Wiley Interdiscip Rev Syst Biol Med - Branched-chain amino acid supplementation: impact on signaling and relevance to critical illness.

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Resumo

The changes that occur in mammalian systems following trauma and sepsis, termed systemic inflammatory response syndrome, elicit major changes in carbohydrate, protein, and energy metabolism. When these events persist for too long they result in a severe depletion of lean body mass, multiple organ dysfunction, and eventually death. Nutritional supplementation has been investigated to offset the severe loss of protein, and recent evidence suggests that diets enriched in branched-chain amino acids (BCAAs) may be especially beneficial. BCAAs are metabolized in two major steps that are differentially expressed in muscle and liver. In muscle, BCAAs are reversibly transaminated to the corresponding a-keto acids. For the complete degradation of BCAAs, the a-keto acids must travel to the liver to undergo oxidation. The liver, in contrast to muscle, does not significantly express the branched-chain aminotransferase. Thus, BCAA degradation is under the joint control of both liver and muscle. Recent evidence suggests that in liver, BCAAs may perform signaling functions, more specifically via activation of mTOR (mammalian target of rapamycin) signaling pathway, influencing a wide variety of metabolic and synthetic functions, including protein translation, insulin signaling, and oxidative stress following severe injury and infection. However, understanding of the system-wide effects of BCAAs that integrate both metabolic and signaling aspects is currently lacking. Further investigation in this respect will help rationalize the design and optimization of nutritional supplements containing BCAAs for critically ill patients.

Resumo Limpo

chang occur mammalian system follow trauma sepsi term system inflammatori respons syndrom elicit major chang carbohydr protein energi metabol event persist long result sever deplet lean bodi mass multipl organ dysfunct eventu death nutrit supplement investig offset sever loss protein recent evid suggest diet enrich branchedchain amino acid bcaa may especi benefici bcaa metabol two major step differenti express muscl liver muscl bcaa revers transamin correspond aketo acid complet degrad bcaa aketo acid must travel liver undergo oxid liver contrast muscl signific express branchedchain aminotransferas thus bcaa degrad joint control liver muscl recent evid suggest liver bcaa may perform signal function specif via activ mtor mammalian target rapamycin signal pathway influenc wide varieti metabol synthet function includ protein translat insulin signal oxid stress follow sever injuri infect howev understand systemwid effect bcaa integr metabol signal aspect current lack investig respect will help ration design optim nutrit supplement contain bcaa critic ill patient

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