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Tikunov AP, Shim YS, Bhattarai N, Siler SQ, Soldatow V, LeCluyse EL, McDunn JE, Watkins PB, Macdonald JM. Dose-response in a high density three-dimensional liver device with real-time bioenergetic and metabolic flux quantification. Toxicol In Vitro 2017; 45:119-127. [DOI: 10.1016/j.tiv.2017.08.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 08/23/2017] [Accepted: 08/30/2017] [Indexed: 12/17/2022]
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Bezborodkina NN, Chestnova AY, Okovity SV, Kudryavtsev BN. Activity of glycogen synthase and glycogen phosphorylase in normal and cirrhotic rat liver during glycogen synthesis from glucose or fructose. ACTA ACUST UNITED AC 2013; 66:147-54. [PMID: 24373751 DOI: 10.1016/j.etp.2013.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 11/01/2013] [Accepted: 12/03/2013] [Indexed: 02/06/2023]
Abstract
Cirrhotic patients often demonstrate glucose intolerance, one of the possible causes being a decreased glycogen-synthesizing capacity of the liver. At the same time, information about the rates of glycogen synthesis in the cirrhotic liver is scanty and contradictory. We studied the dynamics of glycogen accumulation and the activity of glycogen synthase (GS) and glycogen phosphorylase (GP) in the course of 120min after per os administration of glucose or fructose to fasted rats with CCl4-cirrhosis or fasted normal rats. Blood serum and liver pieces were sampled for examinations. In the normal rat liver administration of glucose/fructose initiated a fast accumulation of glycogen, while in the cirrhotic liver glycogen was accumulated with a 20min delay and at a lower rate. In the normal liver GS activity rose sharply and GPa activity dropped in the beginning of glycogen synthesis, but 60min later a high synthesis rate was sustained at the background of a high GS and GPa activity. Contrariwise, in the cirrhotic liver glycogen was accumulated at the background of a decreased GS activity and a low GPa activity. Refeeding with fructose resulted in a faster increase in the GS activity in both the normal and the cirrhotic liver than refeeding with glucose. To conclude, the rate of glycogen synthesis in the cirrhotic liver is lower than in the normal one, the difference being probably associated with a low GS activity.
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Affiliation(s)
- Natalia N Bezborodkina
- Laboratory of Cellular Pathology, Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia.
| | - Anna Yu Chestnova
- Laboratory of Cellular Pathology, Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia
| | - Sergey V Okovity
- Cathedra of Pharmacology, Saint Petersburg State Chemical Pharmaceutical Academy, St. Petersburg, Russia
| | - Boris N Kudryavtsev
- Laboratory of Cellular Pathology, Institute of Cytology, Russian Academy of Sciences, St. Petersburg, Russia
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Metts B, Thatcher S, Lewis E, Karounos M, Cassis L, Smith R, Lodder RA. DDDAS Design of Drug Interventions for the Treatment of Dyslipidemia in ApoE -/- Mice. ACTA ACUST UNITED AC 2013; 2. [PMID: 25866829 DOI: 10.4172/2329-6631.1000107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Computational models of complex systems, such as signaling networks and biological systems, can be used to explain the behavior of such systems under various conditions. The large number of integrated processes and variables, and the nonlinearities inherent in the fundamental processes, make it difficult for scientists unassisted by computer simulations to effectively predict the consequences of a particular intervention. For this reason, computer simulation has become an important tool for generating hypotheses about the behavior of these systems that can then be tested in the laboratory and clinic. A dynamic data-driven application simulation (DDDAS) was designed by Biospherics to model complex metabolic disease pathways by testing potential binary therapies in simulations at various combinations of two points in the pathways. Since DDDAS chooses the most effective pair-wise combinations, this data-driven system allows for the implementation of real-time data to model or predict a measurement or event. By incorporating data dynamically rather than statically, the predictions and measurements become more reliable. Dyslipidemia, a common precursor to atherosclerosis, can be manifested by high triglycerides, increased apolipoprotein (Apo) B, high levels of LDL, and low levels of HDL. SPX106 and D-tagatose is a combination drug therapy composed of a carbohydrate (D-tagatose) and SPX106. D-tagatose has been studied for the treatment of diabetes for several years, and has the ability to lower blood insulin levels and to decrease glycogen formation. SPX106 is a natural substance that accelerates lipid catabolism and inhibits dyslipidemia. In apolipoprotein E knockout mice (ApoE-/-), this drug combination has been shown to significantly lower both the amount of atherosclerosis and blood cholesterol levels. This study used 26 male ApoE-/- mice (n=13 in each group, control and treated). The control group received the normal "Western" diet (Harlan TD88137) and the treatment group received a modified version in which the sucrose was replaced with D-tagatose and 1g of SPX106 was added for every kilogram of chow. Mice were fed the diet for 8 weeks and then sacrificed via cardiac puncture. Blood serum was analyzed for cholesterol concentration. A significant difference was observed between the control and treated groups for total cholesterol levels. FPLC separations were done on fractions from both control and treated groups. A significant difference between VLDL and HDL levels was found between the treated and control mice (p<0.05 for both). Aortas were also taken and preserved in formalin to be quantified for atherosclerosis. Aortic sinuses were frozen in OCT and sectioned using a cryostat and then quantified for atherosclerosis. Treated mice showed statistically significant reduction in atherosclerosis in the aortic arch (p<0.01), the thoracic aorta (p<0.05), and the aortic sinus (p<0.05) as well as a reduction of cholesterol (p<0.05).
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Affiliation(s)
| | - Sean Thatcher
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Eboni Lewis
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Mike Karounos
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Lisa Cassis
- Graduate Center for Nutritional Sciences, University of Kentucky, USA
| | - Rebecca Smith
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, USA
| | - Robert A Lodder
- Department of Chemistry, University of Kentucky, USA ; Graduate Center for Nutritional Sciences, University of Kentucky, USA ; Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, USA ; Biospherics, Lexington, KY, USA
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Prats C, Cadefau JA, Cussó R, Qvortrup K, Nielsen JN, Wojtaszewski JFP, Wojtaszewki JFP, Hardie DG, Stewart G, Hansen BF, Ploug T. Phosphorylation-dependent translocation of glycogen synthase to a novel structure during glycogen resynthesis. J Biol Chem 2005; 280:23165-72. [PMID: 15840572 DOI: 10.1074/jbc.m502713200] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Glycogen metabolism has been the subject of extensive research, but the mechanisms by which it is regulated are still not fully understood. It is well accepted that the rate-limiting enzymes in glycogenesis and glycogenolysis are glycogen synthase (GS) and glycogen phosphorylase (GPh), respectively. Both enzymes are regulated by reversible phosphorylation and by allosteric effectors. However, evidence in the literature indicates that changes in muscle GS and GPh intracellular distribution may constitute a new regulatory mechanism of glycogen metabolism. Already in the 1960s, it was proposed that glycogen was present in dynamic cellular organelles that were termed glycosomas but no such cellular entities have ever been demonstrated. The aim of this study was to characterize muscle GS and GPh intracellular distribution and to identify possible translocation processes of both enzymes. Using in situ stimulation of rabbit tibialis anterior muscle, we show GS and GPh intracellular redistribution at the beginning of glycogen resynthesis after contraction-induced glycogen depletion. We identify a new "player," a new intracellular compartment involved in skeletal muscle glycogen metabolism. They are spherical structures that were not present in basal muscle, and we present evidence that indicate that they are products of actin cytoskeleton remodeling. Furthermore, for the first time, we show a phosphorylation-dependent intracellular distribution of GS. Here, we present evidence of a new regulatory mechanism of skeletal muscle glycogen metabolism based on glycogen enzyme intracellular compartmentalization.
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Affiliation(s)
- Clara Prats
- Copenhagen Muscle Research Centre, University of Copenhagen, Denmark.
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Bruynseels K, Bergans N, Gillis N, van Dorpen F, Van Hecke P, Stalmans W, Vanstapel F. On the inhibition of hepatic glycogenolysis by fructose. A 31P-NMR study in perfused rat liver using the fructose analogue 2,5-anhydro-D-mannitol. NMR IN BIOMEDICINE 1999; 12:145-156. [PMID: 10414949 DOI: 10.1002/(sici)1099-1492(199905)12:3<145::aid-nbm559>3.0.co;2-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Inhibition of hormone-stimulated hepatic glycogenolysis by fructose (Fru) has been attributed to accumulation of the competitive inhibitor Fru1P and/or to the associated depletion of the substrate phosphate (Pi). To evaluate the relative importance of either factor, we used the Fru analogue 2,5-anhydro-D-mannitol (aHMol). This analogue is avidly phosphorylated, traps Pi, and inhibits hormone-stimulated glycogenolysis, but it is not a gluconeogenic substrate, and hence does not confound glycogenolytic glucose production. Livers were continuously perfused with dibutyryl-cAMP (100 microM) to clamp phosphorylase in its fully activated a form. We administered aHMol (3.8 mM), and studied changes in glycogenolysis (glucose, lactate and pyruvate output) and in cytosolic Pi and phosphomonoester (PME), using in situ 31P-NMR spectroscopy (n = 4). Lobes of seven livers perfused outside the magnet were extracted for evaluation, by high-resolution 31P-NMR, of the evolution of aHMol1P and of aHMol(1,6)P2. After addition of aHMol, both glycogenolysis and the NMR Pi signal dropped precipitously, while the PME signal rose continuously and was almost entirely composed of aHMol1P. Inhibition of glycogenolysis in excess of the drop in Pi could be explained by continuing accumulation of aHMol1P. A subsequent block of mitochondrial ATP synthesis by KCN (1 mM) caused a rapid increase of Pi. Despite recovery of Pi to values exceeding control levels, glycogenolysis only recovered partially, attesting to the Pi-dependence of glycogenolysis, but also to inhibition by aHMol phosphorylation products. However, KCN resulted in conversion of the major part of aHMol1P into aHMol(1,6)P2. Residual inhibition of glycogenolysis was due to aHMol1P. Indeed, the subsequent withdrawal of aHMol caused a further gradual decrease in the proportion of aHMol1P (being converted into aHMol(1,6)P2, in the absence of de novo aHMol1P synthesis), and this resulted in a gradual de-inhibition of glycogenolysis, in the absence of marked changes in Pi. Glycogenolytic rates were consistently predicted by a model assuming non-saturated Pi kinetics and competition by aHMol1P exclusively: In conclusion, limited Pi availability and the presence of competitive inhibitors are decisive factors in the control of the in situ catalytic potential of phosphorylase a.
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Affiliation(s)
- K Bruynseels
- Biomedical NMR Unit, Department of Radiology, Leuven, Belgium
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Carabaza A, Ricart MD, Mor A, Guinovart JJ, Ciudad CJ. Role of AMP on the activation of glycogen synthase and phosphorylase by adenosine, fructose, and glutamine in rat hepatocytes. J Biol Chem 1990. [DOI: 10.1016/s0021-9258(19)39862-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Ciudad CJ, Carabaza A, Guinovart JJ. Glycogen synthesis from glucose and fructose in hepatocytes from diabetic rats. Arch Biochem Biophys 1988; 267:437-47. [PMID: 3145717 DOI: 10.1016/0003-9861(88)90049-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In rat hepatocytes, the basal glycogen synthase activation state is decreased in the fed and diabetic states, whereas glycogen phosphorylase a activity decreases only in diabetes. Diabetes practically abolishes the time- and dose-dependent activation of glycogen synthase to glucose especially in the fed state. Fructose, however, is still able to activate this enzyme. Glycogen phosphorylase response to both sugars is operative in all cases. Cell incubation with the combination of 20 mM glucose plus 3 mM fructose produces a great activation of glycogen synthase and a potentiated glycogen deposition in both normal and diabetic conditions. Using radiolabeled sugars, we demonstrate that this enhanced glycogen synthesis is achieved from both glucose and fructose even in the diabetic state. Therefore, the presence of fructose plays a permissive role in glycogen synthesis from glucose in diabetic animals. Glucose and fructose increase the intracellular concentration of glucose 6-phosphate and fructose reduces the concentration of ATP. There is a close correlation between the ratio of the intracellular concentrations of glucose 6-phosphate and ATP (G6-P/ATP) and the activation state of glycogen synthase in hepatocytes from both normal and diabetic animals. However, for any given value of the G6-P/ATP ratio, the activation state of glycogen synthase in diabetic animals is always lower than that of normal animals. This suggests that the system that activates glycogen synthase (synthase phosphatase activity) is impaired in the diabetic state. The permissive effect of fructose is probably exerted through its capacity to increase the G6-P/ATP ratio which may partially increase synthase phosphatase activity, rendering glycogen synthase active.
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Affiliation(s)
- C J Ciudad
- Department de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Spain
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Ciudad CJ, Carabaza A, Bosch F, Gòmez I Foix AM, Guinovart JJ. Glycogen synthase activation by sugars in isolated hepatocytes. Arch Biochem Biophys 1988; 264:30-9. [PMID: 3134856 DOI: 10.1016/0003-9861(88)90566-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We have investigated the activation by sugars of glycogen synthase in relation to (i) phosphorylase a activity and (ii) changes in the intracellular concentration of glucose 6-phosphate and adenine nucleotides. All the sugars tested in this work present the common denominator of activating glycogen synthase. On the other hand, phosphorylase a activity is decreased by mannose and glucose, unchanged by galactose and xylitol, and increased by tagatose, glyceraldehyde, and fructose. Dihydroxyacetone exerts a biphasic effect on phosphorylase. These findings provide additional evidence proving that glycogen synthase can be activated regardless of the levels of phosphorylase a, clearly establishing that a nonsequential mechanism for the activation of glycogen synthase occurs in liver cells. The glycogen synthase activation state is related to the concentrations of glucose 6-phosphate and adenine nucleotides. In this respect, tagatose, glyceraldehyde, and fructose deplete ATP and increase AMP contents, whereas glucose, mannose, galactose, xylitol, and dihydroxyacetone do not alter the concentration of these nucleotides. In addition, all these sugars, except glyceraldehyde, increase the intracellular content of glucose 6-phosphate. The activation of glycogen synthase by sugars is reflected in decreases on both kinetic constants of the enzyme, M0.5 (for glucose 6-phosphate) and S0.5 (for UDP-glucose). We propose that hepatocyte glycogen synthase is activated by monosaccharides by a mechanism triggered by changes in glucose 6-phosphate and adenine nucleotide concentrations which have been described to modify glycogen synthase phosphatase activity. This mechanism represents a metabolite control of the sugar-induced activation of hepatocyte glycogen synthase.
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Affiliation(s)
- C J Ciudad
- Department de Bioquímica y Biologia Molecular, Universidad Autónoma de Barcelona, Spain
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10
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Niewoehner CB, Nuttall BQ, Nuttall FQ. Effects of graded intravenous doses of fructose on glycogen synthase in the liver of fasted rats. Metabolism 1987; 36:338-44. [PMID: 3104729 DOI: 10.1016/0026-0495(87)90204-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
We have examined in fasted rats the effects of graded doses of intravenous fructose (50 to 500 mg/kg) in order to determine potential mechanisms by which different concentrations of fructose reaching the liver may modify the activity of glycogen synthase (and phosphorylase). With increasing fructose doses the % synthase I increased threefold to a maximum at a dose of 125 mg/kg and then decreased progressively after higher fructose doses were given. The % phosphorylase a decreased by 30% to a minimum at a dose of 125 mg/kg but increased with higher doses to 370% of the control values. Both the % synthase I and the % phosphorylase a were elevated above the control values at fructose doses of 175 to 225 mg/kg. The increase in % synthase I after low doses of fructose occurred with a significant increase in glucose-6-P but no significant change in hepatic fructose, glucose, UDPglucose, ATP/Mg++, Pi, cAMP, plasma insulin, or glucagon concentrations. The reciprocal decrease in % synthase I and increase in % phosphorylase a occurred despite increases in glucose and glucose-6-P, at fructose doses resulting in no change in ATP/Mg++, Pi or cAMP, and only a small increase (0.39 mmol/L) in the fructose-1-P concentration. We propose that activation of synthase phosphatase by a rise in the glucose-6-P concentration is responsible for the increase in % synthase I after low doses of fructose. The mechanism by which higher fructose doses overcome the expected activation of synthase phosphatase by glucose and glucose-6-P and a decreased ATP/Mg++ ratio is uncertain.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ciudad CJ, Carabaza A, Guinovart JJ. Glucose 6-phosphate plays a central role in the activation of glycogen synthase by glucose in hepatocytes. Biochem Biophys Res Commun 1986; 141:1195-200. [PMID: 3101679 DOI: 10.1016/s0006-291x(86)80171-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The state of activation of glycogen synthase enhanced by glucose, other sugars and gluconeogenic precursors shows a strong positive correlation with the intracellular concentrations of glucose 6-P when ATP concentrations remain constant. The concentrations of glucose 6-P achieved upon incubation of hepatocytes with glucose plus mannoheptulose, an inhibitor of glucokinase and hexokinase, were lower than those found when the incubation was carried out with glucose alone. Under these conditions, in keeping with the decrease in glucose 6-P, the activation of glycogen synthase by glucose was also impaired. On the other hand the inactivation of glycogen phosphorylase was not altered in the presence of mannoheptulose.
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Egaña M, Trueba M, Sancho MJ. Some special characteristics of glycogen synthase from chicken liver. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. B, COMPARATIVE BIOCHEMISTRY 1986; 83:771-4. [PMID: 3086029 DOI: 10.1016/0305-0491(86)90144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
An anomalous initial grade of activation is observed for glycogen synthase from chicken liver when it is compared with synthase from mammalian liver. Some possible experimental causes for this discrepancy are investigated as well as the possibility of a different development stage to explain the special behaviour of avian synthase. It is concluded that avian synthase is less affected by external treatment than mammalian synthase. Avian synthase is always highly active, independently of external conditions and of development stage.
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Gergely P, Tóth B, Farkas I, Bot G. Effect of fructose 1-phosphate on the activation of liver glycogen synthase. Biochem J 1985; 232:133-7. [PMID: 3936480 PMCID: PMC1152849 DOI: 10.1042/bj2320133] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The activation (dephosphorylation) of glycogen synthase and the inactivation (dephosphorylation) of phosphorylase in rat liver extracts on the administration of fructose were examined. The lag in the conversion of synthase b into a was cancelled, owing to the accumulation of fructose 1-phosphate. A decrease in the rate of dephosphorylation of phosphorylase a was also observed. The latency re-appeared in gel-filtered liver extracts. Similar latency was demonstrated in extracts from glucagon-treated rats. Addition of fructose 1-phosphate to the extract was able to abolish the latency, and the activation of glycogen synthase and the inactivation of phosphorylase occurred simultaneously. Fructose 1-phosphate increased the activity of glycogen synthase b measured in the presence of 0.2-0.4 mM-glucose 6-phosphate. According to kinetic investigations, fructose 1-phosphate increased the affinity of synthase b for its substrate, UDP-glucose. The accumulation of fructose 1-phosphate resulted in glycogen synthesis in the liver by inducing the enzymic activity of glycogen synthase b in the presence of glucose 6-phosphate in vivo and by promoting the activation of glycogen synthase.
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Seibert H. Effects of temperature on glucose release and glycogen metabolism in isolated hepatocytes from rainbow trout (Salmo gairdneri). COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. B, COMPARATIVE BIOCHEMISTRY 1985; 81:877-83. [PMID: 4042629 DOI: 10.1016/0305-0491(85)90082-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Endogenous glucose release and glycogen metabolism were investigated in isolated hepatocytes from rainbow trout acclimated to 10 and 20 degrees C. Thermal acclimation did not significantly affect hepatocyte glycogen contents and the rates of glucose release during substrate-free incubations. In both acclimation groups glucose production and glycogen metabolism exhibited clearly different dependencies on assay temperature. It was concluded, that there are different sources of glucose release in the lower and upper temperature range--gluconeogenesis from endogenous precursors at low temperatures and glycogenolysis at high temperatures. This conclusion was supported by experiments with 3-mercaptopicolinic acid, which stimulated glycogen breakdown especially in the low temperature range.
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Abstract
Livers isolated from both fed normal and alloxan diabetic rats were perfused for 30 min using Krebs-Henseleit bicarbonate blood buffer medium followed by 10 min flow-through infusions with either 5 mM or 28 mM fructose concentrations. In livers of normal and diabetic rats, both 5 mM and 28 mM fructose concentrations produced an elevation in tissue cyclic AMP levels, activation of glycogen phosphorylase, increased protein kinase activity, decreased tissue ATP levels, large increases in tissue fructose-1-phosphate, and variable effects upon glycogen synthase. These results are consistent with previously reported cyclic AMP mediated activation of glycogen phosphorylase by fructose via protein kinase in normal rat liver. In addition, both 5 mM and 28 mM fructose infusion resulted in large decreases in normal and diabetic synthase phosphatase activity. Therefore, these results in both normal and diabetic livers are inconsistent with a direct beneficial effect of fructose in the isolated perfused rat liver.
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