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Protein-Amino Acid Metabolism Disarrangements: The Hidden Enemy of Chronic Age-Related Conditions

Scientific Clinical Institutes Maugeri, IRCCS Lumezzane, Cardiac Rehabilitation Division, 25065 Lumezzane (Brescia), Italy
Division of Human Anatomy and Physiopathology, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa, 11-25124 Brescia, Italy
Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy
Department of Geriatrics, Neurosciences and Orthopaedics, Catholic University of the Sacred Heart, 00198 Rome, Italy
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Author to whom correspondence should be addressed.
These authors contribute equally to this work.
Nutrients 2018, 10(4), 391;
Received: 15 February 2018 / Revised: 15 March 2018 / Accepted: 21 March 2018 / Published: 22 March 2018
(This article belongs to the Special Issue Dietary Protein and Muscle in Aging People)
Proteins are macro-molecules crucial for cell life, which are made up of amino acids (AAs). In healthy people, protein synthesis and degradation are well balanced. However, in the presence of hypercatabolic stimulation (i.e., inflammation), protein breakdown increases as the resulting AAs are consumed for metabolic proposes. Indeed, AAs are biochemical totipotent molecules which, when deaminated, can be transformed into energy, lipids, carbohydrates, and/or biochemical intermediates of fundamental cycles, such as the Krebs’ cycle. The biochemical consequence of hyper-catabolism is protein disarrangement, clinically evident with signs such as sarcopenia, hypalbuminemia, anaemia, infection, and altered fluid compartmentation, etc. Hypercatabolic protein disarrangement (HPD) is often underestimated by clinicians, despite correlating with increased mortality, hospitalization, and morbidity quite independent of the primary disease. Simple, cheap, repeatable measurements can be used to identify HPD. Therefore, identification and treatment of proteins’ metabolic impairment with appropriate measurements and therapy is a clinical strategy that could improve the prognosis of patients with acute/chronic hypercatabolic inflammatory disease. Here, we describe the metabolism of protein and AAs in hypercatabolic syndrome, illustrating the clinical impact of protein disarrangement. We also illustrate simple, cheap, repeatable, and worldwide available measurements to identify these conditions. Finally, we provide scientific evidence for HPD nutritional treatment. View Full-Text
Keywords: protein metabolism; sarcopenia; muscle wasting; amino acids; catabolism; inflammation protein metabolism; sarcopenia; muscle wasting; amino acids; catabolism; inflammation
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Pasini, E.; Corsetti, G.; Aquilani, R.; Romano, C.; Picca, A.; Calvani, R.; Dioguardi, F.S. Protein-Amino Acid Metabolism Disarrangements: The Hidden Enemy of Chronic Age-Related Conditions. Nutrients 2018, 10, 391.

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