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Drummer DJ, McAdam JS, Seay R, Aban I, Lavin KM, Wiggins D, Touliatos G, Yang S, Kelley C, Tuggle SC, Peoples B, Siegel H, Ghanem E, Singh JA, Schutzler S, Barnes CL, Ferrando AA, Bridges SL, Bamman MM. Perioperative assessment of muscle inflammation susceptibility in patients with end-stage osteoarthritis. J Appl Physiol (1985) 2022; 132:984-994. [PMID: 35238652 PMCID: PMC8993516 DOI: 10.1152/japplphysiol.00428.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/22/2022] Open
Abstract
Many individuals with end-stage osteoarthritis (OA) undergo elective total hip/knee arthroplasty (THA/TKA) to relieve pain, improve mobility and quality of life. However, ∼30% suffer long-term mobility impairment following surgery. This may be in part due to muscle inflammation susceptibility (MuIS+), an overt proinflammatory pathology localized to skeletal muscle surrounding the diseased joint, present in some patients with TKA/THA. We interrogated the hypothesis that MuIS+ status results in a perturbed perioperative gene expression profile and decreases skeletal muscle integrity in patients with end-stage OA. Samples were leveraged from the two-site, randomized, controlled trial R01HD084124, NCT02628795. Participants were dichotomized based on surgical (SX) muscle gene expression of TNFRSF1A (TNF-αR). MuIS+/- samples were probed for gene expression and fibrosis. Paired and independent two-tailed t tests were used to determine differences between contralateral (CTRL) and surgical (SX) limbs and between-subject comparisons, respectively. Significance was declared at P < 0.05. Seventy participants (26M/44F; mean age 62.41 ± 8.86 yr; mean body mass index 31.10 ± 4.91 kg/m2) undergoing THA/TKA were clustered as MuIS+ (n = 24) or MuIS- (n = 46). Lower skeletal muscle integrity (greater fibrosis) exists on the SX versus CTRL limb (P < 0.001). Furthermore, MuIS+ versus MuIS- muscle exhibited higher proinflammatory (IL-6R and TNF-α) and catabolic (TRIM63) gene expression (P < 0.001, P = 0.004, and 0.024 respectively), with a trend for greater fibrosis (P = 0.087). Patients with MuIS+ exhibit more inflammation and catabolic gene expression in skeletal muscle of the SX limb, accompanied by decreased skeletal muscle integrity (Trend). This highlights the impact of MuIS+ status emphasizing the potential value of perioperative MuIS assessment to inform optimal postsurgical care.NEW & NOTEWORTHY This study assessed the skeletal muscle molecular characteristics associated with end-stage osteoarthritis and refined an important phenotype, in some patients, termed muscle inflammation susceptibility (MuIS+) that may be an important consideration following surgery. Furthermore, we provide evidence of differential inflammatory and catabolic gene expression between the contralateral and surgical limbs along with differences between the skeletal muscle surrounding the diseased hip versus knee joints.
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Affiliation(s)
- Devin J Drummer
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jeremy S McAdam
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Regina Seay
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Inmaculada Aban
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kaleen M Lavin
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Derek Wiggins
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gabriel Touliatos
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sufen Yang
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christian Kelley
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - S Craig Tuggle
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
| | - Brandon Peoples
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Herrick Siegel
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Elie Ghanem
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jasvinder A Singh
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Comprehensive Arthritis, Musculoskeletal, Bone, and Autoimmunity Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Scott Schutzler
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - C Lowry Barnes
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Arny A Ferrando
- Department of Geriatrics and Center for Translational Research in Aging and Longevity, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - S Louis Bridges
- Department of Medicine, Hospital for Special Surgery, New York, New York
- Division of Rheumatology, Weill Cornell Medical Center, New York, New York
| | - Marcas M Bamman
- UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, Alabama
- Florida Institute for Human and Machine Cognition, Pensacola, Florida
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Drummer D, Lavin K, McAdam J, Seay R, Wiggins D, Aban I, Touliatos G, Yang S, Kelly C, Schutzler S, Singh J, Siegel H, Ghanem E, Zhang J, Craig M, Kadakia M, Barnes L, Ferrando A, Louis Bridges S, Bamman M. Muscle Inflammation Susceptibility: A Potential Prognostic Factor For Optimal Post-surgical Rehabilitation. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764676.28273.0b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Evans W, Shankaran M, Nyangau E, Field T, Mohammed H, Wolfe R, Schutzler S, Hellerstein M. Effects of Fortetropin on the Rate of Muscle Protein Synthesis in Older Men and Women: A Randomized, Double-Blinded, Placebo-Controlled Study. J Gerontol A Biol Sci Med Sci 2021; 76:108-114. [PMID: 32598445 PMCID: PMC7756695 DOI: 10.1093/gerona/glaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Fortetropin is a proteo-lipid complex made from fertilized egg yolk and, in young men, has been shown to increase lean body mass. METHODS The purpose of this study was to examine the effects of 21 days of Fortetropin supplementation on the fractional synthetic rate (FSR) of muscle protein in 10 healthy, older men and 10 women (66.4 ± 4.5 y). We used 2H2O labeling to measure FSR of multiple muscle protein ontologies. D3-creatine dilution was used to determine muscle mass at baseline. Subjects ingested 70% 2H2O for 21 day and saliva samples were collected to determine body 2H2O enrichment. A microbiopsy was obtained from the m. vastus lateralis on Day 21. Subjects were randomly assigned to Fortetropin (19.8 g/d) or placebo (cheese powder, 19.8 g/d). RESULTS Restricting kinetic data to proteins with ≥2 peptides measured in at least 4 subjects per group resulted in 117 proteins meeting these criteria. The mean FSR for a majority of proteins in several muscle gene ontologies was higher in the Fortetropin group compared to placebo (32/38 myofibril proteins, 33/44 sarcoplasmic proteins, and 12/17 mitochondrial proteins) and this proportion was significantly different between groups using a binomial test and were independent of sex or baseline muscle mass. CONCLUSIONS The overall magnitude of the difference in muscle protein FSR of Fortetropin from placebo was 18%, with multiple gene ontologies affected. While these results should be confirmed in larger cohorts, they suggest that Fortetropin supplementation is effective for promoting muscle protein synthesis in older people.
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Affiliation(s)
- William Evans
- Department of Nutritional Sciences and Toxicology, University of California Berkeley.,Division of Geriatrics, Duke University School of Medicine, Durham, North Carolina
| | - Mahalakshmi Shankaran
- Department of Nutritional Sciences and Toxicology, University of California Berkeley
| | - Edna Nyangau
- Department of Nutritional Sciences and Toxicology, University of California Berkeley
| | - Tyler Field
- Department of Nutritional Sciences and Toxicology, University of California Berkeley
| | - Hussein Mohammed
- Department of Nutritional Sciences and Toxicology, University of California Berkeley
| | - Robert Wolfe
- Departement of Geriatrics, University of Arkansas for Medical Sciences, Little Rock
| | - Scott Schutzler
- Departement of Geriatrics, University of Arkansas for Medical Sciences, Little Rock
| | - Marc Hellerstein
- Department of Nutritional Sciences and Toxicology, University of California Berkeley
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Park S, Jang J, Choi MD, Shin YA, Schutzler S, Azhar G, Ferrando AA, Wolfe RR, Kim IY. The Anabolic Response to Dietary Protein Is Not Limited by the Maximal Stimulation of Protein Synthesis in Healthy Older Adults: A Randomized Crossover Trial. Nutrients 2020; 12:nu12113276. [PMID: 33114585 PMCID: PMC7693481 DOI: 10.3390/nu12113276] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/15/2023] Open
Abstract
We have recently demonstrated in young adults that an anabolic response with mixed meal protein intake above ~35 g/meal, previously recognized as an "optimal" protein dose, was further stimulated. However, it is unknown if this applies to older adults. We therefore examined anabolic response to a mixed meal containing either 35 g (MOD, moderate amount of protein) or 70 g (HIGH, high amount of protein) in a randomized cross-over metabolic study in older adults (n = 8). Primed continuous infusions of L-[2H5] phenylalanine and L-[2H2]tyrosine were performed to determine whole-body protein kinetics and muscle protein fractional synthesis rate (MPS) in basal fasted and fed states. Whole-body protein kinetics (NB, net protein balance; PS, protein synthesis; PB, protein breakdown) and MPS was expressed as changes from the baseline post-absorptive state. Consistent with our previous findings in young adults, both feedings resulted in a positive NB, with HIGH being more positive than MOD. Furthermore, NB (expressed as g protein∙240 min) increased linearly with an increasing amount of protein intake, expressed relative to lean body mass. The positive NB was achieved due mainly to the suppression of PB in both MOD and to a greater extent HIGH, while PS was only increased in HIGH. Consistent with the whole-body data, MPS was significantly higher in HIGH than MOD. Plasma concentrations of essential amino acids and insulin were greater in HIGH vs. MOD. We conclude that in the context of mixed meals, whole-body anabolic response linearly increases with increasing protein intake primarily through the suppression of PB, and MPS was further stimulated with protein intake above the previously considered "optimal" protein dose in older adults.
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Affiliation(s)
- Sanghee Park
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (S.P.); (J.J.)
- Department of Molecular Medicine, College of Medicine, Gachon University, Incheon 21999, Korea
| | - Jiwoong Jang
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (S.P.); (J.J.)
- Gil Medical Center, Gachon University, Incheon 21565, Korea
| | - Myung Dong Choi
- Department of Human Movement Science, Oakland University, Rochester, MI 48309, USA;
| | - Yun-A Shin
- Department of Prescription & Rehabilitation of Exercise, Dankook University, Cheonan 31116, Korea;
| | - Scott Schutzler
- Center for Translational Research in Aging and Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (S.S.); (G.A.); (A.A.F.); (R.R.W.)
| | - Gohar Azhar
- Center for Translational Research in Aging and Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (S.S.); (G.A.); (A.A.F.); (R.R.W.)
| | - Arny A. Ferrando
- Center for Translational Research in Aging and Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (S.S.); (G.A.); (A.A.F.); (R.R.W.)
| | - Robert R. Wolfe
- Center for Translational Research in Aging and Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (S.S.); (G.A.); (A.A.F.); (R.R.W.)
| | - Il-Young Kim
- Lee Gil Ya Cancer and Diabetes Institute, Gachon University, Incheon 21999, Korea; (S.P.); (J.J.)
- Department of Molecular Medicine, College of Medicine, Gachon University, Incheon 21999, Korea
- Center for Translational Research in Aging and Longevity, Department of Geriatrics, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; (S.S.); (G.A.); (A.A.F.); (R.R.W.)
- Correspondence: ; Tel.: +81-10-9701-8335
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Drummer D, Lavin K, McAdam J, Seay R, Wiggins D, Aban I, Touliatos G, Schutzler S, Singh J, Siegel H, Ghanem E, Zhang J, Ferrando A, Kadakia M, Barnes L, Bridges SL, Bamman M. Characterization Of Muscle Inflammation Susceptibility: A Potential Prognostic Factor For Optimal Post-surgical Rehabilitation. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000670956.83693.d2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Park S, Kim IY, Schutzler S, Ferrando A, Wolfe R. Ounce Equivalent Protein Ingestion Does Not Result in Equivalent Responses of Protein Kinetics (OR27-05-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz046.or27-05-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
The progressive loss of muscle mass, or sarcopenia, is inherent to aging and related to functionality and independence. It is well established that the loss of muscle mass can be mitigated with adequate dietary protein intake. To help the consumers meet protein requirements utilizing a variety of protein food sources, the Dietary Guidelines for Americans (DGAs) published an “ounce equivalents” recommendation for protein food sources. However, the actual equivalency of these varied protein food groups has not been established. We examined the responses of protein kinetics in response to consumption of ounce equivalents of ground beef, sirloin, eggs, pork loin, kidney beans, peanut butter, tofu, and mixed nuts in young subjects.
Methods
Subjects adhered to 3 days of activity and dietary control, and were then studied using an 8.5 h metabolic study which included a 4.5 h basal overnight-fasted period followed by a 4 h post-meal period. All groups were balanced by sex (4 males/4 females).
Results
Consumption of animal-based protein food sources resulted in higher whole body net balance than the plant-based protein food sources (P < 0.05). Consumption of beef sirloin, eggs, and pork loin induced a higher whole-body anabolic response than ground beef and the plant- based proteins. Consumption of tofu (soy-protein) induced a higher whole-body anabolic response than the other plant proteins (P < 0.05). The improvement in whole-body net balance with animal-based protein sources and tofu was due to a significant increase in protein synthesis (P < 0.05) as well as a significant suppression of protein breakdown in most protein sources (P < 0.05). Whole-body net balance was related to higher plasma EAA concentrations with animal-based protein sources and tofu realizing greater peripheral concentrations (P < 0.05).
Conclusions
The results of this study indicate that the “ounce equivalents” as expressed in the DGAs do not produce equivalent anabolic responses, nor are they equivalent in terms of the amount of protein provided, or the caloric cost of protein consumption. The magnitude of anabolic response appears to be largely determined by the amount of essential amino acids per gram of protein food source.
Funding Sources
The Beef Checkoff, National Pork Board, and Egg Nutrition Center.
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Affiliation(s)
| | - Il-Young Kim
- Lee Gil Ya Cancer and Diabetes Institute Gachon University School of Medicine
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Marquis BJ, Hurren NM, Carvalho E, Kim IY, Schutzler S, Azhar G, Wolfe RR, Børsheim E. Skeletal Muscle Acute and Chronic Metabolic Response to Essential Amino Acid Supplementation in Hypertriglyceridemic Older Adults. Curr Dev Nutr 2017; 1:e002071. [PMID: 29955688 PMCID: PMC5998789 DOI: 10.3945/cdn.117.002071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 09/28/2017] [Accepted: 10/16/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Supplementation with essential amino acids (EAAs) + arginine is a promising nutritional approach to decrease plasma triglyceride (TG) concentrations, which are an independent risk factor for ischemic heart disease. Objective: The objective of this study was to examine the effects of 8 wk of EAA supplementation on skeletal muscle basal metabolite concentrations and changes in metabolic response to acute EAA intake, with an emphasis on mitochondrial metabolism, in adults with elevated TGs to better understand the mechanisms of lowering plasma TGs. Methods: Older adults with elevated plasma TG concentrations were given 22 g EAAs to ingest acutely before and after an 8-wk EAA supplementation period. Skeletal muscle biopsy samples were collected before and after acute EAA intake, both pre- and postsupplementation (4 biopsy samples), and targeted metabolomic analyses of organic acids and acylcarnitines were conducted on the specimens. Results: Acute EAA intake resulted in increased skeletal muscle acylcarnitine concentrations associated with oxidative catabolism of the supplement components, with the largest increases found in acylcarnitines of branched-chain amino acid oxidative catabolism, including isovaleryl-carnitine (2200%) and 2-methylbutyryl-carnitine (2400%). The chronic EAA supplementation resulted in a 19% decrease in plasma TGs along with accumulation of long-chain acylcarnitines myristoyl- (90%) and stearoyl- (120%) carnitine in skeletal muscle and increases in succinyl-carnitine (250%) and the late-stage tricarboxylic acid cycle intermediates fumarate (44%) and malate (110%). Conclusions: Supplementation with EAAs shows promise as an approach for moderate reduction in plasma TGs. Changes in skeletal muscle metabolites suggest incomplete fatty acid oxidation and increased anaplerosis, which suggests a potential bottleneck in fatty acid metabolism.
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Affiliation(s)
- Bryce J Marquis
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Nicholas M Hurren
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Arkansas Children's Nutrition Center, Little Rock, AR
- Departments of Arkansas Children's Research Institute, Little Rock, AR
| | - Eugenia Carvalho
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Il-Young Kim
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Scott Schutzler
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Gohar Azhar
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Robert R Wolfe
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Elisabet Børsheim
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Departments of Arkansas Children's Nutrition Center, Little Rock, AR
- Departments of Arkansas Children's Research Institute, Little Rock, AR
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Kim IY, Schutzler S, Schrader AM, Spencer HJ, Azhar G, Wolfe RR, Ferrando AA. Protein intake distribution pattern does not affect anabolic response, lean body mass, muscle strength or function over 8 weeks in older adults: A randomized-controlled trial. Clin Nutr 2017; 37:488-493. [PMID: 28318687 DOI: 10.1016/j.clnu.2017.02.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS In our recent acute metabolic study, we found no differences in the anabolic response to differing patterns of dietary protein intake. To confirm this in a chronic study, we investigated the effects of protein distribution pattern on functional outcomes and protein kinetics in older adults over 8 weeks. METHODS To determine chronic effects of protein intake pattern at 1.1 g protein/kg/day in mixed meals on lean body mass (LBM), functional outcomes, whole body protein kinetics and muscle protein fractional synthesis rate (MPS) over 8-week respective dietary intervention, fourteen older subjects were randomly divided into either EVEN or UNVEN group. The UNEVEN group (n = 7) consumed the majority of dietary protein with dinner (UNEVEN, 15/20/65%; breakfast, lunch, dinner), while the EVEN group (n = 7) consumed dietary protein evenly throughout the day (EVEN: 33/33/33%). RESULTS We found no significant differences in LBM, muscle strength, and other functional outcomes between EVEN and UNEVEN before and after 8-week intervention. Consistent with these functional outcomes, we did not find significant differences in the 20-h integrated whole body protein kinetics [net protein balance (NB), protein synthesis (PS), and breakdown (PB)] above basal states and MPS between EVEN and UNEVEN intake patterns. CONCLUSIONS We conclude that over an 8-week intervention period, the protein intake distribution pattern in mixed meals does not play an important role in determining anabolic response, muscle strength, or functional outcomes. This trial is registered at https://ClinicalTrials.gov as NCT02787889.
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Affiliation(s)
- Il-Young Kim
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Department of Molecular Medicine, Lee Gil Ya Cancer and Diabetes Institute Gachon University School of Medicine, Incheon, Republic of Korea.
| | - Scott Schutzler
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Amy M Schrader
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Horace J Spencer
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Gohar Azhar
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Robert R Wolfe
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Arny A Ferrando
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Kim IY, Schutzler S, Schrader A, Spencer HJ, Azhar G, Ferrando AA, Wolfe RR. The anabolic response to a meal containing different amounts of protein is not limited by the maximal stimulation of protein synthesis in healthy young adults. Am J Physiol Endocrinol Metab 2016; 310:E73-80. [PMID: 26530155 PMCID: PMC4675798 DOI: 10.1152/ajpendo.00365.2015] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/02/2015] [Indexed: 12/12/2022]
Abstract
We have determined whole body protein kinetics, i.e., protein synthesis (PS), breakdown (PB), and net balance (NB) in human subjects in the fasted state and following ingestion of ~40 g [moderate protein (MP)], which has been reported to maximize the protein synthetic response or ~70 g [higher protein (HP)] protein, more representative of the amount of protein in the dinner of an average American diet. Twenty-three healthy young adults who had performed prior resistance exercise (X-MP or X-HP) or time-matched resting (R-MP or R-HP) were studied during a primed continuous infusion of l-[(2)H5]phenylalanine and l-[(2)H2]tyrosine. Subjects were randomly assigned into an exercise (X, n = 12) or resting (R, n = 11) group, and each group was studied at the two levels of dietary protein intake in random order. PS, PB, and NB were expressed as increases above the basal, fasting values (mg·kg lean body mass(-1)·min(-1)). Exercise did not significantly affect protein kinetics and blood chemistry. Feeding resulted in positive NB at both levels of protein intake: NB was greater in response to the meal containing HP vs. MP (P < 0.00001). The greater NB with HP was achieved primarily through a greater reduction in PB and to a lesser extent stimulation of protein synthesis (for all, P < 0.0001). HP resulted in greater plasma essential amino acid responses (P < 0.01) vs. MP, with no differences in insulin and glucose responses. In conclusion, whole body net protein balance improves with greater protein intake above that previously suggested to maximally stimulating muscle protein synthesis because of a simultaneous reduction in protein breakdown.
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Affiliation(s)
- Il-Young Kim
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
| | - Scott Schutzler
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
| | - Amy Schrader
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Horace J Spencer
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Gohar Azhar
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
| | - Arny A Ferrando
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
| | - Robert R Wolfe
- Department of Geriatrics, Center for Translational Research in Aging and Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and
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Coker RH, Deutz NE, Schutzler S, Beggs M, Miller S, Wolfe RR, Wei J. Nutritional Supplementation with Essential Amino Acids and Phytosterols May Reduce Risk for Metabolic Syndrome and Cardiovascular Disease in Overweight Individuals with Mild Hyperlipidemia. J Endocrinol Diabetes Obes 2015; 3:1069. [PMID: 26726312 PMCID: PMC4696774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Hyperlipidemia and insulin resistance are risk factors for the development of metabolic syndrome and cardiovascular disease. We have previously observed that supplementation with essential amino acids (EAA) could lower plasma triglycerides, and may improve glucose metabolism. OBJECTIVE We sought to determine whether EAA's combined with whey protein and phytosterols would facilitate improvements in plasma lipids and insulin sensitivity in adults with mild hypertriglyceridemia. DESIGN We enrolled nine subjects who were 50 years or older, had a documented plasma TG >150 mg/dl, and had not recently taken statin medications (within 6 weeks). Each subject served as his or her own control. These individuals underwent an oral glucose tolerance test (OGTT) before and after four weeks consumption of the oral nutritional supplement without dietary counseling or recommendations for physical activity. RESULTS Plasma total cholesterol and LDL levels decreased in all nine volunteers (P<0.005 for cholesterol and P<0.02 for LDL). In six of these individuals, plasma triglycerides (TG) fell by 95±13 mg/dl (P=0.007); while the other three showed no TG reduction. Genotyping revealed that in two of the three individuals that did not have TG reduction in response to the nutritional supplementation. Insulin sensitivity (ISI) and the total AUCins/glucose were significantly reduced by leucine/EAAs and phytosterol supplementation (P=0.008). CONCLUSIONS These findings suggest that a dietary supplementation of EAAs and phytosterols may promote favorable reductions of blood lipids as well as insulin resistance in individuals with hypertriglyceridemia. Future larger studies of SNPs and TG response to dietary supplements will be of interest.
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Affiliation(s)
- Robert H. Coker
- Center for Alaska Native Health Research, University of Alaska-Fairbanks, USA
| | | | - Scott Schutzler
- Department of Geriatrics, University of Arkansas for Medical Sciences, USA
| | | | - Sharon Miller
- Department of Geriatrics, University of Arkansas for Medical Sciences, USA
| | - Robert R. Wolfe
- Department of Geriatrics, University of Arkansas for Medical Sciences, USA
| | - Jeanne Wei
- Department of Geriatrics, University of Arkansas for Medical Sciences, USA
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Kim I, Schutzler S, Spore J, Williams R, Ferrando A, Wolfe R. Higher protein intake during a mixed meal ingestion increases net protein accretion through a reduction in protein breakdown. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.270.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Il‐Young Kim
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
| | - Scott Schutzler
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
| | - Josh Spore
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
| | - Rick Williams
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
| | - Arny Ferrando
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
| | - Robert Wolfe
- Geriatrics The University of Arkansas for Medical SciencesLittle RockArkansasUnited States
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Kim IY, Schutzler S, Schrader A, Spencer H, Kortebein P, Deutz NEP, Wolfe RR, Ferrando AA. Quantity of dietary protein intake, but not pattern of intake, affects net protein balance primarily through differences in protein synthesis in older adults. Am J Physiol Endocrinol Metab 2015; 308:E21-8. [PMID: 25352437 PMCID: PMC4280213 DOI: 10.1152/ajpendo.00382.2014] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To examine whole body protein turnover and muscle protein fractional synthesis rate (MPS) following ingestions of protein in mixed meals at two doses of protein and two intake patterns, 20 healthy older adult subjects (52-75 yr) participated in one of four groups in a randomized clinical trial: a level of protein intake of 0.8 g (1RDA) or 1.5 g·kg(-1)·day(-1) (∼2RDA) with uneven (U: 15/20/65%) or even distribution (E: 33/33/33%) patterns of intake for breakfast, lunch, and dinner over the day (1RDA-U, 1RDA-E, 2RDA-U, or 2RDA-E). Subjects were studied with primed continuous infusions of L-[(2)H5]phenylalanine and L-[(2)H2]tyrosine on day 4 following 3 days of diet habituation. Whole body protein kinetics [protein synthesis (PS), breakdown, and net balance (NB)] were expressed as changes from the fasted to the fed states. Positive NB was achieved at both protein levels, but NB was greater in 2RDA vs. 1RDA (94.8 ± 6.0 vs. 58.9 ± 4.9 g protein/750 min; P = 0.0001), without effects of distribution on NB. The greater NB was due to the higher PS with 2RDA vs. 1RDA (15.4 ± 4.8 vs. -18.0 ± 8.4 g protein/750 min; P = 0.0018). Consistent with PS, MPS was greater with 2RDA vs. 1RDA, regardless of distribution patterns. In conclusion, whole body net protein balance was greater with protein intake above recommended dietary allowance (0.8 g protein·kg(-1)·day(-1)) in the context of mixed meals, without demonstrated effects of protein intake pattern, primarily through higher rates of protein synthesis at whole body and muscle levels.
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Affiliation(s)
- Il-Young Kim
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
| | - Scott Schutzler
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
| | - Amy Schrader
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Horace Spencer
- College of Medicine Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Patrick Kortebein
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
| | - Nicolaas E P Deutz
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
| | - Robert R Wolfe
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
| | - Arny A Ferrando
- Department of Geriatrics, the Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, Little Rock, Arkansas; and
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Kim I, Schutzler S, Deutz N, Wolfe R. Citrulline ingestion did not improve the age‐associated reduction in nitric oxide synthesis (698.6). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.698.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Il‐Young Kim
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Scott Schutzler
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Nicolaas Deutz
- Geriatrics the University of Arkansas for Medical Sciences College Station TXUnited States
| | - Robert Wolfe
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
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Kim I, Schutzler S, Wolfe R, Ferrando A. Quantity of dietary protein, but not pattern of intake, affects net protein accretion in older adults (272.4). FASEB J 2014. [DOI: 10.1096/fasebj.28.1_supplement.272.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Il‐Young Kim
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Scott Schutzler
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Robert Wolfe
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
| | - Arny Ferrando
- Geriatrics the University of Arkansas for Medical SciencesLITTLE RocKARUnited States
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Coker RH, Miller S, Schutzler S, Deutz N, Wolfe RR. Whey protein and essential amino acids promote the reduction of adipose tissue and increased muscle protein synthesis during caloric restriction-induced weight loss in elderly, obese individuals. Nutr J 2012; 11:105. [PMID: 23231757 PMCID: PMC3546025 DOI: 10.1186/1475-2891-11-105] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/28/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Excess adipose tissue and sarcopenia presents a multifaceted clinical challenge that promotes morbidity and mortality in the obese, elderly population. Unfortunately, the mortality risks of muscle loss may outweigh the potential benefits of weight loss in the elderly. We have previously demonstrated the effectiveness of whey protein and essential amino acids towards the preservation of lean tissue, even under the conditions of strict bedrest in the elderly. METHODS In the context of caloric restriction-based weight loss, we hypothesized that a similar formulation given as a meal replacement (EAAMR) would foster the retention of lean tissue through an increase in the skeletal muscle fractional synthesis rate (FSR). We also proposed that EAAMR would promote the preferential loss of adipose tissue through the increased energy cost of skeletal muscle FSR. We recruited and randomized 12 elderly individuals to an 8 week, caloric restriction diet utilizing equivalent caloric meal replacements (800 kcal/day): 1) EAAMR or a 2) competitive meal replacement (CMR) in conjunction with 400 kcal of solid food that totaled 1200 kcal/day designed to induce 7% weight loss. Combined with weekly measurements of total body weight and body composition, we also measured the acute change in the skeletal muscle FSR to EAAMR and CMR. RESULTS By design, both groups lost ~7% of total body weight. While EAAMR did not promote a significant preservation of lean tissue, the reduction in adipose tissue was greater in EAAMR compared to CMR. Interestingly, these results corresponded to an increase in the acute skeletal muscle protein FSR. CONCLUSION The provision of EAAMR during caloric restriction-induced weight loss promotes the preferential reduction of adipose tissue and the modest loss of lean tissue in the elderly population.
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Affiliation(s)
- Robert H Coker
- Center for Translational Research in Aging and Longevity, Little Rock, AR, USA
| | - Sharon Miller
- Department of Geriatrics, University of Arkansas for Medical Sciences, and Healthspan, LLC, Little Rock, AR, USA
| | - Scott Schutzler
- Center for Translational Research in Aging and Longevity, Little Rock, AR, USA
| | - Nicolaas Deutz
- Center for Translational Research in Aging and Longevity, Little Rock, AR, USA
| | - Robert R Wolfe
- Center for Translational Research in Aging and Longevity, Little Rock, AR, USA
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Deutz NEP, Safar A, Schutzler S, Memelink R, Ferrando A, Spencer H, van Helvoort A, Wolfe RR. Muscle protein synthesis in cancer patients can be stimulated with a specially formulated medical food. Clin Nutr 2011; 30:759-68. [PMID: 21683485 DOI: 10.1016/j.clnu.2011.05.008] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 05/02/2011] [Accepted: 05/19/2011] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Maintenance of muscle mass is crucial to improving outcome and quality of life in cancer patients. Stimulating muscle protein synthesis is the metabolic basis for maintaining muscle mass, but in cancer patients normal dietary intake has minimal effects on muscle protein synthesis. Adding leucine to high protein supplements stimulates muscle protein synthesis in healthy older subjects. The objective was to determine if a specially formulated medical food, high in leucine and protein, stimulates muscle protein synthesis acutely in individuals with cancer to a greater extent than a conventional medical food. DESIGN A randomized, controlled, double-blind, parallel-group design was used in 25 patients with radiographic evidence of cancer. Patients were studied before their cancer treatment was started or 4 weeks after their treatment was completed or halted. The fractional rate of muscle protein synthesis (FSR) was measured using the tracer incorporation technique with L-[ring-(13)C(6)]-phenylalanine. The experimental group (n = 13) received a medical food containing 40 g protein, based on casein and whey protein and enriched with 10% free leucine and other specific components, while the control group (n = 12) was given a conventionally used medical food based on casein protein alone (24 g). Blood and muscle samples were collected in the basal state and 5h hours after ingestion of the medical foods. RESULTS The cancer patients were in an inflammatory state, as reflected by high levels of C-reactive protein (CRP), IL-1 β and TNF-α, but were not insulin resistant (HOMA). After ingestion of the experimental medical food, plasma leucine increased to about 400 μM as compared to the peak value of 200 μM, after the control medical food (p < 0.001). Ingestion of the experimental medical food increased muscle protein FSR from 0.073 (SD: 0.023) to 0.097 (SD: 0.033) %/h (p = 0.0269). In contrast, ingestion of the control medical food did not increase muscle FSR; 0.073 (SD: 0.022) and 0.065 (SD: 0.028) %/h. CONCLUSIONS In cancer patients, conventional nutritional supplementation is ineffective in stimulating muscle protein synthesis. This anabolic resistance can be overcome with a specially formulated nutritional supplement.
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Affiliation(s)
- Nicolaas E P Deutz
- Center for Translational Research in Aging & Longevity, Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, 4301 W. Markham St. Slot 806, Little Rock, AR 72205, USA
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Abstract
The use of cadaveric skin has made a major impact in the survival of patients experiencing major thermal injury. However, the availability of cadaveric skin is often limited by potentially pathogenic organisms. Very little data exists as to why cadaveric skin from donors who have been previously screened was discarded. From March 1994 to March 1996, 813 donors were referred to our tissue bank. All donors were reviewed for the cause of death, history and physical, and social history. One hundred fifty-three donors screened were discarded. Sixty-one donors of this group were discarded because of positive serologies. The following are the percentages of the specific positive serologies: hepatitis B core antibody, 52.3%; hepatitis B surface antigen, 18.1%; hepatitis C virus antibody, 14.3%; human immunodeficiency virus antibody, 4.9%; human T lymphocyte virus antibody, 4.9% and syphilis, 5.5%. Retrospectively, all donor screening questionnaires were reviewed for possible indicators in relation to positive serologic testing. Current screening methods, although excellent in social screening, still fail to identify a significant number of donors who may have positive serologies because of hepatitis, human immunodeficiency virus, human T lymphocyte virus, or syphilis. As the field of tissue banking continues to evolve, the focus will need to be directed toward better screening mechanisms in order to decrease our current discard rates after donors have been approved through the screening process.
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Affiliation(s)
- J R Barnett
- University of Texas Medical Branch and Shriners Burns Hospital-Galveston, 77550, USA
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