TY - JOUR
T1 - The impact of catecholamines on skeletal muscle following massive burns
T2 - Friend or foe?
AU - Blears, Elizabeth
AU - Ross, Evan
AU - Ogunbileje, John
AU - Porter, Craig
AU - Murton, Andrew J.
N1 - Funding Information:
The authors’ work was supported by an endowment provided to The University of Texas Medical Branch in memory of the 15 individuals who died in the 2005 Texas City refinery explosion. EB and ER were additionally supported by a training grant from the National Institute of Health ( T32 GM008256 ). The funders had no involvement in the preparation of the manuscript or the decision to publish. The authors would like to acknowledge Anthony Nguyen and Zhihao Zhu for initial drafting of figures.
Funding Information:
The authors? work was supported by an endowment provided to The University of Texas Medical Branch in memory of the 15 individuals who died in the 2005 Texas City refinery explosion. EB and ER were additionally supported by a training grant from the National Institute of Health (T32 GM008256). The funders had no involvement in the preparation of the manuscript or the decision to publish. The authors would like to acknowledge Anthony Nguyen and Zhihao Zhu for initial drafting of figures.
Publisher Copyright:
© 2021 Elsevier Ltd and ISBI
PY - 2021/6
Y1 - 2021/6
N2 - 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.
AB - 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.
KW - Beta-adrenergic signaling
KW - Burns
KW - Hypermetabolism
KW - Lipolysis
KW - Muscle cachexia
KW - Muscle protein turnover
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U2 - 10.1016/j.burns.2021.01.009
DO - 10.1016/j.burns.2021.01.009
M3 - Review article
C2 - 33568281
AN - SCOPUS:85100627604
SN - 0305-4179
VL - 47
SP - 756
EP - 764
JO - Burns
JF - Burns
IS - 4
ER -