The enemy within. How to identify chronic diseases induced-protein metabolism impairment and its possible pharmacological treatment

Recent clinical and experimental data show that considerable impairment of protein metabolism occurs in patients with chronic diseases such as heart failure. However, too often the extent of impairment is under-estimated or ignored by most clinicians and no therapy is considered leading to progressive loss of body proteins, increase morbidity, hospital stay and mortality. This paper illustrates the possible biological markers to evaluate general protein metabolism, including quantification of related damage and possible improvement of the metabolism using specific therapeutical metabolic strategies recently studied in a clinical setting. (C) 2013 Elsevier Ltd. All rights reserved.