This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Per-Olof Hasselgren, MD, PhD; Peter Pedersen, MD; Harry C. Sax, MD; Brad W. Warner, MD; Josef E. Fischer, MD

Arch Surg. 1988;123(8):992-999.

Abstract
• The metabolic response to trauma and sepsis is characterized by a negative nitrogen balance, accelerated muscle proteolysis, increased ureagenesis, and stimulated acute-phase protein synthesis in liver. Inhibited uptake of amino acids and accelerated protein breakdown in muscle increase the flux of amino acids from the periphery to the liver. Concomitantly, hepatic uptake of amino acids is stimulated and protein synthesis and gluconeogenesis in the liver are enhanced. These events are important to the survival of patients with sepsis. Stimulated ureagenesis resulting in nitrogen loss from the body is another important aspect of hepatic nitrogen metabolism following trauma and sepsis. The mediator(s) initiating metabolic changes is not yet exactly defined, although regulatory protein(s) released from stimulated macrophages (particularly interleukin 1 and tumor necrosis factor) may play a major role in altered amino acid and protein metabolism in muscle and liver during sepsis. However, these factors alone are probably not responsible for the metabolic disturbances, since the catabolic hormones cortisol, glucagon, and the catecholamines can simulate the metabolic pattern observed in sepsis. Other possible mediators include prostaglandins and thyroid hormones. It is possible that the interaction between different types of mediators is necessary for the full manifestation of host responses to severe injury and sepsis.

(Arch Surg 1988;123:992-999)

Author Affiliations
From the Department of Surgery, University of Cincinnati Medical Center.

Footnotes
Accepted for publication June 2, 1987.

Reprint requests to Department of Surgery, University of Cincinnati Medical Center, 231 Bethesda Ave (ML#558), Cincinnati, OH 45267-0558 (Dr Hasselgren).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Amino acids augment muscle protein synthesis in neonatal pigs during acute endotoxemia by stimulating mTOR-dependent translation initiation
Orellana et al.
Am. J. Physiol. Endocrinol. Metab. 2007;293:E1416-E1425.
ABSTRACT | FULL TEXT  

Pharmacologic Levels of Dietary Arginine in CB6F1 Mice Increase Serum Ammonia in the Healthy State and Serum Nitrite in Endotoxemia
Nieves et al.
JPEN J Parenter Enteral Nutr 2007;31:101-108.
ABSTRACT | FULL TEXT  

Insulin stimulates muscle protein synthesis in neonates during endotoxemia despite repression of translation initiation
Orellana et al.
Am. J. Physiol. Endocrinol. Metab. 2007;292:E629-E636.
ABSTRACT | FULL TEXT  

Modulation of muscle protein synthesis by insulin is maintained during neonatal endotoxemia
Orellana et al.
Am. J. Physiol. Endocrinol. Metab. 2006;291:E159-E166.
ABSTRACT | FULL TEXT  

Therapeutic Use of Branched-Chain Amino Acids in Burn, Trauma, and Sepsis
De Bandt and Cynober
J. Nutr. 2006;136:308S-313S.
ABSTRACT | FULL TEXT  

Amino Acid Adequacy in Pathophysiological States
Soeters et al.
J. Nutr. 2004;134:1575S-1582S.
ABSTRACT | FULL TEXT  

Endotoxemia reduces skeletal muscle protein synthesis in neonates
Orellana et al.
Am. J. Physiol. Endocrinol. Metab. 2002;283:E909-E916.
ABSTRACT | FULL TEXT  

Heat shock protects L6 myotubes from catabolic effects of dexamethasone and prevents downregulation of NF-kappa B
Luo et al.
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2001;281:R1193-R1200.
ABSTRACT | FULL TEXT  

Amino acid kinetics in patients with sepsis
Druml et al.
Am. J. Clin. Nutr. 2001;73:908-913.
ABSTRACT | FULL TEXT  

A Sustained Rat Model for Studying the Long-Lasting Catabolic State of Sepsis
Breuille et al.
Infect. Immun. 1999;67:1079-1085.
ABSTRACT | FULL TEXT  

New Experimental Model of Acute Renal Failure and Sepsis in Rats
Kuhlmann et al.
JPEN J Parenter Enteral Nutr 1994;18:477-485.
ABSTRACT  

Review: The Phospholipid/Arachidonic Acid Second Messenger System: Its Possible Role in Physiology and Pathophysiology of Metabolism
Hartl and Wolfe
JPEN J Parenter Enteral Nutr 1990;14:416-427.
ABSTRACT  

Leucine Limitation Induces Autophagy and Activation of Lysosome-dependent Proteolysis in C2C12 Myotubes through a Mammalian Target of Rapamycin-independent Signaling Pathway
Mordier et al.
J. Biol. Chem. 2000;275:29900-29906.
ABSTRACT | FULL TEXT