Differential regulation of skeletal muscle protein turnover by insulin and IGF-I after bacteremia.

Skeletal muscle catabolism is a characteristic metabolic response to sepsis. We investigated the ability of physiological insulin (2 nM) or insulin-like growth factor I (IGF-I, 10 nM) concentrations to modify protein metabolism during incubation of epitrochlearis 2, 6, or 15 days after injection of live Escherichia coli. On days 2 and 6 postinfection, skeletal muscle exhibited an exacerbated negative protein balance resulting from both an inhibition in protein synthesis (25%) and an enhanced proteolysis (90%) compared with controls. By day 15 postinfection, protein balance in infected rats was significantly improved compared with either day 2 or 6. At this time, protein synthesis was augmented and protein degradation was decreased in infected rats relative to day 6. Insulin or IGF-I stimulated protein synthesis in muscles from septic and control rats in vitro to the same extent at each time point examined. The ability of insulin or IGF-I to limit protein degradation was severely blunted 48 h after infection. On day 6 postinfection, the effect of insulin or IGF-I to inhibit proteolysis was more pronounced than on day 2. Incubation with IGF-I limited proteolysis to a greater extent than insulin on both days in infected but not control rats. By day 15, insulin diminished proteolysis to the same extent as in controls. The results suggest that injection of bacteria causes fundamental derangements in protein metabolism that persist for days after infection.