Effects of pharmacological interventions on muscle protein synthesis and breakdown in recovery from burns

Eva C. Diaz, David Herndon, Craig Porter, Labros S. Sidossis, Oscar Suman, Elisabet Børsheim

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objective The pathophysiological response to burn injury disturbs the balance between skeletal muscle protein synthesis and breakdown, resulting in severe muscle wasting. Muscle loss after burn injury is related to increased mortality and morbidity. Consequently, mitigation of this catabolic response has become a focus in the management of these patients. The aim of this review is to discuss the literature pertaining to pharmacological interventions aimed at attenuating skeletal muscle catabolism in severely burned patients. Data selection: Review of the literature related to skeletal muscle protein metabolism following burn injury was conducted. Emphasis was on studies utilizing stable isotope tracer kinetics to assess the impact of pharmacological interventions on muscle protein metabolism in severely burned patients. Conclusion Data support the efficacy of testosterone, oxandrolone, human recombinant growth hormone, insulin, metformin, and propranolol in improving skeletal muscle protein net balance in patients with severe burns. The mechanisms underlying the improvement of protein net balance differ between types and dosages of drugs, but their main effect is on protein synthesis. Finally, the majority of studies have been conducted during the acute hypermetabolic phase of the injury. Except for oxandrolone, the effects of drugs on muscle protein kinetics following discharge from the hospital are largely unknown.

Original languageEnglish (US)
Pages (from-to)649-657
Number of pages9
JournalBurns
Volume41
Issue number4
DOIs
StatePublished - Jun 1 2015

Fingerprint

Muscle Proteins
Burns
Pharmacology
Skeletal Muscle
Oxandrolone
Wounds and Injuries
Muscles
Human Growth Hormone
Metformin
Propranolol
Isotopes
Pharmaceutical Preparations
Growth Hormone
Testosterone
Proteins
Insulin
Morbidity
Mortality

Keywords

  • Burn injury
  • Catabolism
  • Hypermetabolism
  • Muscle
  • Protein
  • Stable isotopes

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Effects of pharmacological interventions on muscle protein synthesis and breakdown in recovery from burns. / Diaz, Eva C.; Herndon, David; Porter, Craig; Sidossis, Labros S.; Suman, Oscar; Børsheim, Elisabet.

In: Burns, Vol. 41, No. 4, 01.06.2015, p. 649-657.

Research output: Contribution to journalArticle

Diaz, Eva C. ; Herndon, David ; Porter, Craig ; Sidossis, Labros S. ; Suman, Oscar ; Børsheim, Elisabet. / Effects of pharmacological interventions on muscle protein synthesis and breakdown in recovery from burns. In: Burns. 2015 ; Vol. 41, No. 4. pp. 649-657.
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N2 - Objective The pathophysiological response to burn injury disturbs the balance between skeletal muscle protein synthesis and breakdown, resulting in severe muscle wasting. Muscle loss after burn injury is related to increased mortality and morbidity. Consequently, mitigation of this catabolic response has become a focus in the management of these patients. The aim of this review is to discuss the literature pertaining to pharmacological interventions aimed at attenuating skeletal muscle catabolism in severely burned patients. Data selection: Review of the literature related to skeletal muscle protein metabolism following burn injury was conducted. Emphasis was on studies utilizing stable isotope tracer kinetics to assess the impact of pharmacological interventions on muscle protein metabolism in severely burned patients. Conclusion Data support the efficacy of testosterone, oxandrolone, human recombinant growth hormone, insulin, metformin, and propranolol in improving skeletal muscle protein net balance in patients with severe burns. The mechanisms underlying the improvement of protein net balance differ between types and dosages of drugs, but their main effect is on protein synthesis. Finally, the majority of studies have been conducted during the acute hypermetabolic phase of the injury. Except for oxandrolone, the effects of drugs on muscle protein kinetics following discharge from the hospital are largely unknown.

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