TRAUMA--REGULATORS AND MODULATORS OF CATABOLIC STATE

创伤是美国的一个主要医疗保健问题。改进后的 紧急医疗护理更多的受伤患者正在从最初的 受伤只会造成严重的并发症，并持续很长时间 康复前住院治疗。其他人经常在几周的密集训练后死亡 关心。创伤后反应的原因(S)尚不清楚，但 在某种程度上与对损伤、组织破坏的高分解反应有关， 免疫抑制、慢性炎症和/或感染。目标 这一建议的目的是，首先确定新陈代谢的调节物 受伤后的反应。白介素1，前列腺素， 内毒素和其他炎症介质将在这两个 人类和实验动物。这些调解人对 伤口内的巨噬细胞、循环中的单核细胞和中性粒细胞等 其他组织，如肺、骨骼肌和肝脏将被评估。 骨骼肌蛋白质净分解代谢的机制 将受伤患者进行测定，并派生肌肉的功能 评估其他组织中的氨基酸。生长激素对净增重的影响 将研究蛋白质的分解代谢，特别是在服用 低热量喂养。添加氨基酸的安全性和有效性 谷氨酰胺静脉营养配方将被确定。这个 将评估对喂养的预期反应的重要性，以及 神经调节在这个系统中的作用是确定的。

Trauma is a major health care problem in the United States. With improved emergency medical care more injured patients are surviving the initial injury only to sustain major complications and undergo prolonged hospitalization before recovery. Others often die after weeks of intensive care. The cause(s) of the posttraumatic responses remains unknown, but is somehow related to the hypercatabolic response to injury, tissue breakdown, immunosuppression, chronic inflammation and/or infection. The objectives of this proposal are, first, to determine the mediators of the metabolic responses following injury. The role of interleukin-1, prostaglandins, endotoxin, and other inflammatory mediators will be determined in both humans and experimental animals. The effect of these mediators on macrophages in the wound, circulating monocytes and neutrophils, and on other tissues such as lung, skeletal muscle, and liver will be assessed. The mechanisms that lead to net catabolism of skeletal muscle proteins in injured patients will be determined, and the function of muscle-derived amino acids in other tissues assessed. The effect of growth hormone on net protein catabolism will be investigated, especially when administered with hypocaloric feedings. The safety and efficacy of adding the amino acid glutamine to intravenous nutritional formulas will be determined. The significance of the anticipatory response to feeding will be assessed, and the role of neural regulation in this system determined.