Synthesis rates of total liver protein and albumin are both increased in patients with an acute inflammatory response
Abstract
The general perception that catabolism and inflammation are associated with a high synthesis rate of total liver protein and a low albumin synthesis rate has been challenged in recent years by several studies in man, indicating that the synthesis rate of albumin in response to a catabolic insult is increased rather than decreased. Thus changes in liver protein synthesis rates in conjunction with catabolism and acute inflammation in man need to be characterized better. The aim of the present study was to measure protein synthesis rates of total liver protein and albumin during a state of acute inflammation. Patients (n=10) undergoing acute laparoscopic cholecystectomy due to acute cholecystitis were investigated. FSRs (fractional synthesis rates) of total liver protein (liver biopsy specimens) and albumin (plasma samples) were investigated as early as possible during the surgical procedure, using a flooding dose of L-[2H5]phenylalanine. The results were compared with a reference group of patients without cholecystitis undergoing elective laparoscopic cholecystectomy (n=17). FSR of total liver protein was 60% higher (P<0.001) and the FSR of albumin was 45% higher (P<0.01) in the cholecystitis patients compared with the control group. In conclusion, the synthesis rates of total liver protein and albumin are both increased in patients with an acute general inflammatory reaction undergoing laparoscopic cholecystectomy.
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Urea cycle enzymes like OTC support ammonia clearance, but their later decrease likely marks exhaustion of this reserve and progression toward chronic hepatocyte dysfunction, mirroring hallmarks of advanced liver injury.
“Urea cycle enzymes like OTC support ammonia clearance, but their later decrease likely marks exhaustion of this reserve and progression toward chronic hepatocyte dysfunction, mirroring hallmarks of advanced liver injury such as impaired urea cycle function and reduced albumin synthesis (Barle et al., 2006; Amouzandeh et al., 2023; Rutherford and Chung, 2008).”
From A 3D bioengineered human liver for the study of acute and chronic drug-induced hepatotoxicity and fibrosis (2026) · cites this paper as Barle et al., 2006
In most disease states in which synthesis rates have been measured, fractional synthesis rate in plasma is normal or mildly increased.
“However, in most disease states in which synthesis rates have been measured, fractional synthesis rate (FSR) in plasma has been reported to be normal or mildly increased (Table 1).63, 64, 65, 66, 67, 68, 69, 70, 71”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [69]
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References 35 · Cited by 59
- Authors
- Barle, H., Hammarqvist, F., Westman, B., Klaude, M., Rooyackers, O., Garlick, P. J., & Wernerman, J.
- Affiliations
- Danderyds sjukhus (SE)
- Karolinska University Hospital (SE)
- University of Illinois Urbana-Champaign (US)
- Corresponding author
- Barle, Hans
- Venue
- Clinical Science
- Publisher
- Portland Press Ltd.
- Published
- 2005-12-12
- Volume
- 110
- Issue
- 1
- Pages
- 93-99
- ISSN
- 0143-5221 (ISSN-L)
- 1470-8736
- OpenAlex
- W2020504757
- Cited by
- 59
- References
- 35
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 7 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 4 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 2.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Science (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- hepatic protein synthesis, albumin synthesis, acute inflammation, fractional synthesis rate, acute cholecystitis, laparoscopic cholecystectomy, catabolism, phenylalanine tracer, liver biopsy
- MeSH terms
- Acute Disease, Adult, Aged, Anthropometry, Cholecystitis, Female, Humans, Intraoperative Period, Liver, Male, Middle Aged, Serum Albumin, Protein Biosynthesis, Cholecystectomy, Laparoscopic
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