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United States Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center and Sections of Critical Care and Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030
Protein synthesis in skeletal muscle is
reduced by as much as 50% as early as 4 h after a septic
challenge in adults. However, the effect of sepsis on muscle protein
synthesis has not been determined in neonates, a highly anabolic
population whose muscle protein synthesis rates are elevated and
uniquely sensitive to insulin and amino acid stimulation. Neonatal
piglets (n = 10/group) were infused for 8 h with
endotoxin [lipopolysaccharide (LPS), 0 and 10 µg · kg
1 · h1].
Plasma amino acid and glucose concentrations were kept at the fed level
by infusion of dextrose and a balanced amino acid mixture. Fractional
protein synthesis rates were determined by use of a flooding dose of
[3H]phenylalanine. LPS infusion produced a septic-like
state, as indicated by an early and sustained elevation in body
temperature, heart rate, and plasma tumor necrosis factor-
,
interleukin-1, cortisol, and lactate concentrations. Plasma levels of
insulin increased, whereas glucose and amino acids decreased,
suggesting the absence of insulin resistance. LPS significantly reduced
protein synthesis in longissimus dorsi muscle by only 11% and in
gastrocnemius by only 15%, but it had no significant effect in
masseter and cardiac muscles. LPS increased protein synthesis in the
liver (22%), spleen (28%), kidney (53%), jejunum (19%), diaphragm
(21%), lung (50%), and skin (13%), but not in the stomach, pancreas, or brain. These findings suggest that, when substrate supply is maintained, skeletal muscle protein synthesis in neonates compared with
adults is relatively resistant to the catabolic effects of sepsis.
sepsis; nutrition; infection; insulin; amino acids
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