Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis

D C Macallan, M A McNurlan, A V Kurpad, G de Souza, P S Shetty, Alexander Graham Calder, G E Griffin

    Research output: Contribution to journalArticle

    68 Citations (Scopus)

    Abstract

    1. Differing patterns of protein metabolism are seen in wasting due to undernutrition and wasting due to chronic infection. 2. We investigated whole body energy and protein metabolism in nine subjects with pulmonary tuberculosis, six undernourished subjects (body mass index <18.5 kg/m2) and seven control subjects from an Indian population. Fasting subjects were infused with L-[1-13C]leucine (2.3 mumol.h-1.kg-1) for 8 h, 4 h fasted then 4 h fed. Leucine kinetics were derived from 13C-enrichment of leucine and alpha-ketoisocaproic acid in plasma and CO2 in breath. 3. Undernourished subjects, but not tuberculosis subjects, had higher rates of whole body protein turnover per unit lean body mass than controls [163.1 +/- 9.4 and 148.6 +/- 14.6 mumol compared with 142.8 +/- 14.7 mumol leucine/h per kg, based on alpha-ketoisocaproic acid enrichment (P = 0.039)]. 4. In response to feeding, protein oxidation increased in all groups. Tuberculosis subjects had the highest fed rates of oxidation (47.0 +/- 10.5 compared with 37.1 +/- 5.4 mumol.h-1.kg-1 in controls), resulting in a less positive net protein balance in the fed phase (controls, 39.7 +/- 6.2; undernourished subjects, 29.2 +/- 10.6; tuberculosis subjects, 24.5 +/- 9.3; P = 0.010). Thus fed-phase tuberculosis subjects oxidized a greater proportion of leucine flux (33.2%) than either of the other groups (controls, 24.0%; undernourished subjects, 24.0%; P = 0.017). 5. Tuberculosis did not increase fasting whole body protein turnover but impaired the anabolic response to feeding compared with control and undernourished subjects. Such 'anabolic block' may contribute to wasting in tuberculosis and may represent the mechanism by which some inflammatory states remain refractory to nutrition support.
    Original languageEnglish
    Pages (from-to)321-331
    Number of pages11
    JournalClinical Science
    Volume94
    Issue number3
    Publication statusPublished - 1 Mar 1998

    Fingerprint

    Pulmonary Tuberculosis
    Malnutrition
    Tuberculosis
    Leucine
    Proteins
    Fasting
    Energy Metabolism
    Body Mass Index
    Control Groups
    Infection
    Population

    Keywords

    • Adolescent
    • Adult
    • Aged
    • Anthropometry
    • Cachexia
    • Cytokines
    • Deficiency Diseases
    • Energy Metabolism
    • Female
    • Humans
    • Keto Acids
    • Leucine
    • Male
    • Middle Aged
    • Oxidation-Reduction
    • Proteins
    • Tuberculosis, Pulmonary
    • tuberculosis
    • lung
    • malnutrition
    • metabolism
    • protein
    • whole body
    • energy
    • biosynthesis
    • biochemical analysis
    • comparative study
    • human
    • mycobacterial infection
    • bacteriosis
    • infection
    • respiratory disease
    • lung disease

    Cite this

    Macallan, D. C., McNurlan, M. A., Kurpad, A. V., de Souza, G., Shetty, P. S., Calder, A. G., & Griffin, G. E. (1998). Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis. Clinical Science, 94(3), 321-331.

    Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis. / Macallan, D C; McNurlan, M A; Kurpad, A V; de Souza, G; Shetty, P S; Calder, Alexander Graham; Griffin, G E.

    In: Clinical Science, Vol. 94, No. 3, 01.03.1998, p. 321-331.

    Research output: Contribution to journalArticle

    Macallan, DC, McNurlan, MA, Kurpad, AV, de Souza, G, Shetty, PS, Calder, AG & Griffin, GE 1998, 'Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis', Clinical Science, vol. 94, no. 3, pp. 321-331.
    Macallan DC, McNurlan MA, Kurpad AV, de Souza G, Shetty PS, Calder AG et al. Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis. Clinical Science. 1998 Mar 1;94(3):321-331.
    Macallan, D C ; McNurlan, M A ; Kurpad, A V ; de Souza, G ; Shetty, P S ; Calder, Alexander Graham ; Griffin, G E. / Whole body protein metabolism in human pulmonary tuberculosis and undernutrition: evidence for anabolic block in tuberculosis. In: Clinical Science. 1998 ; Vol. 94, No. 3. pp. 321-331.
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    AU - Macallan, D C

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    AB - 1. Differing patterns of protein metabolism are seen in wasting due to undernutrition and wasting due to chronic infection. 2. We investigated whole body energy and protein metabolism in nine subjects with pulmonary tuberculosis, six undernourished subjects (body mass index <18.5 kg/m2) and seven control subjects from an Indian population. Fasting subjects were infused with L-[1-13C]leucine (2.3 mumol.h-1.kg-1) for 8 h, 4 h fasted then 4 h fed. Leucine kinetics were derived from 13C-enrichment of leucine and alpha-ketoisocaproic acid in plasma and CO2 in breath. 3. Undernourished subjects, but not tuberculosis subjects, had higher rates of whole body protein turnover per unit lean body mass than controls [163.1 +/- 9.4 and 148.6 +/- 14.6 mumol compared with 142.8 +/- 14.7 mumol leucine/h per kg, based on alpha-ketoisocaproic acid enrichment (P = 0.039)]. 4. In response to feeding, protein oxidation increased in all groups. Tuberculosis subjects had the highest fed rates of oxidation (47.0 +/- 10.5 compared with 37.1 +/- 5.4 mumol.h-1.kg-1 in controls), resulting in a less positive net protein balance in the fed phase (controls, 39.7 +/- 6.2; undernourished subjects, 29.2 +/- 10.6; tuberculosis subjects, 24.5 +/- 9.3; P = 0.010). Thus fed-phase tuberculosis subjects oxidized a greater proportion of leucine flux (33.2%) than either of the other groups (controls, 24.0%; undernourished subjects, 24.0%; P = 0.017). 5. Tuberculosis did not increase fasting whole body protein turnover but impaired the anabolic response to feeding compared with control and undernourished subjects. Such 'anabolic block' may contribute to wasting in tuberculosis and may represent the mechanism by which some inflammatory states remain refractory to nutrition support.

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    KW - Adult

    KW - Aged

    KW - Anthropometry

    KW - Cachexia

    KW - Cytokines

    KW - Deficiency Diseases

    KW - Energy Metabolism

    KW - Female

    KW - Humans

    KW - Keto Acids

    KW - Leucine

    KW - Male

    KW - Middle Aged

    KW - Oxidation-Reduction

    KW - Proteins

    KW - Tuberculosis, Pulmonary

    KW - tuberculosis

    KW - lung

    KW - malnutrition

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    KW - protein

    KW - whole body

    KW - energy

    KW - biosynthesis

    KW - biochemical analysis

    KW - comparative study

    KW - human

    KW - mycobacterial infection

    KW - bacteriosis

    KW - infection

    KW - respiratory disease

    KW - lung disease

    M3 - Article

    VL - 94

    SP - 321

    EP - 331

    JO - Clinical Science

    JF - Clinical Science

    SN - 0143-5221

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