In vivo portal-hepatic venous gradients of glycogenic precursors and incorporation of D-[3-3H]glucose into liver glycogen in the awake rat

Gut Barrier in Critical States of the Body

The intestinal barrier (IB) is a system of diffusion barriers separating the intestinal chyme and blood. The aim of the review is to identify the role of IB dysfunction in the formation of critical states of the body and to substantiate ways to prevent these states. Toxic substances produced by normal intestinal microflora are characterized. The involvement of endotoxin and ammonia in the pathogenesis of sepsis, acute circulatory disorders, secondary acute pulmonary lesions, and acute cerebral insufficiency is shown. Approaches to protect the IB in critical states of the body are proposed.

Secondary Dysfunction of the Intestinal Barrier in the Pathogenesis of Complications of Acute Poisoning

The last decade has been marked by an exponential increase in the number of publications on the physiological role of the normal human gut microbiota. The idea of a symbiotic relationship between the human organism and normal microbiota of its gastrointestinal tract has been firmly established as an integral part of the current biomedical paradigm. However, the type of this symbiosis varies from mutualism to parasitism and depends on the functional state of the host organism. Damage caused to the organism by external agents can lead to the emergence of conditionally pathogenic properties in the normal gut microbiota, mediated by humoral factors and affecting the outcome of exogenous exposure. Among the substances produced by symbiotic microbiota, there are an indefinite number of compounds with systemic toxicity. Some occur in the intestinal chyme in potentially lethal amounts in the case they enter the bloodstream quickly. The quick entry of potential toxicants is prevented by the intestinal barrier (IB), a set of structural elements separating the intestinal chyme from the blood. Hypothetically, severe damage to the IB caused by exogenous toxicants can trigger a leakage and subsequent systemic redistribution of toxic substances of bacterial origin. Until recently, the impact of such a redistribution on the outcome of acute exogenous poisoning remained outside the view of toxicology. The present review addresses causal relationships between the secondary dysfunction of the IB and complications of acute poisoning. We characterize acute systemic toxicity of such waste products of the normal gut microflora as ammonia and endotoxins, and demonstrate their involvement in the formation of such complications of acute poisoning as shock, sepsis, cerebral insufficiency and secondary lung injuries. The principles of assessing the functional state of the IB and the approaches to its protection in acute poisoning are briefly considered.

Promotion of the toxic action of cyclophosphamide by digestive tract luminal ammonia in rats

To estimate the influence of the digestive tract luminal ammonia pool on acute toxic effects of cyclophosphamide, the dynamics of blood ammonia, glutamine and urea level, symptoms of toxic action and the survival time have been studied in rats, intraperitoneally treated with cyclophosphamide, at the background of the gavage with non-lethal dose of ammonium acetate (12 mmol/kg, i.e., 0.35 LD50). Ammonium acetate enhanced the hyperammonaemic action of cyclophosphamide while promoting its lethal action: the mean survival time decreased 1.5, 2.1, 2.8, or 6.1 times at the background of cyclophosphamide i/p doses 200, 600, 1000, or 1400 mg/kg, respectively. Animals exposed to the combination of toxicants, manifested symptoms which were characteristic of the effect of lethal doses of ammonia salts. These data provide the evidence of the detrimental role of gastrointestinal luminal ammonia in the acute high-dose cyclophosphamide toxicity.

Fulminant hyperammonaemia induced by thiopental coma in rats

Fulminant hyperammonaemia as a threshold effect of coma-inducing dose of sodium thiopental has been revealed in rats. Blood ammonia content increased progressively after the introduction of 1.0 LD(50) (but not 0.8 LD(50)) of sodium thiopental three times in 3h and five times in 18h. The urinary ammonia excretion was not impaired while the volatilization of ammoniac from the body of ST-treated rats was higher, giving evidence of the augmentation of ammonia production. Blood urea increased by one third despite of insignificant alterations of haematocrit and blood creatinine. Ammonia hyperproduction in the digestive tract could result from gastrointestinal stasis, which has been verified by roentgenography and confirmed by correlation of hyperammonaemia with the stool retardation. In thiopental coma rats the slope of a dose-dependent increase of the blood ammonia and the blood urea after the intraperitoneal injection of ammonium acetate did not exceed that in intact animals. So the ammonia hyperproduction in the digestive tract could be the main contributing cause of fulminant hyperammonaemia in rats with thiopental coma and thus be involved into pathogenesis of the coma.

Effect of hepatic denervation on peripheral insulin sensitivity in conscious dogs

We tested the hypothesis that the loss of hepatic nerves decreases peripheral insulin sensitivity. Surgical hepatic denervation (DN) was performed in 22 dogs approximately 16 days before study; 7 dogs (Sham-Sal) had a sham procedure. A euglycemic hyperinsulinemic (1 mU x kg(-1) x min(-1); arterial insulin 35 +/- 1 microU/ml in all dogs) clamp was performed in conscious dogs. From 0 to 90 min of the clamp, all dogs received the same treatment; then the DN dogs were divided into three groups. From 90 to 180 min, DN-PeA (n = 7) and DN-PoA (n = 7) groups received acetylcholine 2.5 microg x kg(-1) x min(-1) via peripheral or portal vein, respectively, and DN-Sal (n = 8) received no acetylcholine. During 150-180 min, the Sham-Sal, DN-Sal, DN-PeA, and DN-PoA groups exhibited glucose infusion rates of 12.4 +/- 0.8, 9.3 +/- 0.8 (P < 0.05 vs. Sham-Sal), 9.1 +/- 0.1 (P < 0.05 vs. Sham-Sal), and 12.7 +/- 1.6 mg. kg(-1) x min(-1); nonhepatic glucose uptakes of 11.5 +/- 0.9, 8.9 +/- 0.7 (P < 0.05 vs. Sham-Sal), 8.6 +/- 0.9 (P < 0.05 vs. Sham-Sal), and 11.9 +/- 1.7 mg. kg(-1). min(-1); net hindlimb glucose uptakes of 18.4 +/- 2.1, 13.7 +/- 1.1 (P < 0.05 vs. Sham-Sal), 17.5 +/- 1.9, and 16.7 +/- 3.2 mg/min; and glucose utilization rates of 14.4 +/- 1.4, 10.4 +/- 0.8 (P < 0.05 vs. Sham-Sal), 9.8 +/- 0.9 (P < 0.05 vs. Sham-Sal), and 13.6 +/- 1.8 mg. kg(-1) x min(-1), respectively. DN caused peripheral insulin resistance, and intraportal but not peripheral acetylcholine restored insulin sensitivity.

Tissue spaces in rat heart, liver, and skeletal muscle in vivo

Tissue spaces were determined in rat heart, liver, and skeletal muscle in vivo using isotopically labeled [14C]inulin. Tracer was injected into the jugular vein of pentobarbital-anesthetized male Sprague-Dawley rats. After a 30-min equilibration period, a blood sample was taken, and heart, liver, and gastrocnemius muscle were excised and immediately freeze clamped at liquid nitrogen temperatures. The extracellular inulin space was 0.209 +/- 0.006 (n = 13), 0.203 +/- 0.080 (n = 7), and 0.124 +/- 0.006 (SE) ml/g wet wt tissue (n = 8) for heart, liver, and skeletal muscle, respectively. Total tissue water was 0.791 +/- 0.005 (n = 9), 0.732 +/- 0.002 (n = 9), and 0.755 +/- 0.005 ml/g wet wt tissue (n = 10) for heart, liver, and skeletal muscle, respectively. Expressed as a percentage of total tissue water, the intracellular space was 73.6, 72.2, and 83. 7% for heart, liver, and skeletal muscle, respectively. With use of 2,3-diphospho-D-glyceric acid as a vascular marker, the interstitial space was calculated by subtracting the counts in tissue due to whole blood from total tissue counts and dividing by plasma counts. The interstitial space was 18.8, 22.4, and 14.5% of total tissue water, with accompanying plasma spaces of 7.7, 5.3, and 1.8% for heart, liver, and gastrocnemius muscle, respectively. The tracer method used in this study provides a quantitative assessment of water distribution in tissues of nonnephrectomized rats that has applications for calculation of tissue ion and metabolite concentrations, gradients, and fluxes under normal and pathophysiological conditions.

The effect of xenobiotic acetylation on interorgan metabolism of glucose in fasted rats

The effect of cytosolic acetylation on interorgan glucose metabolism was studied by arteriovenous (AV) difference and tracer kinetic techniques in fasted, ketamine-anesthetized rats. The administration of sulfamethazine (SMZ, 2 mmol/kg, i.p.) resulted in 39% and 313% increases in hepatic contents of glucose and lactate, respectively. Plasma concentrations of glucose and lactate in the aorta, portal vein and hepatic vein also increased (33-43% for glucose, and 86-200% for lactate). Net hepatic release of glucose was not significantly different from the control. Net hepatic uptake of lactate increased 72-151% in the SMZ-treated rats. The concentration and hepatic gradient of alanine were little changed in the SMZ-treated rats. The rates of turnover for plasma glucose, estimated from [3-3H]-glucose, were not significantly different between the control and SMZ-treated rats. The rate of glucose recycling, estimated from the difference in the rates of turnover between [3-3H]-and[U-14C]-glucose, decreased by 42% in the SMZ-treated rats. Muscle glycogen in the SMZ-treated rats also decreased (33%). In conclusion, our data indicate that cytosolic acetylation can affect not only ketogenesis, as we have previously reported, but also interorgan metabolism of glucose. Although direct evidence is not available, increases in the levels of plasma and liver glucose suggest that gluconeogenesis is increased in the SMZ-treated rats. A net loss of lactate from muscle glycogen store to the liver is indicated by the increase in hepatic uptake of lactate and the decrease in the rate of glucose recycling in the rats treated with SMZ.

Cytosolic acetylation of sulfamethazine decreases hepatic release of ketone bodies in vivo in fasting rats

The effect of sulfamethazine (SMZ) on ketogenesis was studied in this report. SMZ, a sulfonamide metabolized by cytosolic acetylation in liver, was intraperitoneally injected (2 mmol/kg) to ketamine-anesthetized, overnight-fasted rats. Ketogenesis was measured by the Fick principle from the transhepatic (A-V) gradients of acetoacetate (AcAc) and D-beta-hydroxybutyrate (beta-OHB). Prior to SMZ injection, A-V gradient of ketone bodies (KB) (AcAc + beta-OHB) was -1.38 mM, indicating release from the liver. After SMZ injection, the release of KB decreased rapidly, maintaining at a level approximately 50% less than controls throughout the 2-h experimental period. Plasma concentrations of AcAc and beta-OHB also decreased. In contrast, plasma concentrations and trans-hepatic gradients of free fatty acids (FFA) were not significantly affected. Our results thus indicate that SMZ acetylation in liver mobilizes acetyl CoA from mitochondria. Decreased hepatic ketogenesis limits the availability of KB and may thus affect energy metabolism in the extrahepatic tissues. The incomplete inhibition on ketogenesis may indicate compartmentation of acetyl CoA in liver mitochondria.

Hepatic metabolism during fasting-refeeding transition in conscious pregnant rabbits

The aim of the present study was to determine changes induced by pregnancy in the hepatic handling of nutrients during the fasting-refeeding transition. Net hepatic and gut substrate fluxes were determined by the Fick principle in conscious pregnant (day 30) and nonpregnant rabbits in the 2 h after consumption of a mixed meal. Hepatic glucose production was suppressed by approximately 50% in both groups from 15 to 90 min. Pregnant rabbits returned to control levels at 120 min. Pregnant females displayed a larger gut glucose output and a greater arterial hyperglycemia. The hepatic and gut balance of lactate as well as the arterial level was almost unchanged. In pregnant females the hepatic uptake and arterial concentration of free fatty acids (FFA) remained almost unchanged, whereas these measures decreased in nonpregnant females by approximately 55 and approximately 80%, respectively, at 120 min. The decline in hepatic output of beta-hydroxybutyrate was similar in both groups. In pregnant rabbits arterial levels of beta-hydroxybutyrate did not parallel changes in the hepatic release as in nonpregnant females. Pregnant females displayed a greater hyperinsulinemia both in the portal vein and the artery over the first hour. It is concluded that, in pregnant rabbits fed a mixed meal, the ability of the liver to handle glucose is impaired because of insulin resistance. The latter brings about a greater and prolonged arterial hyperglycemia, which is reinforced by peripheral insulin resistance. Furthermore, the higher level of FFA may also contribute to the hyperglycemia. As a result, a greater amount of glucose is diverted to other sites, presumably the uterus.

Glycogen metabolism as detected by in vivo and in vitro 13C-NMR spectroscopy using [1,2-13C2]glucose as substrate

The metabolism of glucose to glycogen in the liver of fasted and well-fed rats was investigated with 13C nuclear magnetic resonance spectroscopy using [1,2-(13)C2]glucose as the main substrate. The unique spectroscopic feature of this molecule is the 13C-13C homonuclear coupling leading to characteristic doublets for the C-1 and C-2 resonances of glucose and its breakdown products as long as the two 13C nuclei remain bonded together. The doublet resonances of [1,2-(13)C2]glucose thus provide an ideal marker to follow the fate of this exogenous substrate through the metabolic pathways. [1,2-(13)C2]Glucose was injected intraperitoneally into anesthetized rats and the in vivo 13C-NMR measurements of the intact animals revealed the transformation of the injected glucose into liver glycogen. Glycogen was extracted from the liver and high resolution 13C-NMR spectra were obtained before and after hydrolysis of glycogen. Intact [1,2-13C2]glucose molecules give rise to doublet resonances, natural abundance [13C]glucose molecules produce singlet resonances. From an analysis of the doublet-to-singlet intensities the following conclusions were derived. (i) In fasted rats virtually 100% of the glycosyl units in glycogen were 13C-NMR visible. In contrast, the 13C-NMR visibility of glycogen decreased to 30-40% in well-fed rats. (ii) In fed rats a minimum of 67 +/- 7% of the exogenous [1,2-(13)C2]glucose was incorporated into the liver glycogen via the direct pathway. No contribution of the indirect pathway could be detected. (iii) In fasted rats externally supplied glucose appeared to be consumed in different metabolic processes and less [1,2-(13)C2]glucose was found to be incorporated into glycogen (13 +/- 1%). However, the observation of [5,6-(13)C2]glucose in liver glycogen provided evidence for the operation of the so-called indirect pathway of glycogen synthesis. The activity of the indirect pathway was at least 9% but not more than 30% of the direct pathway. (vi) The pentose phosphate pathway was of little significance for glucose but became detectable upon injection of [1-(13)C]ribose.