Modification of core body temperature by amino acid administration.

The feeling of warmth after a meal is caused by the ingestion of nutrients and the sensation is known as nutrition-induced thermogenesis or specific dynamic action. Core body temperature (Tb) is constantly maintained within a narrow range, but thermoregulation can become impaired by the inhalation or intravenous administration of anesthetics that inhibit hypothalamic thermoregulation. Hypothermia during surgery is directly associated with postoperative complications. Devices are available to maintain heat during surgery and thus prevent hypothermia. On the other hand, intravenous amino acid (AA) administration can attenuate hypothermia during anaesthesia, prompting many clinical trials of AA mixtures to maintain Tb. However, although the thermal effect of AA during anaesthesia is obvious, the underlying mechanism of metabolic heat production and accumulation remains obscure. A nutritional physiological approach using a rat model will be introduced in this symposium. Data from our recent studies suggest that the administration of an AA mixture during anaesthesia stimulates muscle protein synthesis via insulin-mTOR-dependent activation of the translation initiation factors, 4E-BP 1 and S6K1, as a result of increased insulin concentrations. Thus, heat accumulation in the body is facilitated. Furthermore, the content of the AA mixture applied during anaesthesia alters the thermal effect and branched chain AAs are necessary, but not sufficient, for the prevention of hypothermia.