Scandinavian Journal of Infectious Diseases

ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19

Human Skeletal Muscle in Bacterial Infection: Enzyme Activities and their Relationship to Age Eva Åström, Göran Friman & Lars Pilström To cite this article: Eva Åström, Göran Friman & Lars Pilström (1977) Human Skeletal Muscle in Bacterial Infection: Enzyme Activities and their Relationship to Age, Scandinavian Journal of Infectious Diseases, 9:3, 193-195, DOI: 10.3109/inf.1977.9.issue-3.07 To link to this article: http://dx.doi.org/10.3109/inf.1977.9.issue-3.07

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Date: 12 May 2016, At: 02:18

Scand J Infect Dis 9: 193-195, 1977

Human Skeletal Muscle in Bacterial Infection: Enzyme Activities and Their Relationship to Age EVA ASTROM,' GORAN FRIMANZ and LARS PILSTROM'

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From the 2Department of Infectious Diseases, University Hospital and the 'Itistitute of Zoophysiology. University of Uppsala, Uppsala, Sweden

ABSTRACT. 8 male patients (age 65-82 years) suffering from bacterial pneumonia or erysipelas were subjected to skeletal muscle biopsies. Significantly lower activities of lactate dehydrogenase (LDH) and glyceraldehyde-3-phosphate dehydrogenase (TPD) of skeletal muscle were recorded in the acute phase of the illness as compared to after the end of the convalescent phase. For citrate synthetase (CS) a similar although non-significant tendency was observed, while cytochrome c oxidase (CYTOX) was not altered by infection. Similar results have been reported in young patients with viral and mycoplasma infections. In the old patients the activity of LDH was approximately half of that found in the young patients (and in young controls confined to bed) on all occasions of measurement.

INTRODUCTION Viral and mycoplasma infections affect metabolic enzymes and the ultrastructure of skeletal muscle of young men (1, 2, 3), alterations that might be related to the symptom of myalgia. However, myalgia can also occur in bacterial infections (6). Therefore, it seemed to be of interest to establish whether muscle is similarly influenced in such conditions. Since on the wards of our department those patients suffering bacterial infections belong most frequently to older age groups, the present investigation of the influence of bacterial infection on the activities of 4 metabolic enzymes in skeletal muscle was performed on old men. This provided an opportunity for studying possible age-related differences in the activities of these enzymes, since data were also obtained during and after the convalescent phase and comparisons could then be made with similar data from younger patients and from healthy control subjects. MATERIAL AND METHODS Subjects-clinical procedure Eight hospitalized male patients aged 65-82 (73.3f2.4) years were selected to take part in the investigation after giving informed consent. Seven of them suffered from bacterial pneumonia and one from erysipelas (Fig. I ) . They were included consecutively with no selective criteria except those of aetiology, age and sex. All patients were examined by one of the authors ( G . F.) The routine admission procedure for patients with acute infectious disease was followed as reported earlier 13-77 I958

(2). The duration of the illnesses averaged 7.9f 1.4 days, that of fever 7.5f1.5, and that of bed rest 6.3k1.6 days (Fig. l ) , these variables being defined as in a previous study (7). Clinical examination did not reveal unexpected complications to the illness concerned in any patient. For a diagnosis of pneumonia a positive chest X-ray was required. In the erysipelas case the diagnosis was based on the characteristic appearance of a local erythema in the vicinity of an ulcus cruris and a positive culture of beta-haemolytic streptococci group A from the secretion. In all pneumonia patients tests for complement-fixing (CF) antibodies were performed on paired sera against Mycoplasma pneumoniae and influenza A and B viruses. In no case was a significant change in titres recorded. In addition, antibodies against pneumococci and Haemophilus influenzae were determined (Dr Jerzy Wasserman, Institute of Microbiology, County Council of Stockholm). High titres were found in two cases. Supporting a bacterial aetiology, all patients but two showed raised polymorphonuclear white blood cell counts in the acute phase and all responded promptly to treatment with phenoxymethylpenicillin. The results from the above-mentioned patients were compared with those from two groups of young men (aged 20-40 years). One of these groups consisted of patients who suffered from viral or mycoplasma infections and the other of healthy men, who were confined to bed for 7 days. Clinical data from these two groups have been reported earlier (2). Biopsy Biopsies were taken percutaneously from m. vastus lateralis as reported earlier (2). The timing of the first muscle biopsy was directly related to that of the acute disease (10.3f2.4 days after onset of illness), while the follow-up biopsies were performed after 48.6f5.8 days and 182.3f 33.3 days, respectively.

194

E . Astrom e t a / .

Patient Age Days of disease (years) Onset of symptoms ,5, Jq J?+

GE GW EB EG JB JE

Jq

A

29

78 76 82 71 81 65 67 66

A6 EP

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RESULTS

3-1 Confined lo

0 bed

Arnbulont

Biopsy No 1

Fig. 1 . Bed rest data and time for first biopsies of the

patients examined. Patient E. P. had erysipelas, the others bronchopneumonia. None of the patients reported distinct myalgia, although most suffered some indefinite muscular discomfort.

Enzyme ussnys The biopsy was rapidly weighed and homogenized in 20 times (wlv) ice-cold KCI 0.15 mol/l, EDTA 6 mmol/l and KHCO, 50 mmol/l at pH 7.4, using a Potter-Elvehjelm allglass homogenizer in the same manner as reported earlier (2). This homogenate was used for estimation of the activities of cytochrome c oxidase (CYTOX; E.C. 1.9.3.I), citrate synthetase (CS; E.C. 4.1.3.7), glyceraldehyde-3-phosphate (triosephosphate) dehydrogenase (TPD; E.C. I .2.1.12) and lactate dehydrogenase (LDH; E.C. I . 1.1.27). The methods used for these estimations were for CYTOX that of Tottmar et al. (9), for CS that of Srere (8), and for TPD and LDH those of Bass et al. (4).

The activities of cytochrome oxidase (CYTOX) and citrate synthetase (CS) in skeletal muscle of old men did not differ significantly during and after bacterial infection (Table I). For CYTOX this is in agreement with the results from young men suffering viral or mycoplasma infections. However, the activity of CS rose in muscle of young patients during recovery, and a similar although nonsignificant tendency was found in the muscle of old patients suffering bacterial infections (Table I). In the old patients muscle lactate dehydrogenase (LDH) and glyceraldehyde-3-phosphate dehydrogenase (TPD) exhibited lower activities in relation to the acute disease than 4-6 months later (Table I). Furthermore, on any comparable occasion, the activity of LDH in the old patients was only half of that found in the young patients (Table I). For TPD no such difference was found.

DISCUSSION Viral or mycoplasma infection in young men reduces the activities of TPD, LDH and CS in skeletal muscle and induces alterations of the normal ultrastructural organization (2, 3). The reason for this is obscure, but as symptoms of myalgia and muscle fatigue are also present in bacterial infection (6), it is not surprising to find similar enzymatic altera-

Table I. Activities of 4 enzymes in skeletal niirscle of young healthy men ( Y H M )arid of young (YDM) and old (ODM) male patients with infectious disease The activities are expressed as nmol . min-' .g-' tissue except for citrate synthetase, which is expressed as nmol . min-' 'g-' muscle tissue. The figures are mean va1uesfS.E.M. The P-values indicate the significance of differences between the groups YDM and ODM on comparable occasions. The symbols *, ** and *** denote: *P

Human skeletal muscle in bacterial infection: enzyme activities and their relationship to age.

Scandinavian Journal of Infectious Diseases ISSN: 0036-5548 (Print) 1651-1980 (Online) Journal homepage: http://www.tandfonline.com/loi/infd19 Human...
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