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1 Duke University
2 Beth Israel Deaconess Medical Center
* To whom correspondence should be addressed. E-mail: phasselg{at}bidmc.harvard.edu.
Muscle wasting in sepsis reflects activation of multiple proteolytic mechanisms, including lyosomal and ubiquitin-proteasome-dependent protein breakdown. Recent studies suggest that activation of the calpain system also plays an important role in sepsis-induced muscle wasting. Perhaps the most important consequence of calpain activation in skeletal muscle during sepsis is disruption of the sarcomere, allowing for the release of myofilaments that are subsequently ubiquitinated and degraded by the 26S proteasome. Other important consequences of calpain activation that may contribute to muscle wasting during sepsis include degradation of certain transcription factors and nuclear cofactors, activation of the 26S proteasome, and inhibition of Akt activity, allowing for downstream activation of Foxo transcription factors and GSK-3
. Importantly, treatment of septic rats with calpain inhibitors prevented sepsis-induced muscle proteolysis in recent studies, suggesting that the calpain system may be a therapeutic target in the treatment of muscle wasting during sepsis.
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