Measurement of human tissue protein synthesis: an optimal approach

This paper reviews the evidence for and against the adoption of methods for the measurement of human tissue protein synthesis based upon the incorporation of stable isotopically labeled amino acids administered either as a continuous infusion or as a flooding dose. The practical advantages of the flooding dose method are the relative ease of application of the tracer and the ability to make a repeat measurement within approximately 2 h. For the method depending upon continuous infusion of labeled amino acid, the advantages include the use of labeled amino acids at true tracer doses (i.e., with no disturbance of metabolism) and the ability to make simultaneous measurements of whole body turnover and limb or organ turnover (given appropriate sampling techniques). The crucial question concerning the accuracy of the two methods (e.g., the 2-fold difference in the rate of skeletal muscle protein synthesis) remains unresolved, but in our opinion more evidence exists in favor of the values obtained from the continuous infusion method. Furthermore, as techniques for measurement of stable isotopically labelled amino acids improve, the length of time necessary for tracer infusion will fall, and the practical advantages of the flooding dose protocol will lessen in comparison.