Nuclear magnetic resonance assessment of adenosine triphosphate (ATP) dynamics in ischemic mouse livers perfused with adenine and ribose

Resuscitation of ischemic donor livers with normothermic machine perfusion: a metabolic flux analysis of treatment in rats

Normothermic machine perfusion has previously been demonstrated to restore damaged warm ischemic livers to transplantable condition in animal models. However, the mechanisms of recovery are unclear, preventing rational optimization of perfusion systems and slowing clinical translation of machine perfusion. In this study, organ recovery time and major perfusate shortcomings were evaluated using a comprehensive metabolic analysis of organ function in perfusion prior to successful transplantation. Two groups, Fresh livers and livers subjected to 1 hr of warm ischemia (WI) received perfusion for a total preservation time of 6 hrs, followed by successful transplantation. 24 metabolic fluxes were directly measured and 38 stoichiometrically-related fluxes were estimated via a mass balance model of the major pathways of energy metabolism. This analysis revealed stable metabolism in Fresh livers throughout perfusion while identifying two distinct metabolic states in WI livers, separated at t = 2 hrs, coinciding with recovery of oxygen uptake rates to Fresh liver values. This finding strongly suggests successful organ resuscitation within 2 hrs of perfusion. Overall perfused livers regulated metabolism of perfusate substrates according to their metabolic needs, despite supraphysiological levels of some metabolites. This study establishes the first integrative metabolic basis for the dynamics of recovery during perfusion treatment of marginal livers. Our initial findings support enhanced oxygen delivery for both timely recovery and long-term sustenance. These results are expected to lead the optimization of the treatment protocols and perfusion media from a metabolic perspective, facilitating translation to clinical use.

Concanavalin A, ribose, and adenine resuscitate preserved rat hearts

Preserved hearts may have cardiac dysfunction associated with inadequate myocardial high-energy phosphates. To resuscitate preserved hearts, hearts from male Wistar adult rats were preserved in 4.0 degrees C cold-modified Krebs-Henseleit buffer (pH 7.40) for 8 h, subjected to 30 min of reperfusion at 36.5 degrees C with the administration of concanavalin A (Con A; 40 mg/L), ribose (0.1 mM), and adenine (0.1 mM). In comparison with the normal control, the preserved group had a decrease in cardiac output (CO; p < 0.001), myocardial adenosine triphosphate (ATP; p < 0.001), and creatine phosphate (CP; p < 0.001), associated with an increase in myocardial Ca2+ (p < 0.01) and release of myocardial adenine nucleosides (ANs; p < 0.001). In comparison with the preserved group, the group reperfused with ribose and adenine had no improvement of these parameters (p > 0.05). The group reperfused with Con A had an increase in CO (p < 0.01) and myocardial CP (p < 0.01), associated with a decrease in myocardial Ca2+ (p < 0.05) and ANs release (p < 0.01), and no change in myocardial ATP. However, the group reperfused with Con A, ribose, and adenine achieved a significant increase in CO (p < 0.005), ATP (p < 0.005), CP (p < 0.005), and a decrease in myocardial Ca2+ (p < 0.01) and ANs release (p < 0.01). Data suggest that the combination of Con A, ribose, and adenine may resuscitate cold-preserved rat hearts.

Regulation of and intervention into the oxidative pentose phosphate pathway and adenine nucleotide metabolism in the heart

The capacity of the oxidative pentose pathway (PPP) in the heart is limited, since the activity of glucose-6-phosphate dehydrogenase (G-6-PD), the first and regulating enzyme of this pathway, is very low. Two mechanisms are involved in the regulation of this pathway. Under normal conditions, G-6-PD is inhibited by NADPH. This can be overcome in the isolated perfused rat heart by increasing the oxidized glutathione and by elevating the NADP+/NADPH ratio. Besides this rapid control mechanism, there is a long-term regulation which involves the synthesis of G-6-PD. The activity of G-6-PD was elevated in the rat heart during the development of cardiac hypertrophy due to constriction of the abdominal aorta and in the non-ischemic part of the rat heart subsequent to myocardial infarction. The catecholamines isoproterenol and norepinephrine stimulated the activity of myocardial G-6-PD in a time- and dose-dependent manner. The isoproterenol-induced stimulation was cAMP-dependent and due to increased new synthesis of enzyme protein. The G-6-PD mRNA was elevated by norepinephrine. As a consequence of the stimulation of the oxidative PPP, the available pool of 5-phosphoribosyl-1-pyrophosphate (PRPP) was expanded. PRPP is an important precursor substrate for purine and pyrimidine nucleotide synthesis. The limiting step in the oxidative PPP, the G-6-PD reaction, can be bypassed with ribose. This leads to an elevation of the cardiac PRPP pool. The decline in ATP that is induced in many pathophysiological conditions was attenuated or even entirely prevented by i.v. infusion of ribose. In two in vivo rat models, the overloaded and catecholamine-stimulated heart and the infarcted heart, the normalization of the cardiac adenine nucleotide pool by ribose was accompanied by an improvement of global heart function. Combination of ribose with adenine or inosine in isoproterenol-treated rats was more effective to restore completely the cardiac ATP level within a short period of time than either intervention alone.

31P NMR assessment of orthotopic liver rejection in a rat model

31P NMR spectroscopy was used serially to study rejecting (ACl-->LEW) and nonrejecting (ACl-->ACl) orthotopic liver transplants in rats. Recipients were evaluated on post-transplant days 1, 3, 5, 7, 9, and 11. The relative changes in phosphomonoester (PME), inorganic phosphate (Pi), high-energy phosphates and pH were studied. The earliest significant difference between the rejecting and nonrejecting groups was a decrease in the alpha-NTP peak area on Day 5. This was followed by significant decreases in beta-NTP and pH, and increases in PME and Pi on Day 7. High-resolution 31P NMR spectra of perchloric acid extracts demonstrated the PME increase to be due mainly to elevated phosphoethanolamine. Using the parameter (Pi + PME)/(alpha + beta + gamma-NTP), rejecting livers were distinguished from nonrejecting livers at a moderate stage of rejection.

The oxidative pentose phosphate pathway in the heart: regulation, physiological significance, and clinical implications

The capacity of the oxidative pentose phosphate pathway (PPP) in the heart is small, since the activity of glucose-6-phosphate dehydrogenase (G-6-PD), the first and rate-limiting enzyme, is very low. Basically, two mechanisms are involved in the regulation of this pathway. Under normal conditions, G-6-PD is inhibited by NADPH. This can immediately be overcome in the isolated perfused rat heart by increasing the oxidized glutathione and by elevating the NADP+/NADPH ratio. Apart from this rapid control mechanism, there exists a long-term regulation which involves the synthesis of G-6-PD. All catecholamines that were administered stimulated the activity of myocardial G-6-PD in a time- and dose-dependent manner. This stimulation was due to increased new synthesis of enzyme protein, since the G-6-PDmRNA was specifically enhanced. As a consequence of the stimulation of the oxidative PPP, the available pool of 5-phosphoribosyl-1-pyrophosphate (PRPP) was elevated which serves as an important precursor substrate for purine and pyrimidine nucleotide synthesis. The limiting step in the oxidative PPP can be bypassed by ribose which leads to an elevation of the cardiac PRPP pool. The decline in the ATP that is induced in many pathophysiological conditions can be attenuated or even entirely prevented by i.v. infusion of ribose. In some experimental in vivo rat models such as in the overloaded and catecholamine-stimulated heart and in the non-ischemic region of the infarcted heart, the normalization of the metabolic situation was accompanied by an improvement of global heart function. Ribose application has been shown to be beneficial in several clinical disease states such as myoadenylate deaminase deficiency and McArdle's disease. Moreover, ribose facilitated thallium-201 redistribution and markedly improved the detection of reversible ischemic injury of the pig and human heart.

Nucleotide precursors modify the effects of isoproterenol. Studies on heart function and cardiac adenine nucleotide content in intact rats

In closed-chest rats, isoproterenol (ISO, 25 mg/kg), 5 hours after subcutaneous administration, increased heart rate by 53%, left ventricular (LV) dP/dtmax by 80%, and cardiac output by 37%. LV systolic pressure (LVSP, -10%), mean arterial pressure (MAP, -12%), and total peripheral resistance (TPR, -36%) were diminished. In separate experiments, continuous intravenous infusion of adenine (50 mg/kg/hr) for 5 hours reduced heart rate (-11%), LVSP (-16%), MAP (-20%), TPR (-33%), and LV dP/dtmax (-20%). Cardiac output was increased (+20%). Inosine has been shown to have similar effects, except for a decline in cardiac output. Adenine (50 mg/kg/hr) attenuated the ISO-induced increase in heart rate and LV dP/dtmax and aggravated the decline in LVSP, MAP, and TPR. The increase in cardiac output was not changed. Inosine (200 mg/kg/hr) modified the ISO effects to a similar extent. Ribose (200 mg/kg/hr) added to the adenine infusion did not have functional effects. However, it aggravated the modifying influence of inosine on LVSP, LV dP/dtmax, and MAP. ISO reduced the cardiac ATP content (mumol/g) from a control value of 5.02 +/- 0.06 (n = 12) to 3.51 +/- 0.13 (n = 10). Adenine (3.56 +/- 0.21, n = 7) and ribose (3.64 +/- 0.11, n = 9) alone did not affect it, but inosine attenuated it (4.33 +/- 0.08, n = 8). Adenine and inosine in combination with ribose abolished the ISO-induced ATP decline (5.18 +/- 0.23, n = 7, and 4.76 +/- 0.10, n = 8, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

ATP hydrolysis by ischemic mitochondria

Cellular ATP levels are determined by the rates of ATP production and ATP hydrolysis. Both phenomena are affected by ischemia. Mitochondrial enzymes are damaged, inhibiting this organelle's ability to make ATP. Mitochondria are also uncoupled by ischemia and have the ability to hydrolyze ATP. We designed a series of experiments to determine whether decreased production or increased hydrolysis of ATP was the primary effect of mitochondrial damage. Rat hearts were subjected to 45 min of warm ischemia in order to induce irreversible cell damage. ATP or ADP was injected into cuvettes containing mitochondria isolated from normal myocardium or myocardium damaged by ischemia. Luciferin-luciferase, which fluoresces in the presence of ATP, was also added to the tubes as an indicator of ATP levels. Mixtures of uncoupled and coupled mitochondria were made and compared with the mitochondria damaged by ischemia. The results showed that mitochondria damaged by prolonged ischemia hydrolyze ATP more rapidly than normal mitochondria; however, normal mitochondria can easily compensate for increased ATP hydrolysis when in mixture with equal amounts of uncoupled mitochondria. These data suggests that the low cellular levels of ATP following irreversible ischemia are primarily due to decreased ATP synthesis and not to increased hydrolysis.

Phosphodiesters in the liver: the effect of field strength on the 31P signal

31P NMR spectra of the rat liver were recorded in vivo at 2.35 and 8.5 T. There was a large peak in the phosphodiester region of spectra obtained at 2.35 T which was much reduced at 8.5 T. The peak at 2.35 T is unlikely to be primarily from free cytosolic phosphodiesters, which would not be expected to display such a marked field dependence.