The impact of catecholamines on skeletal muscle following massive burns: Friend or foe?

Elizabeth Blears, Evan Ross, John O. Ogunbileje, Craig Porter, Andrew J. Murton

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Profound skeletal muscle wasting in the setting of total body hypermetabolism is a defining characteristic of massive burns, compromising the patient's recovery and necessitating a protracted period of rehabilitation. In recent years, the prolonged use of the non-selective beta-blocker, propranolol, has gained prominence as an effective tool to assist with suppressing epinephrine-dependent burn-induced hypermetabolism and by extension, blunting muscle catabolism. However, synthetic β-adrenergic agonists, such as clenbuterol, are widely associated with the promotion of muscle growth in both animals and humans. Moreover, experimental adrenodemedullation is known to result in muscle catabolism. Therefore, the blunting of muscle β-adrenergic signaling via the use of propranolol would be expected to negatively impair muscle protein homeostasis. This review explores these paradoxical observations and identifies the manner by which propranolol is thought to exert its anti-catabolic effects in burn patients. Moreover, we identify potential avenues by which the use of beta-blocker therapy in the treatment of massive burns could potentially be further refined to promote the recovery of muscle mass in these critically ill patients while continuing to ameliorate total body hypermetabolism.

Original languageEnglish (US)
Pages (from-to)756-764
Number of pages9
JournalBurns
Volume47
Issue number4
DOIs
StatePublished - Jun 2021

Keywords

  • Beta-adrenergic signaling
  • Burns
  • Hypermetabolism
  • Lipolysis
  • Muscle cachexia
  • Muscle protein turnover

ASJC Scopus subject areas

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

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