Branched-Chain Amino Acids in Exercise

Leucine Regulates Translation Initiation of Protein Synthesis in Skeletal

Muscle after Exercise1,2
Layne E. Norton and Donald K. Layman3
Division of Nutritional Sciences, Department of Food Science and Human Nutrition,
University of Illinois at Urbana-Champaign, Urbana, IL 61801

KEY WORDS:  insulin  mTOR  leucine  muscle  exercise

Muscle protein undergoes constant change and remodeling

through synthesis of new proteins and breakdown of existing
proteins. Together, these processes are called protein turnover
and produce muscle growth or hypertrophy when synthesis is
greater than breakdown and muscle wasting when synthesis is
less than breakdown. For nongrowing adults, maintenance of
constant muscle mass requires zero daily balance between synthesis and breakdown. During the course of a day, the comparative ratios of protein synthesis to breakdown change
constantly. After a meal as nutrients are absorbed, the rate of
protein synthesis increases. The rate of protein breakdown also
rises but to a lesser extent, resulting in a net positive balance of
protein turnover (Fig. 1). After an overnight period without
food, protein synthesis decreases by 15 to 30% depending on
the length of the fast. Protein breakdown changes less, resulting
in a net catabolic period (Fig. 1). The catabolic period after an
overnight fast continues until adequate energy and amino acids

are available to stimulate protein synthesis. These short-term

changes in the regulation of protein turnover appear to be
produced by changes in the initiation phase of translation
control of protein synthesis. Key nutrition factors appear to be
energy status of the cell and intracellular concentration of the
BCAA leucine (1,2).
Exercise-induced changes in protein turnover
Exercise produces diverse changes in amino acid metabolism
and protein turnover in skeletal muscle. Acute changes are
driven by energy needs and amino acid availability, whereas
long-term changes allow for adaptation of proteins for structure
and performance (3,4). Acute changes in amino acid metabolism caused by exercise are largely catabolic with net negative
balance between the rates of protein synthesis and protein
breakdown and an increase in the rate of amino acid oxidation.
The magnitudes of these catabolic processes are determined
by the type of exercise. Although acute effects of exercise are
catabolic, exercise clearly does not cause muscle wasting; instead, regular exercise is essential to optimize muscle growth
and hypertrophy. Thus, exercise requires a sequence of metabolic adjustments from the catabolic period of exercise to the
anabolic period of recovery.
Exhaustive endurance exercise inhibits muscle protein
synthesis with the magnitude of the depression related to the
intensity and duration of the activity (57). Similar to changes
during fasting, protein breakdown is higher than protein
synthesis during exercise, resulting in a net catabolic period
(Fig. 1). The time course of the changes in protein synthesis

1
Published in a supplement to The Journal of Nutrition. Presented at the
symposium Branched-Chain Amino Acids in Exercise held June 17, 2005 at
the International Society for Sports Nutrition annual meeting, New Orleans, LA. The
conference was sponsored by the Amino Vital Sports Science Foundation. The
symposium organizers were John D. Fernstrom and Robert R. Wolfe; the guest
editors for the supplement publication were John D. Fernstrom and Robert R.
Wolfe. Guest Editor Disclosure: R. R. Wolfe, received reimbursement from conference sponsor for travel to International Society for Sports Nutrition annual meeting; J. D. Fernstrom, received reimbursement from conference sponsor for travel to
International Society for Sports Nutrition annual meeting; scientic advisor to the
Amino Vital Sports Science Foundation; consulting agreement with Ajinomoto,
Washington, D.C.
2
Author Disclosure: No relationships to disclose.
3
To whom corresponding should be addressed. E-mail: [email protected].

0022-3166/06 $8.00 2006 American Society for Nutrition.

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ABSTRACT High-performance physical activity and postexercise recovery lead to signicant changes in amino
acid and protein metabolism in skeletal muscle. Central to these changes is an increase in the metabolism of the
BCAA leucine. During exercise, muscle protein synthesis decreases together with a net increase in protein
degradation and stimulation of BCAA oxidation. The decrease in protein synthesis is associated with inhibition of
translation initiation factors 4E and 4G and ribosomal protein S6 under regulatory controls of intracellular insulin
signaling and leucine concentrations. BCAA oxidation increases through activation of the branched-chain a-keto acid
dehydrogenase (BCKDH). BCKDH activity increases with exercise, reducing plasma and intracellular leucine
concentrations. After exercise, recovery of muscle protein synthesis requires dietary protein or BCAA to increase
tissue levels of leucine in order to release the inhibition of the initiation factor 4 complex through activation of the
protein kinase mammalian target of rapamycin (mTOR). Leucines effect on mTOR is synergistic with insulin via the
phosphoinositol 3-kinase signaling pathway. Together, insulin and leucine allow skeletal muscle to coordinate protein
synthesis with physiological state and dietary intake. J. Nutr. 136: 533SS537, 2006.

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and breakdown are unknown, largely due to limitations in making measurements during exercise. Protein turnover remains
negative until adequate dietary protein and energy are available
for recovery.
Resistance exercise produces a pattern of changes in protein
turnover that are somewhat different. At the end of exhaustive
resistance exercise, protein synthesis is increased (8,9). Yet,
a single bout of resistance exercise is still catabolic due to
increases in protein breakdown (Fig. 1). Similar to endurance
exercise, skeletal muscle remains in negative nitrogen balance
after resistance exercise until adequate protein and energy are
available for recovery (10). The molecular mechanisms determining the key regulation of protein synthesis under these
conditions place leucine in a central role in the initiation of
translation.
Metabolic roles of leucine in skeletal muscle
Exercise stimulates changes in protein and amino acid
metabolism. Amino acid metabolism in skeletal muscle is limited to six amino acids (glutamate, aspartate, asparagines, and
the three BCAAs). Among these amino acids, the most noteworthy effects have been observed with the BCAA leucine
(3,7,11). Leucine participates in numerous metabolic processes
(2), including its obvious role as a constituent of protein. Of
more direct interest to the present discussion, leucine also functions as (1) a critical regulator of translation initiation of protein synthesis, (2) a modulator of the insulin phosphoinositol
3-kinase (PI3-kinase)4 signal cascade, and (3) a nitrogen donor
for muscle production of alanine and glutamine. The potential
for leucine to impact on translation initiation, insulin signaling,
and the production of alanine and glutamine depends on its
intracellular concentrations. The intracellular leucine concentration represents a balance between the rates of appearance of
leucine from plasma uptake and intracellular protein breakdown and the rates of removal of leucine through intracellular
amino acid oxidation and protein synthesis.
4

Abbreviations used: AMPK, AMP kinase; BCAT, branched-chain aminotransferase; BCKDH, branched-chain a-keto acid dehydrogenase; eIF4E, initiation
factor 4E; eIF4G, initiation factor 4G; mTOR, mammalian target of rapamycin; PI3kinase, phosphoinositol 3-kinase; PKB, protein kinase B; p70S6K, 70-kD ribosomal
protein S6 kinase; rpS6, ribosomal protein S6; tRNA, transfer RNA.

FIGURE 2 Intracellular leucine concentrations inuence protein

synthesis (solid lines), including translation initiation factors eIF4E, rpS6,
and eIF4G and elongation factor eEF2, and energy metabolism (dashed
lines) through BCKDH, pyruvate dehydrogenase (PDH), insulin receptor
substrate-1 (IRS-1), and insulin release from the b-cell of the pancreas.
Arrows indicate stimulation, and blocked lines indicate inhibition.

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FIGURE 1 Skeletal muscle protein turnover illustrates the balance

between protein synthesis (shaded bars) and protein breakdown (open
bars) during different physiological conditions, including the anabolic
period after a meal or the catabolic period during an overnight fast.
Exercise examples represent exhaustive endurance exercise and a
prolonged bout of resistance exercise.

Leucine is unique among amino acids for its regulatory roles

in metabolism, including translational control of protein synthesis (1) and glycemic regulation (12) (Fig. 2). This review
focuses on the role of leucine in the regulation of skeletal
muscle protein synthesis through initiation factors 4E (eIF4E)
and 4G (eIF4G) and ribosomal protein S6 (rpS6). Other aspects
of metabolism sensitive to intracellular leucine concentrations
include (1) the branched-chain a-keto acid dehydrogenase
(BCKDH), the rate-limiting step in BCAA degradation (13);
(2) pyruvate dehydrogenase, a key enzyme in glycolysis that
controls pyruvate entry into the TCA cycle (14); (3) the insulin
receptor substrate-1, the initial phosphorylation target of the
insulin receptor; and (4) the pancreatic b-cell, in relation to
insulin release (12). In total, these diverse metabolic roles allow
leucine to influence directly the rate of muscle protein synthesis, insulin action, and glucose homeostasis.
The effects of leucine are, at least in part, associated with
the absence of the branched-chain aminotransferase (BCAT)
enzyme in liver (15). Absence of BCAT in liver results in an
enriched supply of the three BCAAs channeled to skeletal
muscle. Dietary BCAA reach the blood virtually unaltered from
their levels in the diet; thus, leucine reaches peripheral tissues
in direct proportion to its dietary intake. During exercise, there
also is increased release of leucine from visceral tissues (liver
and gut) and movement to skeletal muscle (16). This pattern of
interorgan movement of amino acids provides for a continuous
supply of leucine to skeletal muscle.
Constant influx of leucine to skeletal muscle is buffered by
the presence of BCAT and BCKDH, the enzymes catalyzing
the first two steps in BCAA degradation (15). BCKDH mediates the rate-limiting step in BCAA degradation; its activity is
proportional to intracellular BCAA concentrations. In skeletal
muscle, BCKDH is normally ,20% active with great capacity
to respond to increased BCAA influx. Thus, although the
plasma levels of BCAA may change 2- to 3-fold after a meal,
the changes in intracellular leucine concentrations are much
smaller due to buffering by BCKDH (2,15).
Our initial interest in the role of leucine in postexercise
recovery began with the observation in young athletes that
plasma leucine concentration decreases dramatically at the
end of exhaustive endurance exercise (17). We modeled this
change in plasma leucine using rats and treadmill running. At
the end of a 2-h exhaustive run, rats experienced a 25%
decrease in the rate of muscle protein synthesis, compared with
fasted controls receiving no exercise (18). These animals were
provided with a series of recovery drinks to evaluate the impact
of carbohydrate and protein on muscle protein synthesis

LEUCINE REGULATION OF MUSCLE PROTEIN SYNTHESIS

(18,19). An electrolyte drink containing glucose and sucrose

increased blood glucose and insulin concentrations as well as
muscle glycogen content but produced no recovery of muscle
protein synthesis. However, a complete meal containing protein (or leucine alone) produced complete recovery of muscle
protein synthesis within the first hour after exhaustive exercise.
It is now clear that leucine stimulates muscle protein synthesis
through the protein kinase mammalian target of rapamycin
(mTOR) activating initiation factors eIF4E and rpS6 (2,20).
Interestingly, plasma levels of leucine do not decrease after
resistance exercise (21); likewise, rates of skeletal muscle protein synthesis do not decrease after resistance exercise compared with nonexercised controls (8,9). However, net protein
balance remains negative after resistance exercise, as protein
breakdown is greater than protein synthesis, and remains negative until dietary protein or leucine is ingested (22).
Translational control of muscle protein synthesis

4E-BP1 by the protein kinase mTOR reduces the affinity of

4E-BP1 for eIF4E (Fig. 3), allowing eIF4E to bind with eIF4G
and form the active eIF4F complex. Activity of mTOR is
sensitive to leucine concentration and stimulation through the
PI3-kinase signal cascade.
Another downstream target of mTOR is the 70-kD rpS6
kinase (p70S6K). p70S6K is activated by phosphorylation from
mTOR (1,24). Inhibiting mTOR prevents phosphorylation of
the kinase and thus prevents the activation of p70S6K. Activation
of p70S6K results in preferential translation of mRNAs that
encode components of the protein synthesis mechanism, including the ribosomal proteins eIF4G, eukaryotic elongation
factors (eEF1 and eEF2), and poly(A) binding protein. All of
these proteins are involved in translation of mRNA to protein; thus, activation of rpS6 increases the cells capacity for
protein synthesis. Together, the effects of leucine concentration through mTOR activity on eIF4E and rpS6 influence
both the rate of translation and the translation capacity in skeletal muscle.
Regulation of muscle protein synthesis via mTOR
Activation of mTOR is not fully understood but is influenced by multiple regulatory proteins, including the tuberous
sclerosis complex (TSC1 and TSC2), Rheb, and AMP kinase
(AMPK) (2729) (Fig. 3). TSC1/TSC2 and Rheb are crucial
regulators situated between protein kinase B (PKB) and mTOR.
Rheb, a Ras-like GTPase, is a positive regulator of mTOR in
vivo. The action of Rheb is opposed by the TSC1/TSC2 complex, which acts as a Rheb GTPase, promoting the conversion
of Rheb-GTP to Rheb-GDP, inhibiting Rhebs positive effect
on mTOR. TSC2 is sensitive to growth factors and energy
(AMPK) but not to amino acids (30). In TSC2 knockout cells,
amino acid deprivation still impairs mTOR signaling (31),
suggesting that the primary site for leucine effects is downstream from TSC2, most likely through Rheb (29).
Energy status of the cell affects mTOR activity through the
activity of AMPK. AMPK is widely regarded as an energy
sensor. Under conditions of exercise, hypoxia, ischemia, heat
shock, and low glucose, AMPK is activated by rising AMP
levels and reduced glycogen content (32,33). Once AMPK is
activated, it phosphorylates multiple substrates aimed at increasing intracellular ATP levels. AMPK also spares ATP by inhibiting the ATP-consuming process of protein synthesis.

FIGURE 3 The metabolic signal cascade of PI3-kinasePKBmTOR

serves to integrate physiological inputs from growth factors (insulin and
IGF-1), the energy status of the cell (AMP concentrations), and intracellular leucine (leu) concentrations to regulate translation initiation at
eIF4E, eIF4G, and rpS6.

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Short-term regulation of protein synthesis is achieved at the

level of translation, with primary emphasis on the assembly of
the structural machinery for protein synthesis through a process
known as initiation (1,23). The basic components for protein
synthesis include the large and small ribosomal subunits (60S
and 40s, respectively), mRNA coding for individual proteins,
transfer RNA (tRNA) for individual amino acids, and more
than a dozen catalytic proteins identified as eIFs. These initiation factors guide the assembly of the ribosome on the mRNA
and are responsive to short-term changes in the availability of
energy, amino acids, and growth factors. Initiation factors provide the cell with sensitivity to environmental factors, including
changes in diet, such as leucine availability, and physical
activity.
Among the catalytic peptides regulating protein synthesis,
most attention has focused on initiation factors eIF2, the eIF4F
complex, and rpS6. Initial assembly of a ribosome on mRNA
requires activation of the 40S ribosomal subunit and preparation of the 59cap end of the mRNA. Activation of the 40S
subunit requires binding with eIF2, which carries a high energy
molecule of GTP, and the initiator amino acid methionine
(Met-tRNA). This complex of eIF2-GTP-Met-tRNA (known
as the ternary complex) binds with the 40S subunit to form the
43S pre-initiation complex. Formation of the ternary complex is
sensitive to cellular energy status and intracellular leucine
concentrations. Formation of the 43S pre-initiation complex
is an essential first step in the initiation sequence; however,
eIF2 is seldom limiting in skeletal muscle (1,24).
Binding of the 43S pre-initiation complex to an mRNA is
believed to be a rate-controlling step in translation initiation
(1,24,25). This step is mediated by eIF4F, a three-subunit complex consisting of (1) eIF4E, a protein that binds to the 59cap
structure of the mRNA to be translated; (2) eIF4G, a peptide
that serves as a scaffold to connect eIF4E and eIF4A with the
mRNA and 40S subunit; and (3) eIF4A, a RNA helicase that
functions to unwind secondary structure in the 59-untranslated
region of the mRNA. The eIF4F complex collectively serves
to recognize, unfold, and guide the mRNA to the 43S preinitiation complex.
Formation of the eIF4F complex is regulated through the
availability of eIF4E for binding with eIF4G and the phosphorylation state of eIF4G. Availability of eIF4E for eIF4G is
controlled by the eIF4E inhibitory binding protein 4E-BP1. The
binding site for 4E-BP1 on eIF4E overlaps with the binding site
for eIF4G, preventing formation of the eIF4E-eIF4G complex
(26). Binding of 4E-BP1 to eIF4E is determined by the phosphorylation state of the binding protein. Phosphorylation of

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Increased AMPK activity is associated with reduced eIF4E

binding with eIF4G and increased 4E-BP1 inhibition of eIF4E
(30). Smith et al. (31) proposed that the effects of AMPK on
mTOR are mediated through TSC2. AMPK directly phosphorylates TSC2, increasing formation of the TSC1/TSC2 complex
and inhibiting Rheb. Because AMPK is activated by exercise
and a decreased ATP/AMP ratio, AMPK activation and its
effects on the mTOR pathway appear to be a primary mechanism reducing protein synthesis after endurance exercise (30).
Leucine and mTOR-independent mechanisms

Effect of exercise on translation initiation factors

Endurance exercise reduces the rate of muscle protein
synthesis in proportion to the duration and intensity of activity
(57). Exhaustive exercise or prolonged low frequency stimulation inhibits mTOR pathways, including inhibition of eIF4E
and rpS6. After exercise, there is increased eIF4E binding to
the inhibitor 4E-BP1 and reduced binding with the eIF4G initiation complex (18,30). Recent reports suggest the mechanism is due to increased activity of the AMPK (30). Exhaustive
exercise decreases ATP, increases the concentration of AMP,
and reduces glycogen concentration. Increased AMP and
reduced glycogen stimulate AMPK, which leads to phosphorylation of TSC2, formation of the TSC1/TSC2 complex, and
inhibition of Rheb and mTOR. Postexercise supplemental
leucine increases intracellular leucine concentrations, which
directly stimulates mTOR and eIF4G, allowing for recovery of

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Although important, mTOR alone does not fully account for

leucine stimulation of muscle protein synthesis. For instance,
co-administration of leucine with the mTOR inhibitor
rapamycin only partially inhibited the leucine-induced increase
in protein synthesis (34). Furthermore, administration of leucine to diabetic rats increased muscle protein synthesis in the
absence of increases in 4E-BP1 or p70S6K phosphorylation
(35). Likewise, rat hindlimbs perfused with leucine at fooddeprived (1 3 ) or superphysiologic (10 3 ) concentrations of
leucine demonstrate increases in protein synthesis in high vs.
low leucine groups, even though signaling through mTOR and
phosphorylation status of 4E-BP1 and p70S6K were not different (36). Furthermore, there was a lack of correlation between leucine concentrations and 4E-BP1 binding with eIF4E
and changes in eIF4G association with eIF4E (37). It is therefore likely that increased intracellular leucine concentrations
stimulate protein synthesis via mTOR-dependent and mTOR
independent pathways.
A known mechanism by which leucine stimulates protein
synthesis independent of mTOR activity is through direct
activation of eIF4G (Fig. 3). Bolster et al. (36) found that
eIF4G phosphorylation was significantly increased in rats supplemented with leucine. They concluded that the increase in
eIF4G phosphorylation increased the availability of eIF4G for
eIF4E, thus increasing the formation of the eIF4E-eIF4G
complex and protein synthesis independent of mTOR. These
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complex is limiting and that the release of a fraction of the total
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eIF4E and activation of eIF4G (Fig. 3).

muscle protein synthesis (34,36). The combination of leucine

plus carbohydrates appears to produce a synergistic effect on
recovery, presumably through the combined effects of leucine
on mTOR and insulin on PI3-kinase and PKB, resulting in
reduced AMPK and TSC2 activity (18,19,30).
Resistance exercise produces increases in protein synthesis
that are evident soon after exercise and persist for up to 48 h
(22). This increase in protein synthesis appears to be mediated
through PI3-kinase and PKB signaling, which are likely stimulated by growth factors such as insulin-like growth factor 1
(IGF-1) and myostatin (30). Studies using high-frequency
stimulation in rats found increases in PKB, resulting in
increased phosphorylation of TSC1 and reduced formation of
the TSC1/TSC2 inhibitory complex, allowing for binding of
Rheb with mTOR and activation of eIF4E and rpS6 (30) (Fig.
3). Furthermore, there is evidence for direct activation of rpS6
by PI3-kinase, which serves to increase the cellular capacity for
protein synthesis after resistance exercise (30). While the
combination of high-frequency stimulation and growth factors
increases protein synthesis postexercise, synthesis is not fully
stimulated and skeletal muscle remains catabolic without
supplemental dietary leucine, either alone or as a part of
protein or an amino acid mixture. Supplemental leucine allows
for the muscle to achieve maximum protein synthesis and
anabolic recovery (10,22).
In summary, exercise highlights the importance of the
BCAA leucine in the regulation of muscle protein synthesis.
After exercise, protein turnover is in negative balanceprotein
synthesis is slower than protein breakdown. This negative
balance reflects inhibition of numerous components of translation initiation. For endurance exercise, energy demands
increased AMPK, stimulating formation of the TSC1/TSC2
complex, which inhibits peptide initiation at mTOR. On the
other hand, resistance exercise generally does not affect AMPK
but increases total capacity for protein synthesis through PI3kinase and PKB activation of rpS6. In both cases, recovery is
apparently dependent on supplemental dietary leucine in order
to increase the intracellular leucine concentration, which
activates mTOR and the initiation factors eIF4E and eIF4G.
At reduced intracellular leucine concentrations, eIF4G and
4E-BP1 are hypophosphorylated, formation of the eIF4E-eIF4G
complex is inhibited, and protein synthesis is reduced. At
slightly elevated intracellular leucine concentrations, 4E-BP1
becomes phosphorylated, while eIF4G remains hypophosphorylated, resulting in limited formation of the eIF4E-eIF4G complex and increased protein synthesis. Elevated intracellular
leucine concentrations fully phosphorylate eIF4G, allowing for
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acids, and other essential amino acids do not have stimulatory
effects on protein synthesis when compared with leucine
(18,39,40). However, in most cases, the combination of amino
acid supplements with carbohydrates produces additive effects
on the stimulation of the PI3-kinase and mTOR pathways,
producing the maximum rates of protein synthesis during
recovery.

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