Skeletal muscle wasting after a severe burn is a consequence of cachexia and sarcopenia
Abstract
Muscle wasting is common and persistent in severely burned patients, worsened by immobilization during treatment. In this review, we posit two major phenotypes of muscle wasting after severe burn, cachexia and sarcopenia, each with distinguishing characteristics to result in muscle atrophy; these characteristics are also likely present in other critically ill populations. An online search was conducted from the PubMed database and other available online resources and we manually extracted published articles in a systematic mini review. We describe the current definitions and characteristics of cachexia and sarcopenia and relate these to muscle wasting after severe burn. We then discuss these putative mechanisms of muscle atrophy in this condition. Severe burn and immobilization have distinctive patterns in mediating muscle wasting and muscle atrophy. In considering these two pathological phenotypes (cachexia and sarcopenia), we propose two independent principal causes and mechanisms of muscle mass loss after burns: (1) inflammationâinduced cachexia, leading to proteolysis and protein degradation, and (2) sarcopenia/immobility that signals inhibition of expected increases in protein synthesis in response to protein loss. Because both are present following severe burn, these should be considered independently in devising treatments. Discussing cachexia and sarcopenia as independent mechanisms of severe burnâinitiated muscle wasting is explored. Recognition of these associated mechanisms will likely improve outcomes.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Sep 02, 2021
- Source ID
- 10.1002/jpen.2238
Entities
People
- Audra Clark
- Charles E Wade
- Juquan Song
- Steven E. Wolf
Organizations
- John S. Dunn Foundation
- McGovern Medical School
- United States Department of Defense
- University of Texas Medical Branch
- University of Texas at Austin