Muscle protein catabolism after severe burn: Effects of IGF-1/IGFBP-3 treatment
Muscle protein catabolism after severe burn: Effects of IGF-1/IGFBP-3 treatment
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DOI：
10.1097/00000658-199905000-00014
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发表时间：
1999-05-01
影响因子：
9
通讯作者：
Wolf, SE
中科院分区：
文献类型：
--
作者：
Herndon, DN;Ramzy, PI;Wolf, SE
目的探讨重组人胰岛素样生长因子-1（IGF-I）及其主要结合蛋白IGFBP-3复合物对严重烧伤儿童骨骼肌代谢的影响。以前的研究表明，营养支持和药物干预与合成代谢剂，如生长激素和胰岛素消除肌肉萎缩和改善净蛋白质合成在严重烧伤。然而，这些药物的使用有一些不良副作用。方法对29例严重烧伤患儿分别给予0.5、1、2、4 mg/kg/d的IGF-1/IGFBP-3治疗，观察治疗前后蛋白质净平衡、肌肉蛋白合成率和糖代谢的变化。另一组进行了研究，在类似的方式没有IGF-1/IGFBP-3治疗作为时间controls.Results 17的29名儿童开始治疗前分解代谢。1.0 mg/kg/天IGF-1/IGFBP-5输注增加了血清IGF-1，2.0和4.0 mg/kg/天未进一步增加。1 - 4 mg/kg/天的IGF-1/IGFBP-3治疗改善了净蛋白质平衡，并增加了肌肉蛋白质合成率。这种影响在分解代谢儿童中更为明显。IGF-1/IGFBP-3并没有影响葡萄糖的摄取在整个腿或改变substrateutilization.Conclusions IGF-1/IGFBP-3的剂量为1至4毫克/公斤/天衰减catabolic在分解代谢烧伤儿童的临床副作用可以忽略不计。
Objective To determine the effects of recombinant human insulin-like growth factor-1 (IGF-I) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children.Summary Background Data Severe burns are associated with a persistent hypermetabolic response characterized by hyperdynamic circulation and severe muscle catabolism and wasting. Previous studies showed that nutritional support and pharmacologic intervention with anabolic agents such as growth hormone and insulin abrogated muscle wasting and improved net protein synthesis in the severely burned. The use of these agents, however, has several adverse side effects. A new combination of IGF-1 and IGFBP-3 is now available for clinical study.Methods Twenty-nine severely burned children were prospectively studied before and after treatment with 0.5, 1, 2, or 4 mg/kg/day IGF-1/IGFBP-3 to determine net balance of protein across the leg, muscle protein fractional synthetic rates, and glucose metabolism. Another group was studied in a similar fashion without IGF-1/IGFBP-3 treatment as time controls.Results Seventeen of 29 children were catabolic before starting treatment. The infusion of 1.0 mg/kg/day IGF-1/IGFBP-5 increased serum IGF-1, which did not further increase with 2.0 and 4.0 mg/kg/day. IGF-1/IGFBP-3 treatment at 1 to 4 mg/kg/day improved net protein balance and increased muscle protein fractional synthetic rates. This effect was more pronounced in catabolic children. IGF-1/IGFBP-3 did not affect glucose uptake across the leg or change substrate utilization.Conclusions IGF-1/IGFBP-3 at doses of 1 to 4 mg/kg/day attenuates catabolism in catabolic burned children with negligible clinical side effects.