Basic metabolism: proteins

Proteins serve a range of physiological functions in health and in disease. Their overall structure is determined predominantly by the sequence of amino acids when they are synthesized, which in turn is a derivative of the sequence of nucleotides in the corresponding segment of DNA. There is a constant turnover of body protein, the rate of which exceeds dietary protein intake and therefore suggests a degree of recycling. Some amino acids that enter the body protein pool can be synthesized ('non-essential' amino acids) while others can only be obtained through dietary means ('essential' amino acids). During critical illness and significant trauma there appears to be dysregulation such that synthesis of some non-essential amino acids is limited, while there is an increase in amino acid oxidation. Modification of dietary intake to address the potential imbalance in illness is probably insufficient in isolation to prevent muscle wasting.