The molecular bases underlying burn-or critical illness-induced insulin resistance still remain unclarified. Muscle protein catabolism is a ubiquitous feature of critical illness. Akt/PKB plays a central role in the metabolic actions of insulin and is a pivotal regulator of hypertrophy and atrophy of skeletal muscle. We therefore examined the effects of burn injury on insulin-stimulated Akt/PKB activation in skeletal muscle. Insulin-stimulated phosphorylation of Akt/PKB was significantly attenuated in burned compared with sham-burned rats. Insulin-stimulated Akt/PKB kinase activity, as judged by immune complex kinase assay and phosphorylation status of the endogenous substrate of Akt/PKB, glycogen synthase kinase-3 (GSK-3), was significantly impaired in burned rats. Furthermore, insulin consistently failed to increase the phosphorylation of p70 S6 kinase, another downstream effector of Akt/PKB, in rats with burn injury, whereas phosphorylation of p70 S6 kinase was increased by insulin in controls. The protein expression of Akt/PKB, GSK-3, and p70 S6 kinase was unaltered by burn injury. However, insulin-stimulated activation of ERK, a signaling pathway parallel to Akt/PKB, was not affected by burn injury. These results demonstrate that burn injury impairs insulin-stimulated Akt/PKB activation in skeletal muscle and suggest that attenuated Akt/PKB activation may be involved in deranged metabolism and muscle wasting observed after burn injury.protein kinase B; glycogen synthase kinase-3; insulin resistance FUNCTIONAL AND METABOLIC ABERRATIONS associated with critical illness such as burn injury include hypermetabolic response, increased protein catabolism, insulin resistance, and muscle wasting. Muscle wasting in critically ill patients leads to muscle weakness, resulting in hypoventilation, difficulties in weaning off respirators, decreased mobilization, prolonged rehabilitation and hospitalization, and even death (2, 3, 4, 6). Insulin resistance is a well-known phenomenon of critical illness and has long been considered to play a cardinal role in the derangements of metabolism and muscle wasting. Binding of insulin to its receptor results in activation of insulin receptor (IR) tyrosine kinase, which in turn phosphorylates the IR substrates (IRSs). Phosphorylation at the tyrosine residues of IRS-1 and IRS-2 transduces signal from IR to phosphatidylinositol 3-kinase (PI3K) (1, 4).A Ser/Thr protein kinase, Akt/PKB, is a major downstream effector of the IR-IRS-PI3K pathway. Akt/PKB is activated by phosphorylation of Thr 308 and Ser 473 residues of the kinase (8, 46, 52). The phosphorylation of Akt/PKB is dependent on phosphatidylinositol 3,4,5-triphosphate, a product of PI3K. Akt/PKB drives a major portion of the PI3K-mediated metabolic actions of insulin. Akt/PKB is required for insulinstimulated glucose uptake and glycogen synthesis (53). Akt/ PKB also promotes protein synthesis via activation of the mTOR-p70 S6 kinase pathway (19). Glycogen synthase kinase-3 (GSK-3), a negative regulator of glycogen synthase...