TRAUMA--REGULATORS AND MODULATORS OF CATABOLIC STATE

创伤是美国的一个主要医疗保健问题。 随着改进的 紧急医疗护理 更多受伤患者在最初阶段幸存下来 受伤只会导致严重的并发症并经历长期的 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。 创伤后反应的原因仍然未知，但 在某种程度上与对损伤、组织分解的过度分解反应有关， 免疫抑制、慢性炎症和/或感染。 目标 该提案的首要任务是确定代谢的介质 受伤后的反应。 白细胞介素-1、前列腺素的作用 内毒素和其他炎症介质将在两者中进行测定 人类和实验动物。 这些介质的作用 伤口中的巨噬细胞、循环单核细胞和中性粒细胞等 其他组织如肺、骨骼肌和肝脏也将被评估。 导致骨骼肌蛋白净分解代谢的机制 受伤患者将被确定，肌肉来源的功能 评估其他组织中的氨基酸。 生长激素对网络的影响 将研究蛋白质分解代谢，特别是当施用 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。 的 将评估对喂养的预期反应的重要性，并且 神经调节在这个系统中的作用所决定。

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.