Glucose and Leucine Metabolism in Lung Tranplanted Patients on Low Dose of Steroids for Immunosuppressive Therapy

This study examined the metabolic effects of lung transplantation in patients with end-stage respiratory failure on low dose of steroids for immunosuppressive therapy. We examined 6 patients, including 2 women and 4 men of overall mean age 53 ± 15 years and age at transplantation 34 ± 12 months, rec...

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Bibliographic Details
Published in:Transplantation proceedings Vol. 40; no. 5; pp. 1566 - 1571
Main Authors: Benedini, S., Ruffini, E., Terruzzi, I., Mancuso, M., Luzi, L.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01.06.2008
Elsevier Science
Subjects:
Adult
Aged
Azathioprine - therapeutic use
Biological and medical sciences
Blood Glucose - metabolism
Cyclosporine - therapeutic use
Fatty Acids, Nonesterified - metabolism
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Glucocorticoids - therapeutic use
Hormones - blood
Humans
Immunosuppressive Agents - therapeutic use
Insulin Resistance
Leucine - metabolism
Lung Transplantation - physiology
Male
Medical sciences
Middle Aged
Prednisone - therapeutic use
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tacrolimus - therapeutic use
Tissue, organ and graft immunology
Human
Steroid
Corticosteroid
Low dose
Lung
Patient
Transplantation
Glucose
Leucine
Metabolism
Respiratory system
Medicine
Treatment
Aminoacid
Surgery
Graft
Immunosuppressive agent
Pharmacokinetics
ISSN:0041-1345, 1873-2623
Online Access:Get full text
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Summary:This study examined the metabolic effects of lung transplantation in patients with end-stage respiratory failure on low dose of steroids for immunosuppressive therapy. We examined 6 patients, including 2 women and 4 men of overall mean age 53 ± 15 years and age at transplantation 34 ± 12 months, receiving cyclosporine 5.73 ± 1.43 mg/kg/d or tacrolimus (FK 506) 4.67 ± 0.58 mg/d, azathioprine 0.47 ± 0.29 mg/kg/d, and prednisone 8.25 mg/d for comparison with 6 healthy subjects, who were selected to be comparable to the recipients in terms of anthropometric features and age. A euglycemic hyperinsulinemic clamp (1 mU/kg/min) associated with infusion of glucose and leucine isotopes was performed with indirect calorimetry. Lung transplanted patients showed postabsorptive leucine and free fatty acid metabolism similar to controls. In contrast, there was peripheral insulin resistance with respect to glucose metabolism namely, higher values of glucose and insulin vs controls ( P < .03 and P < .02, respectively). During the clamp the metabolic picture was characterized by a relative insulin resistance with respect to glucose metabolism ( P = .07). Lipid and protein metabolism in the basal and insulin-stimulated conditions were similar to the control group. In the basal condition insulin resistance is evident with respect to glucose metabolism. The metabolic picture in lung transplanted patients on low-dose steroid therapy was characterized by normal insulin-stimulated glucose, leucine, and free fatty acid metabolism. The minimal metabolic alterations in these patients were not due to transplantation itself but probably mainly attributable to immunosuppressive therapy.
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2008.03.088