Clinical use of branched-chain amino acids in liver disease, sepsis, trauma, and burns
H. C. Sax, M. A. Talamini and J. E. Fischer
The branched-chain amino acids (BCAAs)--leucine, isoleucine, and
valine--share unique biochemical properties that may make them useful in
altered physiologic states. They can be metabolized independently of liver
function to provide energy, other amino acids, or small nitrogenous
compounds. This unique ability makes the BCAAs a desirable supplement in
liver disease with encephalopathy and, to a lesser extent, in sepsis with
hepatic dysfunction. Furthermore, the BCAAs play a role in the regulation
of protein synthesis, suggesting beneficial effects in catabolic states
such as postoperative stress, trauma, renal failure, and burns. However,
initial studies in these areas have presented equivocal results.