[Relation of airway obstruction and respiratory muscle weakness to energy metabolism in pulmonary emphysema]

Resting energy expenditure (REE) was assessed and its relationship to nutritional status, pulmonary function and respiratory muscle function was studied in 25 patients with pulmonary emphysema. The mean value of REE was 1413 +/- 251 Cal and the ratio of REE/REEpred was 1.398 +/- 0.23, suggesting the existence of a hypermetabolic state in these patients. REE/REEpred ratio was inversely correlated with plasma amino acid BCAA/AAA ratio and body muscle mass; and PImax. REE was inversely correlated with FEV1.0%. REE in the patient subgroup with severe hyperinflation (%RV > or = 200) was significantly higher than that in the subgroup with moderate hyperinflation. Malnourished patients showed significantly more severe hyperinflation than well-nourished patients. These findings suggest that augmented REE contributes to malnutrition in patients with emphysema, and that the increase in REE was related to the increase in mechanical work load on the basis of airway obstruction, respiratory muscle weakness and hyperinflation.

[Nutritional assessment and the effect of supplementary oral nutrition in patients with pulmonary emphysema]

Nutritional status and its relation to respiratory function and respiratory muscle strength were assessed in patients with pulmonary emphysema. Energy metabolism was also examined in order to elucidate the mechanism of their malnutrition. BCAA/AAA ratio of plasma amino acid was positively correlated with FEV1.0%. Resting energy expenditure (REE) was negatively correlated with FEV1.0%, and REE/REEpred ratio was also negatively correlated with BCAA/AAA and PImax. These findings suggest that increased mechanical work load, associated with airway obstruction and reduced respiratory muscle efficiency, contribute to the increased energy expenditure and amino acid imbalance. Oral nutritional supplementation using BCAA enriched-elemental diet was found to be effective, as assessed by nutritional parameters, PImax, D.O.E., and QOL index, in malnourished emphysema patients.

Transcription of the T cell receptor beta-chain gene is controlled by multiple regulatory elements

The cis-acting sequences regulating transcription of the beta-chain of the TCR have been analyzed and multiple elements identified. The minimum 5' upstream sequence displaying promoter activity is a fragment extending 85 bp upstream of the transcriptional start site. Deletion of an additional 43 bp from the 5' end of this fragment abolished promoter activity. The presence of the conserved TCR beta-chain decanucleotide motif, an AP-1 consensus sequence and an inverted repeat in the deleted region, suggests their role as targets for transacting factors regulating transcription of the beta chain gene. Sequences between -343 and -85 increase transcription from the -85 fragment in T cells. The promoter is active in both T cells and fibroblasts. The enhancer was capable of enhancing TCR V beta 2 promoter activity in both T cells and fibroblasts. Sequences further upstream of the V beta 2 promoter down regulate V beta 2 promoter activity in the absence of the enhancer but its repressive influence is overcome in the presence of the TCR beta-chain enhancer.

Transcription of the T cell receptor beta-chain gene is controlled by multiple regulatory elements

The cis-acting sequences regulating transcription of the beta-chain of the TCR have been analyzed and multiple elements identified. The minimum 5' upstream sequence displaying promoter activity is a fragment extending 85 bp upstream of the transcriptional start site. Deletion of an additional 43 bp from the 5' end of this fragment abolished promoter activity. The presence of the conserved TCR beta-chain decanucleotide motif, an AP-1 consensus sequence and an inverted repeat in the deleted region, suggests their role as targets for transacting factors regulating transcription of the beta chain gene. Sequences between -343 and -85 increase transcription from the -85 fragment in T cells. The promoter is active in both T cells and fibroblasts. The enhancer was capable of enhancing TCR V beta 2 promoter activity in both T cells and fibroblasts. Sequences further upstream of the V beta 2 promoter down regulate V beta 2 promoter activity in the absence of the enhancer but its repressive influence is overcome in the presence of the TCR beta-chain enhancer.