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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amino acid uptake in skeletal muscle is reduced during different catabolic conditions such as sepsis, endotoxic shock, and uremia. The present study was designed to determine the effect of another catabolic condition, starvation, on amino acid transport in skeletal muscle. Male Sprague-Dawley rats (40-60 g) were starved for 24, 48, or 72 hr and soleus (SOL) muscles were removed intact and incubated for 2 hr in a medium consisting of Krebs-Henseleit bicarbonate buffer (pH 7.4) with glucose (5 mM), [14C]-inulin, and [3H]-alpha-aminoisobutyric acid (AIB). Amino acid uptake was determined from intracellular to extracellular ratio of AIB following incubation. AIB uptake was significantly reduced after 24 hr of starvation and remained low with further fasting. After 72 hr the AIB distribution ratio was approximately 50% of initial value. Amino acid uptake returned to normal within 24 hr after refeeding of animals that had been starved for 72 hr. Plasma (0.25 ml) from starved rats, added to the incubation medium (2.75 ml) of muscles from nonfasted rats, significantly inhibited AIB uptake. The present results suggest that amino acid uptake in skeletal muscle is progressively reduced during starvation, an effect that may be mediated by a circulating factor(s) present in blood.
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PMID:Inhibited amino acid uptake in skeletal muscle during starvation. 277 39

The metabolic response to injury is a different process from starvation. As such, it requires a different set of nutritional support principles in order to provide effective therapy that is cost-conscious and with a minimum of complications. In all cases, it is essential to restore and to maintain oxygen transport prior to instituting nutritional support. In the higher levels of stress, an enhanced response can be achieved with the modified amino acid formulas in a setting of balanced nutritional support. With the principles outlined above, nutritional status can be effectively managed in most settings as a variable that influences morbidity and mortality in surgery, polytrauma, and sepsis.
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PMID:The role of nutrition in the management of metabolic stress. 314 19

Sepsis and starvation are catabolic conditions often occurring simultaneously. We recently found that uptake of the nonmetabolized amino acid analog, alpha-aminoisobutyrate (AIB), was reduced in skeletal muscle during sepsis, and data were presented suggesting that this reduction was caused by a factor present in septic plasma. The purpose of the present study was to determine the effect of starvation on amino acid uptake and to investigate possible interactions between sepsis and starvation regarding effects on muscle amino acid uptake. Soleus muscles were removed intact from rats fasted for 0, 24, 48, or 72 hr. Muscles were incubated for 2 hr in Krebs-Henseleit bicarbonate buffer (pH 7.4) and glucose (5 mM) with or without 0.25 ml of septic plasma (total volume 3 ml). Muscle AIB uptake progressively decreased by approximately 50% during the first 48 hr of starvation, with no further decrease at 72 hr. Addition of septic plasma in vitro reduced AIB uptake in muscles from fed rats and from rats which had been fasted for 24 hr, but did not further reduce uptake after longer periods of starvation. The results suggest that starvation reduces amino acid uptake in skeletal muscle and that the nutritional status of muscle is an important component of the response to the factor(s) in septic plasma capable of inhibiting amino acid uptake.
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PMID:Effect of sepsis and starvation on amino acid uptake in skeletal muscle. 355 42

1. Plasma fibronectin, a glycoprotein, is an opsonin of the reticuloendothelial system. 2. In ten healthy volunteers starved for 4.5 d, daily measurements showed a rapid reduction in plasma fibronectin, no alteration in either C3 or plasma transferrin and, at the end of the starvation period, an elevated serum albumin. 3. On refeeding, plasma fibronectin rapidly returned to its prestarvation level but plasma transferrin was significantly reduced and did not recover by the end of the study. 4. Changes in plasma fibronectin may be a sensitive index of nutritional status. The reduction of plasma fibronectin in short-term starvation may compromise host defence tolerance of injury and sepsis.
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PMID:Changes in plasma fibronectin during acute nutritional deprivation in healthy human subjects. 366 79

Several investigators have demonstrated a diminished rate of ketogenesis during inflammatory or infectious states despite the availability of free fatty acids supplied to the liver. The biochemical mechanism for this effect is unknown. Malonyl-CoA has been proposed to be a regulator of ketogenesis. Malonyl-CoA levels are low in states of rapid ketogenesis such as starvation or diabetes and high in states of reduced ketogenesis such as carbohydrate feeding. In the present study, the effect of an intra-abdominal abscess on the level of hepatic malonyl-CoA was investigated in four groups of animals (fed control, sterile inflammation, small chronic septic abscess, large chronic septic abscess). Liver samples were frozen in situ 5 days following the intraperitoneal introduction of a rat-fecal agar pellet inoculated with a known bacterial flora which generated an abscess [sterile inflammatory; B. fragilis 10(8)/ml + E. coli 10(2)/ml (small, 0.8 ml or large, 1.5 ml) abscess pellet]. The level of malonyl-CoA in normal fed rats was 5.0 +/- 0.6 nmol/gm wet wt (n = 9). The malonyl-CoA level was not altered in animals with a sterile inflammation. However, hepatic malonyl-CoA levels were significantly increased in small (10 +/- 1 nmole/gm wet wt) (p less than 0.05; n = 9) or large (12 +/- 1 nmol/gm wet wt) (p less than 0.01; n = 14) septic abscess rats compared to control fed and sterile inflammatory rats. Hepatic ketone bodies (beta-hydroxybutyrate and acetoacetate) did not increase in sepsis over control or sterile inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A biochemical basis for depressed ketogenesis in sepsis. 370 91

An experimental study was undertaken to study the influences of an infusion of lipid emulsion on phagocytosis of Kupffer's cells in septic rats. Sepsis was induced in 13 rats by ligating the cecum. Five of them received glucose as the sole nonprotein calorie (septic-glucose group), four of the rats received 25% of the nonprotein calorie with lipid emulsion, Intralipid (septic-lipid group), and the remaining four rats did not receive any intravenous solution and were allowed access to water (septic-fasted group). Another four rats which received neither intravenous solution nor ligation of the cecum served as the control group. The intravenous infusion was carried out for 72 hr. The phagocytotic activity of Kupffer's cells was determined by the ability to engulf latex particles with a size of 1.09 micron, in vitro. The phagocytotic activity was enhanced by the presence of sepsis but it was inhibited by starvation. The difference in the phagocytotic activity between the septic-glucose group and the septic-lipid group was not significant. These results suggest that, insofar as an in vitro study is concerned, a 72-hr infusion of lipid emulsion at a rate of 25% of the total nonprotein calorie does not influence the phagocytotic activity of cultured Kupffer's cell obtained from septic rats.
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PMID:Influences of an infusion of lipid emulsion on phagocytotic activity of cultured Kupffer's cells in septic rats. 379 52

The metabolic responses associated with the tumor-bearing state, as compared to states of sepsis and prolonged starvation, were examined. Tumor-bearing rats manifested significant elevation of triglycerides, significant reduction of glucose and insulin levels, significantly increased plasma skeletal muscle proteolysis-inducing activity, and an unchanged hepatic protein synthetic activity compared to control rats. Prolonged starvation produced an adaptation characterized by significant hypoglycemia and hypoinsulinemia, reduced hepatic protein synthesis, and increased peripheral protolysis compared to controls. Septic animals had glucose, insulin, and lipid levels similar to control animals but had increased hepatic protein synthesis. Each state manifested its own unique metabolic response compared to controls. It appears that the metabolic consequences of cancer in this sarcoma rat model is different than septic and prolonged starvation states.
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PMID:Tumor-associated metabolism in the rat is a unique physiologic entity. 388 27

Acute and chronic malnutrition is associated with increased morbidity and mortality in surgical patients. Plasma fibronectin levels have been shown to correlate with reticuloendothelial function and are reduced in burns, shock, trauma, and sepsis. Patients failing to show an increase in fibronectin levels after stress have been shown to do poorly. Starvation studies in human volunteers have demonstrated decreasing plasma fibronectin levels until feeding was resumed. The purpose of this study is to examine the usefulness of fibronectin as an assessment parameter in nutritionally depleted hospitalized patients. Eight patients initiated on parenteral nutrition were studied. Plasma fibronectin, albumin, and transferrin levels were drawn before TPN and repeated at various intervals after total parenteral nutrition (TPN) was begun. Mean pre-TPN transferrin was 198.1 +/- 16.1 gm/dl (nl 220-400). Transferrin levels remained statistically unchanged after 8 to 11 days of TPN. Mean pre-TPN albumin was 3.0 +/- 0.2 gm/dl (nl 3.6-4.8) and also remained statistically unchanged after 8 to 11 days of TPN. The mean fibronectin level pre-TPN was 236.4 +/- 24.4 microgram/ml (nl 370-410). Fibronectin rose statistically (P less than 0.005) after 1 to 4 days of TPN to a mean of 341.9 +/- 30.1 microgram/ml and remained elevated and statistically unchanged after 8 to 11 days of TPN. Six of the eight patients studied survived and had demonstrated at least a 30 per cent increase in fibronectin after 1 to 4 days of TPN. Both patients who died demonstrated minimal increase in fibronectin levels after 1 to 4 days of TPN.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fibronectin. A new nutritional parameter. 392 69

There are many tumors that have paraneoplastic syndromes. Furthermore, location of certain tumors can result in very specific effects on the host, especially tumors in the hypothalamus, the intestinal tract, or the liver. Finally, tumors of the immune system can have significant distant consequences. However, from direct experimental evidence, from model systems, and from the utilization of nutritional manipulation in the treatment of cancer, the data suggest very strongly that there is no unique cancer malnutrition. Early diagnosed cancer does not show malnutrition as a presenting symptom. Furthermore, all metabolic disturbances can be explained on the basis of the metabolic differences of tumor cells and normal cells and are very frequently proportional to the bulk of the tumor. The cachexia that is associated with malignancies is more likely cachexia in cancer patients than it is a specific cancer cachexia, unless the tumor burden is very large. This point was clearly made in a short review of the causes of cachexia in nearly 1500 cancer patients in Russia (145). Brennan also feels that most cases of malnutrition are uncomplicated starvation, and cancer cachexia has many features seen in major injury or sepsis (16). This distinction has great implications in the management of cancer patients.
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PMID:Nutrition and cancer: physiological interrelationships. 392 50

We have developed a conscious septic dog model suitable for in vivo tracer studies. Dogs weighing 10 to 20 kg underwent general anesthesia followed by the insertion of long-term arterial, venous, and portal cannulas and the formation of a long-term tracheostomy. After 7 to 10 days of convalescence, the animals were fed in the morning and 4 hours later 10(10) live Escherichia coli organisms were infused intra-arterially over approximately 30 minutes. One hour later a second dose of 5 X 10(9) bacteria was given, again over 30 minutes. Resuscitation was provided by infusion of 1000 ml of lactated Ringer solution over 3 hours. Twenty-four hours after the induction of sepsis the animals were hemodynamically stable and suitable for study. Cardiac output was increased from the control value of 185 +/- 35 ml/kg X min to 308 +/- 44 ml/kg X min in the septic animals. Heart rate was increased from 98 +/- 10 to 125 +/- 5 beats/min, and arterial pressure was not significantly altered. We employed indirect calorimetry and primed constant infusions of both radioactive and stable isotopes to assess a variety of metabolic parameters. The metabolic rate was increased approximately 25%, and the energy for this increase was primarily provided by the increased oxidation of both free fatty acids and triglyceride. The release of free fatty acids was approximately three times greater than the control value, and triglyceride synthesis increased 500%. The oxidation rate of free fatty acids and the fatty acids contained in very low density lipoproteins-triglyceride increased 40% and 900%, respectively. Glucose production was maintained at approximately the control value, and the rate of glucose oxidation (as measured with 14C-glucose) was also not significantly altered. The plasma insulin concentration was moderately elevated, and plasma glucagon concentration was five to six times greater than the control value. Plasma catecholamine levels were increased significantly. This model is suitable for the performance of metabolic studies in sepsis. The induction of a hyperdynamic septic state in less than 24 hours avoids the complications of starvation and dehydration frequently seen in the various peritonitis and abscess models. Most importantly, the model is predictable in its time course and reproducibly creates a situation that hormonally, hemodynamically, and metabolically resembles what is commonly seen in humans with sepsis.
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PMID:A conscious septic dog model with hemodynamic and metabolic responses similar to responses of humans. 636 96


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