BODY PROTEIN METABOLISM AND NUTRITION IN AIDS-WASTING

体重减轻，特别是瘦体重，是HIV感染的主要表现。瘦体重丢失(LBM)是艾滋病患者出现的消瘦综合征的最早表现。科学证据还表明，很高比例的死亡与营养不良和消瘦有关。我们最近证实，使用两种氨基酸(精氨酸和谷氨酰胺)和亮氨酸的代谢物β-羟基-β-甲基丁酸酯(HMB)进行有针对性的营养干预，在促进瘦体重、增加肌肉质量和功能以及改善免疫功能的一些基本参数方面具有显著的积极效果。这项拟议的研究旨在确定这种氨基酸营养混合物增加艾滋病患者瘦体重和逆转消瘦综合征的机制(S)。前一年体重减轻10%或更多的10名艾滋病患者将被招募参加这项研究。患者的饮食中将添加含有HMB、精氨酸和谷氨酰胺的营养混合物，为期8周。使用稳定同位素技术，将在补充8周之前和之后评估全身蛋白质周转和肌肉蛋白质合成和分解率。我们假设HMB/精氨酸/谷氨酰胺组合将导致蛋白质合成增加和蛋白质分解减少，从而显著逆转这些患者的虚弱综合征，最终导致寿命和生活质量的改善。建议的商业应用：这种营养组合物已被证明可以增强免疫功能，并在消瘦的艾滋病患者中瘦身。这种组合将有可能在各种产品中销售。很高比例的艾滋病患者会出现与疾病相关的无意减肥，这导致这种营养产品有很大的市场潜力。最初的产品含有即饮配方中的营养成分。一种含有高质量蛋白质和其他营养素的均衡营养产品很可能随之而来。这些产品将在市场上脱颖而出，因为它们将基于强大的临床数据。

Weight loss, especially lean body mass, is a major manifestation of HIV infection. Loss of lean body mass (LBM) is the earliest manifestation of the wasting syndrome seen in AIDS patients. Scientific evidence also suggests that a high percentage of deaths is related to malnutrition and wasting. We have recently demonstrated that targeted nutritional intervention using a combination of two amino acids (arginine and glutamine) and a metabolite of leucine, beta-hydroxy-beta-methyl-butyrate (HMB), had marked positive effects in promoting lean body mass, increasing muscle mass and function and improving some essential parameters of immune functions. the proposed study is designed to determine the mechanism(s) by which this amino acid nutrient mixture increased lean body mass and reversed the wasting syndrome in AIDS patients. Ten patients with AIDS who have demonstrated weight loss of 10% or greater in the previous year will be recruited for the study. Patients's diets will be supplemented with the nutrient mixture containing HMB, arginine, and glutamine for 8 weeks. Using stable isotope techniques, whole body protein turnover and muscle protein synthesis and breakdown rates will be assessed prior to and after 8 weeks of supplementation. We hypothesize that the HMB/arginine/glutamine combination will result in an increase in protein synthesis and a decrease in proteolysis leading to a significant reversal in the wasting syndrome seen in these patients, ultimately leading improved longevity and quality of life. PROPOSED COMMERCIAL APPLICATION: This nutritional combination has been shown to enhance immune function and lean mass in wasting AIDS patients. It will be possible to market this combination in a variety of products. A high percent of patients with AIDS will have unintentional weight loss associated with the disease, resulting in a large market potential for the nutritional product. The initial product contains the nutrient combination in a ready-to-drink formulation. A balanced nutritional product containing high quality protein and other nutrients would likely follow. The products will distinguish themselves in the market because they will be based on strong clinical data.