Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, Multidisciplinary Metabolic Research Unit (M2RUN), University of Antwerp, Antwerp, Belgium.
Oscare, Organisation for Burns, Scar After-Care and Research, Antwerp, Belgium.
J Cachexia Sarcopenia Muscle. 2023 Apr;14(2):758-770. doi: 10.1002/jcsm.13188. Epub 2023 Feb 9.
After a severe burn injury, a systemic stress response activates metabolic and inflammatory derangements that, among other, leads to muscle mass loss (muscle wasting). These negative effects on skeletal muscle continue for several months or years and are aggravated by short-term and long-term disuse. The dynamic balance between muscle protein synthesis and muscle protein breakdown (proteolysis) is regulated by complex signalling pathways that leads to an overall negative protein balance in skeletal muscle after a burn injury. Research concerning these molecular mechanisms is still scarce and inconclusive, understanding of which, if any, molecular mechanisms contribute to muscle wasting is of fundamental importance in designing of therapeutic interventions for burn patients as well. This review not only summarizes our present knowledge of the molecular mechanisms that underpin muscle protein balance but also summarizes the effects of exercise on muscle wasting post-burn as promising strategy to counteract the detrimental effects on skeletal muscle. Future research focusing on the pathways causing post-burn muscle wasting and the different effects of exercise on them is needed to confirm this hypothesis and to lay the foundation of therapeutic strategies.
严重烧伤后，全身性应激反应会引发代谢和炎症紊乱，其中包括肌肉质量损失（肌肉减少症）。这些对骨骼肌的负面影响会持续数月甚至数年，并且会因短期和长期废用而加重。肌肉蛋白合成和肌肉蛋白分解（蛋白水解）之间的动态平衡受复杂信号通路调节，导致烧伤后骨骼肌总体呈负蛋白平衡。关于这些分子机制的研究仍然很少且尚无定论，如果有的话，了解哪些分子机制导致肌肉减少症对于烧伤患者的治疗干预措施的设计至关重要。本篇综述不仅总结了支撑肌肉蛋白平衡的分子机制的现有知识，还总结了运动对烧伤后肌肉减少症的影响，这是对抗骨骼肌不良影响的有前途的策略。需要未来的研究集中在导致烧伤后肌肉减少症的途径以及运动对它们的不同影响上，以证实这一假设并为治疗策略奠定基础。
