Disease exacerbations and muscle wasting comprise negative prognostic factors of chronic obstructive pulmonary disease (COPD). Transient systemic inflammation and malnutrition have been implicated in skeletal muscle wasting after acute exacerbations of COPD. However, the interactions between systemic inflammation and malnutrition in their contributions to muscle atrophy, as well as the molecular basis underlying the transition of systemic inflammation to muscle atrophy, remain unresolved. Pulmonary inflammation was induced in mice by an intratracheal instillation of LPS to model acute disease exacerbation. Systemic inflammation, nutritional intake, and body and muscle weights were determined. Muscle inflammatory signaling and atrophy signaling were examined, and the effect of the muscle-specific inactivation of NF-kB on muscle atrophy was assessed in genetically modified mice. The intratracheal LPS instillation was followed by markedly elevated circulating cytokine concentrations and NF-kB activation in extrapulmonary tissues, including skeletal muscle. The administration of intratracheal LPS increased the expression of muscle E3 ubiquitin ligases, which govern muscle proteolysis, in particular MuRF1, and caused a rapid loss of muscle mass. Reduced food intake only partly accounted for the observed muscle atrophy, and did not activate NF-kB in muscle. Rather, plasma transfer experiments revealed the presence of NF-kB-signaling and atrophy-signaling properties in the circulation of intratracheal LPStreated mice. The genetic inhibition of muscle NF-kB activity suppressed intratracheal LPS-induced MuRF1 expression and resulted in a significant sparing of muscle tissue. Systemic inflammation and malnutrition contribute to the muscle wasting induced by acute pulmonary inflammation via distinct mechanisms, and muscle NF-kB activation is required for the transition from inflammatory to muscle atrophy signaling.Keywords: pulmonary inflammation; systemic inflammation; muscle atrophy; NF-kB; cytokines Acute exacerbations of chronic obstructive pulmonary disease (COPD) are accompanied by pulmonary and transient systemic inflammation and malnutrition, which have been implicated in the onset of stepwise weight loss, muscle wasting and increased mortality (1-6). The underlying mechanisms are unknown and difficult to unravel in patients during the acute phase of an exacerbation. In many instances, the acute loss of muscle mass is dependent on increased muscle protein breakdown mediated by the ubiquitin (Ub) 26S-proteasome system (UPS) (7). The rate-limiting enzymes of this process during acute muscle atrophy include the Ub-E3 ligation enzymes atrogin-1/MAFbx and MuRF1. The genetic deletion of these "atrogenes" attenuates muscle atrophy under various conditions (8, 9), and the increased expression of MuRF1 and atrogin-1 has been reported in quadriceps muscle during exacerbations of COPD (1). Inducible transcription factors, including NF-kB, have been implicated in the transcriptional regulation of atrogin-1 and MuRF1 (10). NF-k...