Bases metabólicas da rabdomiólise e atrofia muscular
DOI:
https://doi.org/10.33233/rbfe.v9i2.3481Resumo
A redução da musculatura esquelética ou atrofia muscular ocorre gradativamente a partir dos 30 anos de idade, mas com significância importante a partir da 5ª década. Entretanto, ocorre em qualquer idade, na privação alimentar de carboidratos e no trauma. Pode ocorrer por denervação, desuso, deficiência nutricional, desequilíbrio hormonal e inflamação. A proteólise muscular ocorre predominantemente via ATP-ubiquitina-proteossoma e cooperativamente com os sistemas calpaína e caspase 3. Como promotores da proteólise figuram os glicocorticóides, o FOXO3 e as citocinas pró-inflamatórias. O TNFα, ativa o NF-κB tanto pelo Ca++ intracelular como pelas espécies reativas do oxigênio. Figuram como marcadores moleculares da atrofia muscular, a expressão aumentada dos genes MAFbx/atrogina 1 e MURF-1 e os marcadores proteolíticos como ubiquitina, calpaína, miostatina, TNFα e NF-κB. No geral, a rabdomiólise tem o estresse oxidativo como principal efetor e a disfunção mitocondrial, apoptose celular, como desfecho.
Palavras-chave: rabdomiólise, proteólise, atrofia muscular, caquexia.
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