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Clinical and experimental studies on protein metabolism in acute hepatic failure-with special relation to effects of branched-chain amino acid infusion

Research Project

Project/Area Number 06670533
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Gastroenterology
Research InstitutionGifu University

Principal Investigator

SUGIHARA Jun-ichi  Gifu University School of Medicine Assistant Professor, 医学部・附属病院, 講師 (70216323)

Co-Investigator(Kenkyū-buntansha) MURASE Masahiko  Gifu University School of Medicine Research Associate, 医学部, 助手 (80221620)
MORIWAKI Hisataka  Gifu University School of Medicine Associate Professor, 医学部, 助教授 (50174470)
Project Period (FY) 1994 – 1996
Project Status Completed (Fiscal Year 1996)
Budget Amount *help
¥2,100,000 (Direct Cost: ¥2,100,000)
Fiscal Year 1996: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1995: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1994: ¥700,000 (Direct Cost: ¥700,000)
Keywordsacute hepatic failure / indirect calorimetry / protein metabolism / branched-chain amino acid / nutritional support / 間接カロリーメーター / 分岐鎖アミノ酸
Research Abstract

1) Clinical study
Indirect calorimetry was performed at resting and at 1 hour after infusion of branched-chain amino acid (BCAA) solution (83.6g total amino acids/L,Fischer's ratio 37.1,500ml for 2hr) in 12 patients with fulminant hepatitis (FH), 12 patients with severe type of acute hepatitis (AHS), and 8 healthy controls (HC). Energy expenditure (Kcal/day and a ratio standardized to the estimated basal metabolic rate ; EE/BMR) and oxidation volumes of carbohydrate, fat and protein (g/day) were measured. EE/BMR was significantly higher in patients with FH and in those with AHS than in HC.Infusion of BCAA significantly raised EE/BMR in moderately metabolic FH,in AHS and in HC,although it did not affect the index in hypermetabolic FH.Increases in the protein oxidation volume were brought by BCAA infusion in moderately metabolic FH,in AHS and in HC but not in hypermetabolic FH.In conclusion, BCAA can be utilized as an energy substrate in patients with AHS and in cases of FH with moderatel … More y metabolic state. Precise analysis of energy metabolism is essential in advance, with a use of BCAA infusion in patients with AHF.
2) Experimental study
AHF was induced in male Donryu rats by giving lypopolysaccaride intravenously and D-galactosamine hydrochloride intraperitoneally. From 18 hours after injection, AHF and control rats were given one of the following five solutions intravenously for 6 hours : 1) saline, 2) 10% glucose, 3) standard 10% amino acid formula with total nitrogen content of 12.2g/L and BCAA/aromatic amino acid molar ratio of 37.05,4) BCAA-enriched solution with nitrogen content of 21.9g/L and the ratio of 148.2, or 5) an active placebo against BCAA-enriched solution with nitrogen content of 21.9g/L and the ratio of 37.05. In parallel, each group was given a continuous infusion of ^<14>C-leucine, protein turnover was analyzed according to the kinetic model. When compared with the control, rates of total protein turnover (total flux), oxidation and breakdown all increased significantly in AHF.Infusion of standard 10% amino acid formula, BCAA-enriched solution or the placebo in AHF increased total flux and oxidation significantly as compared with the effect of saline or 10% glucose. Although saline, 10% glucose, standard 10% amino acid formula, and the placebo had no effect on synthesis rate, it was increased significantly with BCAA-enriched solution. Breakdown was not suppressed with any solutions. These results suggest that rats with AHF are in a catebolic state and that any of the three amino acid solutions can be oxidized to provide energy in AHF.In addition, infusion of BCAA-enriched solution may have a specific protein-sparing effect by increasing the protein synthesis. Less

Report

(4 results)
  • 1996 Annual Research Report   Final Research Report Summary
  • 1995 Annual Research Report
  • 1994 Annual Research Report
  • Research Products

    (22 results)

All Other

All Publications (22 results)

  • [Publications] Hiroo Ohnishi et. al.: "Hepatitis C virus infection involved in fulminant hepatitis in Japan" International Hepatology Communications. 2. 347-351 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Yoshiyuki Miwa et. al.: "Effects of branched-chain amino acid infusion on protein metabolism in rats with acute hepatic failure" Hepatology. 22. 291-296 (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Ohnishi H,Muto Y,Sakai T,et al.: "Hepatitis C virus infection involved in fulminant hepatitis in Japan." International Hepatology Communications. 2. 347-351 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] Miwa Y,Kato M,Moriwaki H,et al.: "Effects of branched-chain amino acid infusion on protein metabolism in rats with acute hepatic failure." Hepatology. 22. 291-296 (1995)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1996 Final Research Report Summary
  • [Publications] 大西弘生、他: "Acute-on-chronic肝不全" 日本臨床別冊「肝・胆道系症候群」(上巻). 217-219 (1995)

    • Related Report
      1996 Annual Research Report
  • [Publications] 大西弘生、他: "急性肝不全" 日本臨床別冊「肝・胆道系症候群」(上巻). 243-246 (1995)

    • Related Report
      1996 Annual Research Report
  • [Publications] 大西弘生、他: "本邦C型劇症肝炎、C型亜急性肝炎の臨床統計的研究" 日本臨床増刊「分子肝炎ウイルス病学-基礎・臨床・予防」. 53. 528-533 (1995)

    • Related Report
      1996 Annual Research Report
  • [Publications] 杉原潤一、他: "劇症肝炎" からだの科学「難病」. 190. 139-142 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] 杉原潤一、他: "劇症肝炎" 「ベッドサイド消化器病学」(南江堂). 650-656 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] 杉原潤一、他: "急性劇症肝炎の治療治療法の進歩" 肝炎・肝硬変・肝癌分子メカニズムから病態・診断・治療まで. 96-98 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] Yoshiyuki Miwa,et al.: "Effects of branced-chain amino acid infusion on protein metabolism in rats with acute hepatic failure" Hepatology. 22. 291-296 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 杉原潤一,他: "重症肝炎症例に対するG-511の使用経験" 現代医療. 27. 1489-1498 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 杉原潤一、他: "劇症肝炎" 日本臨床 別冊 領域別症候群シリーズ. 7. 247-251 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 杉原潤一、他: "肝性脳症" Medicina. 32. 191-193 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 大西弘生,他: "劇症肝炎とプロスタグランディン" 現代医療. 27. 2085-2090 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] 石木佳英、他: "急性肝不全 予後の予測" 肝胆膵. 31. 809-816 (1995)

    • Related Report
      1995 Annual Research Report
  • [Publications] Hiroo ohnishi,etal: "Hepatitis C virus infection involved in fulminant hepatitis in Japan" International Hepatology Communications. 2. 347-351 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 冨田栄一,他: "劇症肝炎における膵病変-血中膵酵素の変動を中心として-" 腹部臓器相関-肝・膵相関について-. 3-11 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 山田鉄也,他: "遅発性肝不全(LOHF)" 新臨床肝臓病学-症例による生検・電顕・画像・治療-. 102-110 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 森脇久隆、他: "重症肝障害と成因ウイルス" ICUとCCU. 18. 27-36 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 杉原潤一、他: "劇症肝炎に対する血漿交換療法" 消化器科. 18. 242-254 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 村上啓雄、他: "C型肝炎ウイルスによる劇症肝炎の診断と治療" カレント内科1 C型肝炎. 84-94 (1994)

    • Related Report
      1994 Annual Research Report

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Published: 1994-04-01   Modified: 2016-04-21  

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