Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma
Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volu...
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| Veröffentlicht in: | The New England journal of medicine 1983-03, Vol.308 (10), p.545-552 |
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| creator | Clowes, George H. A George, Barbara C Villee, Claude A Saravis, Calvin A |
| description | Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volunteers and from 15 patients who had undergone "clean" elective surgical procedures. The mean proteolytic activity in the plasma of patients with trauma or sepsis was found to be 190±8.0 per cent of the control value (rat muscle incubated in medium alone), whereas the activity in normal plasma was 124±4.5 per cent (P |
| doi_str_mv | 10.1056/NEJM198303103081001 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_80379862</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4319356831</sourcerecordid><originalsourceid>FETCH-LOGICAL-c402t-e53eb6f04475bfb5d37a28a13868db715fea44983c2e485a340b590dbabe846e2</originalsourceid><addsrcrecordid>eNp9kFtLw0AQhRdRaq3-AhEWBF8kOpu9ZPMopWrFasH2OewmE03Jpe4mSP-9KS0-iDgvAzPfOcwcQs4Z3DCQ6vZl8jRjsebAGXDQDIAdkCGTnAdCgDokQ4BQByKK-TE58X4FfTERD8hA6VCDhiFZzjqflkjnrmmxKTe-8HRaZ12KGbUbaui4cGlXmrao3-kc122RIS1qOu8nWLeefhXtB33D9VbYOLpwpqvMKTnKTenxbN9HZHk_WYwfg-fXh-n47jlIBYRtgJKjVTkIEUmbW5nxyITaMK6VzmzEZI5GiP7DNEShpeECrIwhs8aiFgrDEbna-a5d89mhb5Oq8CmWpamx6XyigUexVmEPXv4CV03n6v62hOlIaCVDxXqK76jUNd47zJO1KyrjNgmDZBt58kfkvepi793ZCrMfzT7jfn-921eVT2pcVf-6fQOEX4cC</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1874865261</pqid></control><display><type>article</type><title>Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma</title><source>MEDLINE</source><creator>Clowes, George H. A ; George, Barbara C ; Villee, Claude A ; Saravis, Calvin A</creator><creatorcontrib>Clowes, George H. A ; George, Barbara C ; Villee, Claude A ; Saravis, Calvin A</creatorcontrib><description>Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volunteers and from 15 patients who had undergone "clean" elective surgical procedures. The mean proteolytic activity in the plasma of patients with trauma or sepsis was found to be 190±8.0 per cent of the control value (rat muscle incubated in medium alone), whereas the activity in normal plasma was 124±4.5 per cent (P<0.001). The activity in the plasma of patients who had undergone elective surgery was slightly elevated at 142±2.5 per cent (P<0.005).
In 25 of the patients with trauma or sepsis the rate of amino acid release from one leg was measured by subtracting the concentration of tyrosine plus phenylalanine in the femoral artery plasma from that in the femoral vein; this rate correlated well with the bioactivity of the plasma in the bioassay system (r = 0.67, P<0.001).
By means of ultrafiltration and chromatography, the plasma factor inducing proteolysis was isolated and found to be a peptide, probably containing sialic acid, with a chain of 33 amino acids and a molecular weight of approximately 4274 daltons. (N Engl J Med. 1983; 308: 545–52.)
The rapid onset of muscle wasting, protein depletion, and elevated urea excretion in patients with trauma
1
or sepsis
2
contrasts with the economic conservation of protein observed during starvation in the normal person.
3
After a brief fast, infected and injured patients were found to release amino acids from the leg at rates three to five times those observed in normal people in the postabsorptive state.
4
,
5
Thus, an increased supply of amino acids is made available in sepsis or trauma not only for energy production by gluconeogenesis and oxidation
2
,
6
but, more important, to satisfy the requirements of the liver and other visceral . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198303103081001</identifier><identifier>PMID: 6828080</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Amino acids ; Amino Acids - blood ; Animals ; Bioassays ; Biological activity ; Biological Assay ; Biopsy ; Breakdowns ; Chromatography ; Fasting ; Femoral artery ; Femur ; Glycopeptides - blood ; Hospitals ; Humans ; Hydrolysis ; In Vitro Techniques ; Infection - blood ; Infection - metabolism ; Insulin ; Metabolism ; Metabolites ; Molecular Weight ; Muscle Proteins - metabolism ; Musculoskeletal system ; Peptides - blood ; Phenylalanine ; Plasma ; Protein synthesis ; Proteins ; Proteolysis ; Rats ; Rats, Inbred Strains ; Rodents ; Sepsis ; Sialic Acids - blood ; Surgery ; Trauma ; Tyrosine ; Ultrafiltration ; Wounds and Injuries - blood ; Wounds and Injuries - metabolism</subject><ispartof>The New England journal of medicine, 1983-03, Vol.308 (10), p.545-552</ispartof><rights>Copyright Massachusetts Medical Society Mar 10, 1983</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-e53eb6f04475bfb5d37a28a13868db715fea44983c2e485a340b590dbabe846e2</citedby><cites>FETCH-LOGICAL-c402t-e53eb6f04475bfb5d37a28a13868db715fea44983c2e485a340b590dbabe846e2</cites></display><links><openurl>$$Topenurl_article</openurl><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/6828080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clowes, George H. A</creatorcontrib><creatorcontrib>George, Barbara C</creatorcontrib><creatorcontrib>Villee, Claude A</creatorcontrib><creatorcontrib>Saravis, Calvin A</creatorcontrib><title>Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volunteers and from 15 patients who had undergone "clean" elective surgical procedures. The mean proteolytic activity in the plasma of patients with trauma or sepsis was found to be 190±8.0 per cent of the control value (rat muscle incubated in medium alone), whereas the activity in normal plasma was 124±4.5 per cent (P<0.001). The activity in the plasma of patients who had undergone elective surgery was slightly elevated at 142±2.5 per cent (P<0.005).
In 25 of the patients with trauma or sepsis the rate of amino acid release from one leg was measured by subtracting the concentration of tyrosine plus phenylalanine in the femoral artery plasma from that in the femoral vein; this rate correlated well with the bioactivity of the plasma in the bioassay system (r = 0.67, P<0.001).
By means of ultrafiltration and chromatography, the plasma factor inducing proteolysis was isolated and found to be a peptide, probably containing sialic acid, with a chain of 33 amino acids and a molecular weight of approximately 4274 daltons. (N Engl J Med. 1983; 308: 545–52.)
The rapid onset of muscle wasting, protein depletion, and elevated urea excretion in patients with trauma
1
or sepsis
2
contrasts with the economic conservation of protein observed during starvation in the normal person.
3
After a brief fast, infected and injured patients were found to release amino acids from the leg at rates three to five times those observed in normal people in the postabsorptive state.
4
,
5
Thus, an increased supply of amino acids is made available in sepsis or trauma not only for energy production by gluconeogenesis and oxidation
2
,
6
but, more important, to satisfy the requirements of the liver and other visceral . . .</description><subject>Amino acids</subject><subject>Amino Acids - blood</subject><subject>Animals</subject><subject>Bioassays</subject><subject>Biological activity</subject><subject>Biological Assay</subject><subject>Biopsy</subject><subject>Breakdowns</subject><subject>Chromatography</subject><subject>Fasting</subject><subject>Femoral artery</subject><subject>Femur</subject><subject>Glycopeptides - blood</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hydrolysis</subject><subject>In Vitro Techniques</subject><subject>Infection - blood</subject><subject>Infection - metabolism</subject><subject>Insulin</subject><subject>Metabolism</subject><subject>Metabolites</subject><subject>Molecular Weight</subject><subject>Muscle Proteins - metabolism</subject><subject>Musculoskeletal system</subject><subject>Peptides - blood</subject><subject>Phenylalanine</subject><subject>Plasma</subject><subject>Protein synthesis</subject><subject>Proteins</subject><subject>Proteolysis</subject><subject>Rats</subject><subject>Rats, Inbred Strains</subject><subject>Rodents</subject><subject>Sepsis</subject><subject>Sialic Acids - blood</subject><subject>Surgery</subject><subject>Trauma</subject><subject>Tyrosine</subject><subject>Ultrafiltration</subject><subject>Wounds and Injuries - blood</subject><subject>Wounds and Injuries - metabolism</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>false</fulltext><rsrctype>article</rsrctype><creationdate>1983</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kFtLw0AQhRdRaq3-AhEWBF8kOpu9ZPMopWrFasH2OewmE03Jpe4mSP-9KS0-iDgvAzPfOcwcQs4Z3DCQ6vZl8jRjsebAGXDQDIAdkCGTnAdCgDokQ4BQByKK-TE58X4FfTERD8hA6VCDhiFZzjqflkjnrmmxKTe-8HRaZ12KGbUbaui4cGlXmrao3-kc122RIS1qOu8nWLeefhXtB33D9VbYOLpwpqvMKTnKTenxbN9HZHk_WYwfg-fXh-n47jlIBYRtgJKjVTkIEUmbW5nxyITaMK6VzmzEZI5GiP7DNEShpeECrIwhs8aiFgrDEbna-a5d89mhb5Oq8CmWpamx6XyigUexVmEPXv4CV03n6v62hOlIaCVDxXqK76jUNd47zJO1KyrjNgmDZBt58kfkvepi793ZCrMfzT7jfn-921eVT2pcVf-6fQOEX4cC</recordid><startdate>19830310</startdate><enddate>19830310</enddate><creator>Clowes, George H. A</creator><creator>George, Barbara C</creator><creator>Villee, Claude A</creator><creator>Saravis, Calvin A</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19830310</creationdate><title>Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma</title><author>Clowes, George H. A ; George, Barbara C ; Villee, Claude A ; Saravis, Calvin A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-e53eb6f04475bfb5d37a28a13868db715fea44983c2e485a340b590dbabe846e2</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1983</creationdate><topic>Amino acids</topic><topic>Amino Acids - blood</topic><topic>Animals</topic><topic>Bioassays</topic><topic>Biological activity</topic><topic>Biological Assay</topic><topic>Biopsy</topic><topic>Breakdowns</topic><topic>Chromatography</topic><topic>Fasting</topic><topic>Femoral artery</topic><topic>Femur</topic><topic>Glycopeptides - blood</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hydrolysis</topic><topic>In Vitro Techniques</topic><topic>Infection - blood</topic><topic>Infection - metabolism</topic><topic>Insulin</topic><topic>Metabolism</topic><topic>Metabolites</topic><topic>Molecular Weight</topic><topic>Muscle Proteins - metabolism</topic><topic>Musculoskeletal system</topic><topic>Peptides - blood</topic><topic>Phenylalanine</topic><topic>Plasma</topic><topic>Protein synthesis</topic><topic>Proteins</topic><topic>Proteolysis</topic><topic>Rats</topic><topic>Rats, Inbred Strains</topic><topic>Rodents</topic><topic>Sepsis</topic><topic>Sialic Acids - blood</topic><topic>Surgery</topic><topic>Trauma</topic><topic>Tyrosine</topic><topic>Ultrafiltration</topic><topic>Wounds and Injuries - blood</topic><topic>Wounds and Injuries - metabolism</topic><toplevel>peer_reviewed</toplevel><creatorcontrib>Clowes, George H. A</creatorcontrib><creatorcontrib>George, Barbara C</creatorcontrib><creatorcontrib>Villee, Claude A</creatorcontrib><creatorcontrib>Saravis, Calvin A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>no_fulltext</fulltext></delivery><addata><au>Clowes, George H. A</au><au>George, Barbara C</au><au>Villee, Claude A</au><au>Saravis, Calvin A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1983-03-10</date><risdate>1983</risdate><volume>308</volume><issue>10</issue><spage>545</spage><epage>552</epage><pages>545-552</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volunteers and from 15 patients who had undergone "clean" elective surgical procedures. The mean proteolytic activity in the plasma of patients with trauma or sepsis was found to be 190±8.0 per cent of the control value (rat muscle incubated in medium alone), whereas the activity in normal plasma was 124±4.5 per cent (P<0.001). The activity in the plasma of patients who had undergone elective surgery was slightly elevated at 142±2.5 per cent (P<0.005).
In 25 of the patients with trauma or sepsis the rate of amino acid release from one leg was measured by subtracting the concentration of tyrosine plus phenylalanine in the femoral artery plasma from that in the femoral vein; this rate correlated well with the bioactivity of the plasma in the bioassay system (r = 0.67, P<0.001).
By means of ultrafiltration and chromatography, the plasma factor inducing proteolysis was isolated and found to be a peptide, probably containing sialic acid, with a chain of 33 amino acids and a molecular weight of approximately 4274 daltons. (N Engl J Med. 1983; 308: 545–52.)
The rapid onset of muscle wasting, protein depletion, and elevated urea excretion in patients with trauma
1
or sepsis
2
contrasts with the economic conservation of protein observed during starvation in the normal person.
3
After a brief fast, infected and injured patients were found to release amino acids from the leg at rates three to five times those observed in normal people in the postabsorptive state.
4
,
5
Thus, an increased supply of amino acids is made available in sepsis or trauma not only for energy production by gluconeogenesis and oxidation
2
,
6
but, more important, to satisfy the requirements of the liver and other visceral . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>6828080</pmid><doi>10.1056/NEJM198303103081001</doi><tpages>8</tpages></addata></record> |
| fulltext | no_fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 1983-03, Vol.308 (10), p.545-552 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE |
| subjects | Amino acids Amino Acids - blood Animals Bioassays Biological activity Biological Assay Biopsy Breakdowns Chromatography Fasting Femoral artery Femur Glycopeptides - blood Hospitals Humans Hydrolysis In Vitro Techniques Infection - blood Infection - metabolism Insulin Metabolism Metabolites Molecular Weight Muscle Proteins - metabolism Musculoskeletal system Peptides - blood Phenylalanine Plasma Protein synthesis Proteins Proteolysis Rats Rats, Inbred Strains Rodents Sepsis Sialic Acids - blood Surgery Trauma Tyrosine Ultrafiltration Wounds and Injuries - blood Wounds and Injuries - metabolism |
| title | Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma |
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