Brook Matthew S, Wilkinson Daniel J, Atherton Philip J
MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular Physiology, National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby.
Queens Medical Centre, Nottingham, UK.
Curr Opin Clin Nutr Metab Care. 2020 May;23(3):174-180. doi: 10.1097/MCO.0000000000000652.
Skeletal muscle has many essential roles in maintaining human health, not only being crucial for locomotion, but further as a metabolically important organ. Muscle wasting in disease (cachexia) is highly prevalent, associated with poor clinical outcomes and is not fully reversible with nutritional interventions. Understanding proteostasis in diseased states is of great importance to design novel, effective nutritional/nutraceutical strategies aimed at alleviating muscle wasting. In this review, we will provide an update on muscle kinetics in disease and the effects of nutritional interventions.
Whole body and skeletal muscle kinetics are commonly shown to be imbalanced in disease, promoting overall catabolism that underlies the development of cachexia. However, recent advancements in defining the effectiveness of nutritional interventions on muscle anabolism are clouded by heterogenous patient populations and a lack of direct incorporation stable isotope techniques. Current recommendations are focused on combating malnutrition, with increased protein intake (high in EAA) demonstrating promise.
Recent progress in understanding catabolic states in cachexia across disease is minimal. Further, studies investigating muscle-specific protein turnover along with nutritional interventions are scarce. As such, there is a significant requirement for strong RCT's investigating both acute and chronic nutritional interventions and their impact on skeletal muscle in individual disease states.
骨骼肌在维持人类健康方面具有许多重要作用，不仅对运动至关重要，而且作为一个代谢重要器官。疾病状态下的肌肉萎缩（恶病质）非常普遍，与不良临床结局相关，并且营养干预不能完全逆转。了解疾病状态下的蛋白质稳态对于设计旨在减轻肌肉萎缩的新型、有效的营养/营养补充剂策略非常重要。在本综述中，我们将提供疾病状态下肌肉动力学以及营养干预效果的最新情况。
全身和骨骼肌动力学在疾病中通常表现为失衡，促进了作为恶病质发展基础的整体分解代谢。然而，在确定营养干预对肌肉合成代谢有效性方面的最新进展因患者群体异质性和缺乏直接纳入稳定同位素技术而受到影响。目前的建议集中在对抗营养不良，增加蛋白质摄入量（富含必需氨基酸）显示出前景。
目前在理解跨疾病恶病质分解代谢状态方面进展甚微。此外，研究肌肉特异性蛋白质周转以及营养干预的研究很少。因此，迫切需要进行强有力的随机对照试验，研究急性和慢性营养干预及其对个体疾病状态下骨骼肌的影响。
