alkaline proteinase activity, a proteinase which has been related to various catabolic conditions. These findings suggest that the increased muscle protein breakdown in uremia is caused by enhanced activity of muscular proteinases and that antiproteolytic agents display favourable effects on the enhanced protein degradation observed in acute uremia.