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Effect of prednisone on protein metabolism in Duchenne dystrophy
Ist Teil von
American journal of physiology: endocrinology and metabolism, 1995-01, Vol.268 (1), p.E67-E74
Ort / Verlag
United States
Erscheinungsjahr
1995
Quelle
MEDLINE
Beschreibungen/Notizen
Z. Rifai, S. Welle, R. T. Moxley 3rd, M. Lorenson and R. C. Griggs
Department of Neurology, University of Rochester, New York 14642.
Prednisone improves strength in Duchenne dystrophy and changes the natural
history of the disease. We studied the in vivo effects of prednisone (0.75
mg.kg-1.day-1) on muscle and whole body protein metabolism in six patients
with Duchenne dystrophy and three patients with Becker dystrophy. Patients
were admitted to the Clinical Research Center for study and consumed a
constant flesh-free diet. Strength was measured by manual and quantitative
muscle testing. Fractional muscle protein breakdown was estimated by the
ratio of 3-methylhistidine to creatinine excretion determined in three
consecutive 24-h urine collections. Whole body protein kinetics were
studied in the postabsorptive state using a primed continuous infusion of
L-[1-13C]leucine. Fractional muscle protein synthesis was determined from
tracer incorporation into noncollagen muscle protein obtained by needle
biopsy. After 6-8 wk of prednisone treatment, average muscle strength
increased by 15% (P < 0.04), and 24-h creatinine excretion (an index of
muscle mass) increased by 21% (P = 0.002). 3-Methylhistidine excretion
decreased by 10%, but the change was not statistically significant. The
ratio of 3-methylhistidine to creatinine excretion decreased by 26% (P <
0.04). Fractional muscle protein synthesis and whole body protein synthesis
and breakdown did not change significantly. We conclude that the beneficial
effect of prednisone on strength in Duchenne dystrophy appears to be
associated with an increase in muscle mass, which may be mediated by
inhibition of muscle proteolysis rather than stimulation of muscle protein
synthesis.