This clinical approach refers to therapeutic strategies designed to overcome the diminished responsiveness of muscle tissue to anabolic stimuli, such as amino acids and hormones like insulin and testosterone. Anabolic resistance is a key factor contributing to muscle loss, or sarcopenia, particularly in aging, chronic illness, and states of metabolic dysfunction. The treatment aims to enhance muscle protein synthesis and mitigate the catabolic processes that lead to muscle wasting. Successfully addressing this resistance is central to preserving lean body mass and maintaining functional independence across the lifespan.
Origin
The concept of anabolic resistance emerged from foundational research in muscle protein metabolism and gerontology, where scientists observed a blunted muscle-building response in older individuals and those with specific diseases, even when adequate nutrients and hormones were present. The term ‘anabolic’ derives from the Greek anabolē, meaning ‘a raising up,’ referring to constructive metabolism, while ‘resistance’ highlights the impaired cellular signaling observed in clinical settings. Treatment protocols evolved from nutritional and exercise science, integrating pharmacological and hormonal interventions to restore cellular sensitivity.
Mechanism
Treatment operates by targeting various points in the muscle protein synthesis signaling cascade, primarily the mTOR pathway. Strategies often include optimizing protein intake, particularly essential amino acids like leucine, which acts as a potent anabolic signal. Furthermore, certain exercise modalities, especially resistance training, mechanically sensitize muscle cells to circulating anabolic hormones. Pharmacological agents may be employed to improve insulin sensitivity or directly modulate androgen receptor function, thereby restoring the necessary hormonal signaling for muscle accretion and mitigating age-related muscle decline.
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