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Die Regulation des Serumalbuminspiegels unter physiologischen und pathologischen Bedingungen

The regulation of serum albumin in physiological and pathological conditions

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Summary

12 g of albumin are synthesized daily by the bound polyribosomes of all human liver cells together, corresponding to 10% of the intravascular albumin mass. The cell is producing a precursor albumin. During secretion albumin is liberated by splitting of a small peptide. Only 40% of the total body albumin is located intravascularly. 12 g of albumin are degraded or excreted daily, 30% of it by the liver, the kidneys and the gastrointestinal tract. The main site of albumin catabolism is unknown. Albumin with a half-life of about 20 days is degraded at a constant fractional catabolic rate. The absolute rate of degradation varies depending on the plasma content. This mechanism allows an effective regulation of the serum albumin level. The fractional catabolic rate, however, is not completely fixed. It is slowly reduced if the serum albumin content is markedly reduced as in protein deficiency, the blind loop syndrome, cirrhosis, nephrosis, and diseases of the gastrointestinal tract. Infusion of albumin increases the fractional catabolic rate slowly. This must be taken in consideration substituting albumin in chronic diseases. The shift from the extravascular to the intravascular compartment is a short-term regulatory mechanism. The regulation of synthesis and degradation are independent from each other. The molecular mechanism of regulation of synthesis and degradation are unknown, partially due to inadequate methods.

Zusammenfassung

Die gebundenen Polyribosomen aller menschlichen Leberzellen zusammen synthetisieren pro Tag etwa 12 g Albumin, was 10% des intravaskulären Albumingehaltes entspricht. In der Zelle wird Proalbumin produziert. Bei der Sekretion entsteht dann durch Abspaltung eines Peptides Albumin. Nur 40% des Gesamtkörperalbumins finden sich intravaskulär. 12 g Albumin werden täglich abgebaut oder ausgeschieden, davon ca. 30% in der Leber, den Nieren und dem Magen-Darm-Trakt. Wo die Hauptmenge des Albumins abgebaut wird, ist unbekannt. Albumin hat mit einer Halbwertszeit von 20 Tagen eine relativ konstante Abbaurate. Die absolute Abbaurate variiert in Abhängigkeit vom Serumalbumingehalt. Dieser Mechanismus gewährleistet eine wirkungsvolle Regulation des Serumalbuminspiegels. Die relative Abbaurate ist jedoch nicht völlig starr fixiert. Bei stark erniedrigtem Serumalbumingehalt, wie bei Eiweißmangelernährung, dem Syndrom der blinden Schlinge, Alkoholismus, Leberzirrhose, nephrotischem Syndrom und Erkrankungen des Magen-Darm-Traktes, wird die prozentuale Abbaurate langsam innerhalb von Tagen und Wochen herabgesetzt. Bei Zufuhr von Albumin steigt die prozentuale Abbaurate langsam an, was bei der Albuminsubstitution bei chronischen Erkrankungen zu berücksichtigen ist. Ein kurzfristig wirksamer Regelmechanismus ist die Verschiebung des Albumins vom extravaskulären zum intravaskulären Kompartiment. Der Abbau und die Synthese von Albumin werden unabhängig voneinander reguliert. Die molekularen Mechanismen der Regulation der Synthese und des Abbaus sind unbekannt, was seine Ursache teilweise in einer unzulänglichen Methodik hat.

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Nachtrag bei der Korrektur

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  1. K. Weigand

    Present address: Massachusetts General Hospital, Gastrointestinal Unit, 02114, Boston, Massachusetts, USA

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  1. Medizinische Universitätsklinik Würzburg, Germany

    K. Weigand

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Weigand, K. Die Regulation des Serumalbuminspiegels unter physiologischen und pathologischen Bedingungen. Klin Wochenschr 55, 295–305 (1977). https://doi.org/10.1007/BF01488107

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