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Amino acid infusion attenuates skeletal muscle protein breakdown in children with severe burns
Author(s) -
Porter Craig,
Cotter Matthew,
Herndon David N,
Sidossis Labros S,
Børsheim Elisabet
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.350.7
Subject(s) - skeletal muscle , medicine , total body surface area , burn injury , phenylalanine , protein catabolism , amino acid , anesthesia , endocrinology , surgery , chemistry , biochemistry
Following a severe burn, skeletal muscle amino acids (AA) are mobilized to act as precursors for wound healing, the immune response and acute phase protein synthesis. The fact that the hypermetabolic, hyperinflammatory stress response to burn injury persists for several years post injury, suggests that sustained exogenous AA provision may play an important role in providing adequate AAs for the pathophysiological response to burns, thus attenuating skeletal muscle protein breakdown (MPB). Twelve pediatric patients (11.9±4.9 years) with large burns (55±15% of total body surface area) (mean±SD) underwent stable isotope infusion studies 22±3 months post injury. A primed constant infusion of L‐[ ring ‐ 2 H 5 ] phenylalanine was used to assess skeletal muscle AA kinetics in the fasted state and during a three hour AA infusion. MPB was reduced by AA infusion (428±73 vs. 237±37 nmol·min −1 100ml leg volume −1 , P<0.05), resulting in significant improvement in AA retention across the leg (synthesis‐breakdown) relative to the fasted period (−72±19 vs. 41±26 nmol·min −1 100ml leg volume −1 , P<0.05) (mean±SEM). Muscle protein synthesis (MPS) did not significantly change in response to AAs. These findings indicate that AA infusion improves skeletal muscle AA retention in children with severe burns two years post injury by attenuating MPB, not by elevating MPS. This suggests that adequate AA provision plays an important role in maintaining muscle mass in burned patients long after wound closure and discharge from hospital. Supported by the National Institutes of Health (P50‐GM60338) and Shriners Hospitals for Children (84090, 84080 and 71006).