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Variability in Skeletal Muscle Protein Synthesis Rates in Critically Ill Patients.

Inga Tjäder¹, Maria Klaude¹, Ali Ait Hssain²

¹Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, 14186 Huddinge, Sweden.

|September 23, 2022

Summary

This summary is machine-generated.

Critically ill patients exhibit wide variations in muscle protein synthesis rates. This variability is not explained by differences in synthesis rates between muscle types or infiltrating cells.

Keywords:

multiple organ failure muscle morphology protein synthesis stable isotopes

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Area of Science:

Critical care medicine
Muscle physiology
Biochemistry

Background:

Critically ill patients experience significant muscle loss despite seemingly normal average muscle protein synthesis rates.
A notable variability in muscle protein synthesis rates exists in this patient population compared to healthy controls.
The underlying causes for this wide variation in muscle protein synthesis remain unclear.

Purpose of the Study:

To investigate the sources of variability in muscle protein synthesis rates among critically ill patients.
To determine if heterogeneity in synthesis rates, morphological changes, infiltrating cells, or differential protein fraction synthesis contribute to this variation.
To compare muscle protein synthesis rates of specific proteins (myosin, actin) between critically ill patients and controls.

Main Methods:

Muscle biopsies were obtained from both legs of 17 critically ill patients.
Mixed and mitochondrial protein synthesis rates and muscle morphology were assessed.
Synthesis rates of myosin and actin were measured and compared to control groups.

Main Results:

Muscle protein synthesis rates in patients varied significantly, ranging from 1.4 to 10.8%/day.
No significant differences in synthesis rates or morphology were found between the two legs of the patients.
Microscopic analysis showed no evidence of infiltrating inflammatory cells.
Synthesis rates for myosin were lower, while actin synthesis rates were higher in critically ill patients compared to controls.

Conclusions:

The wide variation in muscle protein synthesis rates in critically ill patients is not attributable to general synthesis rate heterogeneity or cellular infiltration.
While differences exist in the synthesis rates of specific proteins like myosin and actin, these do not fully account for the observed broad variability.
Further research is needed to elucidate the precise mechanisms driving the wide range of muscle protein synthesis rates in critical illness.