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Am J Physiol Endocrinol Metab 279: E707-E714, 2000;
0193-1849/00 $5.00
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Vol. 279, Issue 3, E707-E714, September 2000

Liver export protein synthetic rates are increased by oral meal feeding in weight-losing cancer patients

Matthew D. Barber1, Kenneth C. H. Fearon1, Donald C. McMillan2, Christine Slater3, James A. Ross1, and Tom Preston3

1 Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW; 2 Department of Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER; and 3 Isotope Biochemistry Laboratory, Scottish Universities Research and Reactor Centre, East Kilbride, United Kingdom G75 0QF

We have demonstrated previously that, in the fasting state, whereas albumin synthesis is similar in cachectic cancer patients compared with controls, fibrinogen synthesis is increased. Whether synthesis of these proteins is altered after an oral meal was examined in eight weight-losing pancreatic cancer patients and six healthy controls by use of an intravenous flooding dose of [2H5]- or [2H8]phenylalanine. Cancer patients had a median weight loss of 19%, a significantly lower serum albumin concentration, and a significantly higher plasma fibrinogen concentration than controls (P < 0.005). Fasting albumin synthesis rates were similar between cancer patients and controls (median total synthesis rate 11.3 vs. 13.9 g/day, respectively) and rose on feeding by a similar degree (median 29 and 24%). The fasting fibrinogen total synthetic rate was significantly higher in cancer patients than in controls (median 3.3 vs. 1.0 g/day, P = 0.0019). In cancer patients in the fed state, fibrinogen synthetic rate rose by a median of 38% (P = 0.012), whereas in controls there was no significant change. These findings demonstrate significant upregulation by feeding of acute-phase protein synthesis in cachectic cancer patients.

albumin; fibrinogen; acute-phase protein response; pancreatic cancer


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