Pamidronate attenuates muscle loss after pediatric burn injury

Elisabet Børsheim, David Herndon, Hal K. Hawkins, Oscar Suman, Matthew Cotter, Gordon L. Klein

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Children who are burned >40% total body surface area lose significant quantities of both bone and muscle mass because of acute bone resorption, inflammation, and endogenous glucocorticoid production, which result in negative nitrogen balance. Because administration of the bisphosphonate pamidronate within 10 days of the burn injury completely prevents the bone loss, we asked whether muscle protein balance was altered by the preservation of bone. We reviewed the results from 17 burned pediatric subjects previously enrolled in a double-blind randomized controlled study of pamidronate in the prevention of post-burn bone loss and who were concurrently evaluated for muscle protein synthesis and breakdown by stable isotope infusion studies during the acute hospitalization. We found a significantly lower fractional protein synthesis rate (FSR) in the pamidronate group and a correspondingly lower rate of appearance of the amino acid tracer in venous blood, suggesting lower muscle protein turnover. Moreover, net protein balance (synthesis minus breakdown) was positive in the subjects receiving pamidronate and negative in those receiving placebo. Muscle fiber diameter was significantly greater in the pamidronate subjects and leg strength at 9 months post-burn was not different between subjects who received pamidronate and normal physically fit age-matched children studied in our lab. Leg strength in burned subjects who served as controls tended to be weaker, although not significantly so. If substantiated by a larger study, these results suggest that bone may have a paracrine mechanism to preserve muscle and this finding may have implications for the treatment of sarcopenia in the elderly.

Original languageEnglish (US)
Pages (from-to)1369-1372
Number of pages4
JournalJournal of Bone and Mineral Research
Volume29
Issue number6
DOIs
StatePublished - 2014

Fingerprint

pamidronate
Pediatrics
Muscles
Muscle Proteins
Wounds and Injuries
Bone and Bones
Burns
Leg
Sarcopenia
Osteitis
Body Surface Area
Diphosphonates
Bone Resorption
Isotopes
Glucocorticoids
Proteins
Hospitalization
Nitrogen
Placebos

Keywords

  • BONE AND MUSCLE LOSS
  • BURN INJURY
  • PAMIDRONATE

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Børsheim, E., Herndon, D., Hawkins, H. K., Suman, O., Cotter, M., & Klein, G. L. (2014). Pamidronate attenuates muscle loss after pediatric burn injury. Journal of Bone and Mineral Research, 29(6), 1369-1372. https://doi.org/10.1002/jbmr.2162

Pamidronate attenuates muscle loss after pediatric burn injury. / Børsheim, Elisabet; Herndon, David; Hawkins, Hal K.; Suman, Oscar; Cotter, Matthew; Klein, Gordon L.

In: Journal of Bone and Mineral Research, Vol. 29, No. 6, 2014, p. 1369-1372.

Research output: Contribution to journalArticle

Børsheim, E, Herndon, D, Hawkins, HK, Suman, O, Cotter, M & Klein, GL 2014, 'Pamidronate attenuates muscle loss after pediatric burn injury', Journal of Bone and Mineral Research, vol. 29, no. 6, pp. 1369-1372. https://doi.org/10.1002/jbmr.2162
Børsheim, Elisabet ; Herndon, David ; Hawkins, Hal K. ; Suman, Oscar ; Cotter, Matthew ; Klein, Gordon L. / Pamidronate attenuates muscle loss after pediatric burn injury. In: Journal of Bone and Mineral Research. 2014 ; Vol. 29, No. 6. pp. 1369-1372.
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