TRAUMA--REGULATORS AND MODULATORS OF CATABOLIC STATE

创伤是美国的一个主要卫生保健问题。 具有改进 紧急医疗护理更多的受伤患者幸存下来的初步 受伤只会导致严重并发症， 康复前住院。 其他人经常在几周的密集治疗后死亡 在乎 创伤后反应的原因仍然未知，但 某种程度上与损伤、组织分解 免疫抑制、慢性炎症和/或感染。 目标 首先，确定代谢的介质， 受伤后的反应。 白细胞介素-1，白藜芦醇， 内毒素和其他炎症介质将在两个 人类和实验动物。 这些介质对 伤口中的巨噬细胞、循环单核细胞和中性粒细胞，以及 将评估其它组织，例如肺、骨骼肌和肝。 导致骨骼肌蛋白质净代谢的机制 受伤的病人将被确定，和肌肉衍生的功能， 评估其他组织中的氨基酸。 生长激素对网织红细胞的影响 将研究蛋白质催化剂，特别是当与 低热量喂养 添加氨基酸的安全有效性 谷氨酰胺静脉营养配方将被确定。 的 将评估对进食的预期反应的重要性， 神经调节在这个系统中的作用确定。

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.