Fructose and D-glyceraldehyde metabolism in the isolated perfused pig liver

Porcine Isolated Liver Perfusion for the Study of Ischemia Reperfusion Injury: A Systematic Review

BACKGROUND

Understanding ischemia reperfusion injury (IRI) is essential to further improve outcomes after liver transplantation (LT). Porcine isolated liver perfusion (ILP) is increasingly used to reproduce LT-associated IRI in a strictly controlled environment. However, whether ILP is a reliable substitute of LT was never validated.

METHODS

We systematically reviewed the current experimental setups for ILP and parameters of interest reflecting IRI.

RESULTS

Isolated liver perfusion was never compared with transplantation in animals. Considerable variability exists between setups, and comparative data are unavailable. Experience so far suggests that centrifugal pump(s) with continuous flow are preferred to reduce the risk of embolism. Hepatic outflow can be established by cannulation of the inferior vena cava or freely drained in an open bath. Whole blood at approximately 38°C, hematocrit of 20% or greater, and the presence of leukocytes to trigger inflammation is considered the optimal perfusate. A number of parameters related to the 4 liver compartments (hepatocyte, cholangiocyte, endothelium, immune cells) are available; however, their significance and relation to clinical outcomes is not well described.

CONCLUSIONS

Porcine ILP provides a reproducible model to study early IRI events. As all models, it has its limitations. A standardization of the setup would allow comparison of data and progress in the field.

The techniques and uses of intracellular pH measurements

Weak-acid, 31P-nuclear magnetic resonance (NMR) and microelectrode techniques for measuring intracellular pH (pHi) are compared by demonstration of their use in rat liver. The ultimate test of suitability of these methods is the confidence with which they can be used to clarify aspects of metabolic regulation, translocation of substances across biological membranes, and the control of cell pH itself. Though resting pHi in perfused liver is fairly similar with all three techniques, substantial quantitative differences between values obtained with 31P NMR and microelectrodes are revealed after addition of fructose to the perfused liver preparation. The use and limitations of weak-acid methods in determining the mechanism of inhibition of gluconeogenesis from lactate by acidosis and in determining the pH responsiveness of the lactate transporter in the hepatocyte plasma membrane are demonstrated. Microelectrode-derived values of pHi are probably referable to the bulk phase of the cytosol, whereas values from the other two methods are more complex in their interpretation. Microelectrode and NMR methods have the great advantage of being non-destructive, and continuous records may be obtained.

Non-invasive investigation of parenchymal liver disease using 31P NMR spectroscopy

Four 31P NMR spectroscopy parameters were measured non-invasively in the liver of 11 healthy pigs and 9 pigs with CCl4-induced liver disease: (i) absolute molar concentration of phosphorous metabolites; (ii) pH based on the chemical shift of the P(i) peak; (iii) T1 of the peaks in the 31P NMR spectrum; and (iv) changes in ATP, P1 and phosphomonoester after fructose administration. Liver disease was verified by histology and blood chemistry. The concentration of ATP decreased from 3.0(2.8-3.1) to 2.0(2.0-2.4) mM (median and quartiles) when liver disease was induced (p < 0.05). The concentration of phosphodiesters (PDEs) decreased from 14.8(11.4-19.5) to 8.7(7.4-11.6) mM (p < 0.05). pH increased by 0.1 unit. T1 relaxation times for the gamma-, alpha- and beta-ATP peaks increased from 320(249-471) to 577(506-638) ms (p < 0.01), from 765(611-786) to 906(820-1058) ms (p < 0.05) and from 402(327-509) to 579(543-743) ms (p < 0.01), respectively, while T1 for the PDE peak decreased from 2204(1909-2404) to 1758(1502-1894) ms (p < 0.05). In the healthy animals injection of fructose was followed by a reduction of ATP (beta-ATP). In diseased livers this reduction was significantly smaller. In conclusion, it was possible non-invasively to show differences between healthy and diseased livers in all NMR parameters evaluated. This means that 31P NMR spectroscopy may have a potential as a non-invasive diagnostic method for studying liver disease.

Metabolic effects of D-glyceraldehyde in isolated hepatocytes

The effects of D-glyceraldehyde on the hepatocyte contents of various metabolites were examined and compared with the effects of fructose, glycerol and dihydroxyacetone, which all enter the glycolytic/gluconeogenic pathways at the triose phosphate level. D-Glyceraldehyde (10 MM) caused a substantial depletion of hepatocyte ATP, as did equimolar concentrations of fructose and glycerol. D-Glyceraldehyde and fructose each caused a 2-fold increase in fructose 1,6-bisphosphate and the accumulation of millimolar quantities of fructose 1-phosphate in the cells. D-Glyceraldehyde caused an increase in the glycerol 3-phosphate content and a decrease in the dihydroxyacetone phosphate content, whereas dihydroxyacetone increased the content of both metabolites. The increase in the [glycerol 3-phosphate]/[dihydroxyacetone phosphate] ratio caused by D-glyceraldehyde was not accompanied by a change in the cytoplasmic [NAD+]/[NADH] ratio, as indicated by the unchanged [lactate]/[pyruvate] ratio. The accumulation of fructose 1-phosphate from D-glyceraldehyde and dihydroxyacetone phosphate in the hepatocyte can account for the depletion of the intracellular content of the latter. Presumably ATP is depleted as the result of the accumulation of millimolar amounts of a phosphorylated intermediate, as is the case with fructose and glycerol. It is suggested that the accumulation of fructose 1-phosphate during hepatic fructose metabolism is the result of a temporary increase in the D-glyceraldehyde concentration because of the high rate of fructose phosphorylation compared with triokinase activity. The equilibrium constant of aldolase favours the formation and thus the accumulation of fructose 1-phosphate.

Quantitative analysis of intermediary metabolism in hepatocytes incubated in the presence and absence of glucagon with a substrate mixture containing glucose, ribose, fructose, alanine and acetate

Hepatocytes were isolated from the livers of fed rats and incubated, in the presence and absence of 100 nM-glucagon, with a substrate mixture containing glucose (10 mM), fructose (4 mM), alanine (3.5 mM), acetate (1.25 mM), and ribose (1 mM). In any given incubation one substrate was labelled with 14C. Incorporation of 14C into glucose, glycogen, CO2, lactate, alanine, glutamate, lipid glycerol and fatty acids was measured after 20 and 40 min of incubation under quasi-steady-state conditions [Borowitz, Stein & Blum (1977) J. Biol. Chem. 252, 1589-1605]. These data and the measured O2 consumption were analysed with the aid of a structural metabolic model incorporating all reactions of the glycolytic, gluconeogenic, and pentose phosphate pathways, and associated mitochondrial and cytosolic reactions. A considerable excess of experimental measurements over independent flux parameters and a number of independent measurements of changes in metabolite concentrations allowed for a stringent test of the model. A satisfactory fit to the data was obtained for each condition. Significant findings included: control cells were glycogenic and glucagon-treated cells glycogenolytic during the second interval; an ordered (last in, first out) model of glycogen degradation [Devos & Hers (1979) Eur. J. Biochem. 99, 161-167] was required in order to fit the experimental data; the pentose shunt contributed approx. 15% of the carbon for gluconeogenesis in both control and glucagon-treated cells; net flux through the lower Embden-Meyerhof pathway was in the glycolytic direction except during the 20-40 min interval in glucagon-treated cells; the increased gluconeogenesis in response to glucagon was correlated with a decreased pyruvate kinase flux and lactate output; fluxes through pyruvate kinase, pyruvate carboxylase, and phosphoenolpyruvate carboxykinase were not coordinately controlled; Krebs cycle activity did not change with glucagon treatment; flux through the malic enzyme was towards pyruvate formation except for control cells during interval II; and 'futile' cycling at each of the five substrate cycles examined (including a previously undescribed cycle at acetate/acetyl-CoA) consumed about 26% of cellular ATP production in control hepatocytes and 21% in glucagon-treated cells.

Biochemistry and differential diagnosis of metabolic acidoses

This paper reviews the biochemical background of metabolic acidoses. The rate of development is judged from production and/or elimination rate of organic acids, particularly carboxylic acids, namely lactate, ketoacids, acetate, formate and glycollate. Further, acid production from changes in the chemical state of phosphate in tissue is evaluated. The main conclusion is that pathological conditions with acidoses are always accompanied by changes in the rate of elimination of the carboxylic acids, whereas changes in the chemical state of phosphate is of quantitatively minor importance. Further, metabolic effects of metabolic acidoses are described with special reference to the effect of low pH in the extra cellular fluid on glycolysis, gluconeogenesis, lipolysis and ketogenesis. A short outline of the differential diagnostic problems in metabolic acidoses due to changes in carbohydrate and lipid metabolism or intoxication is given.

Incorporation of [U-14C]glucose into neutral lipids and sn-glycerol-3-phosphate in muscle from Duchenne muscular dystrophy and control patients

Muscle biopsy tissue from patients suffering from a wide range of neuromuscular disorders, normal muscle removed during regular orthopaedic procedures, and muscle from aborted human fetuses of 12--20 weeks gestation was dissected into fibre-bundles and incubated at 37 degrees C with [U-14C]glucose at a final concentration of 4 mM. Extracts made: (i) after 30 min were used to determine content and radioactivity of sn-glycerol-3-phosphate, and (ii) after 160 min for separation of lipid species. Dystrophic muscle from 8 patients with typical Duchenne dystrophy converted significantly more glucose than normal muscle (11 samples) into neutral lipids, but less into polar lipids. Of total lipid radioactivity a mean value of 66% was found in neutral lipid in the Duchenne group, while in various control groups this proportion was about 40%. The disparity observed was the result of greater incorporation of glucose label into triglycerides, chiefly in the glycerol moiety of the Duchenne group lipids, and was some 3 times greater than normal. Other muscle disease groups also showed slightly raised levels of incorporation but these were not statistically significant in the present series of results. The content and radioactivity of glycerol phosphate in muscle from 15 patients with Duchenne dystrophy were also significantly higher than in normal muscle. These findings are discussed in relation to glucose metabolism in muscle and the energy cost of transforming glucose into triglyceride.

Mechanism of the stimulatory effect of fructose on ethanol oxidation in perfused rat liver

The stimulatory effect of fructose on ethanol oxidation was studied in livers from fasted rats perfused with Krebs-Henseleit-bicarbonate buffer in a non-recirculating system. Two series of experiments were performed: (A) ethanol was infused with stepwise increasing concentrations (0.1-20 mM) in the presence of 4 mM fructose; (B) fructose was infused with stepwise increasing concentrations (0.5-10 mM) in the presence of 2 mM ethanol. From measured metabolic rates the following parameters were calculated: energy-rich phosphates consumed for fructose metabolism which were provided from oxidative phosphorylation (delta approximately P); reducing equivalents derived from stimulated ethanol utilization which were disposed by mitochondrial oxidation (delta2H). Under the various conditions studied a linear relationship between these parameters was observed. The ratio delta approximately P/delta2H was about 2.0. It is suggested that fructose stimulates ethanol oxidation indirectly by increasing the energy consumption of the liver due to the production of glucose from fructose. Consequetnly, the rate of oxidative phosphorylation is increased and, therefore, the capacity of the respiratory chain for oxidizing reducing equivalents derived from ethanol is enhanced. The data support the more general hypothesis that the rate of ethanol oxidation depend upon the rate of hepatic energy consumption in a given metabolic state.

Ethanol metabolism and lipid synthesis by isolated liver cells from fed rats

1. The fatty acid synthesis in isolated liver cells from fed rats was studied with tritiated water as the radioactive precursor. The cells incorporated 3H20 at a rate of 1.26 mumol per min per g packed cells. 2. Addition of ethanol caused a 20% decrease in the incorporation of tritium into fatty acids. The decrease was correlated to the increase in the NAD-redox level. Probably, the decreased tritium incorporation into fatty acids during ethanol metabolism is due to a decrease in the specific activity of the NADPH used for the synthesis of fatty acids, rather than to a real inhibition of the fatty acid synthesis. 3. Ethanol oxidation via NADPH-consuming pathways and ethanol per se at a concentration of 80 mM had no effect upon the incorporation of tritium into fatty acids. 4. Fructose in a concentration of 15 mM inhibited the fatty acid synthesis by 75%, and this inhibition was further augmented by ethanol. 5. The ioslated rat liver cells oxidized ethanol at a rate of 2.72, 2.93 and 3.48 mumol per min per g packed cells at 5, 20 and 80 mM ethanol, respectively. Fructose had no effect upon ethanol oxidation neither at low nor at high concentrations of ethanol. 6. Ethanol oxidation via the non alcohol dehydrogenase pathway(s) may involve a transfer of reducing equivalents from mitochondrial NADH to cyctosolic NADP+ as judged from measurements of metabolite levels. This conclusion is supported by determinations of 14C yield in glucose from [1-14C] ethanol, and the results are taken as evidence for the presence of hydrogen shuttle activity during metabolism of ethanol, catalyzed by the NAD-dependent alcohol dehydrogenase. A metabolic scheme is proposed to account for the observed changes at low and high concentrations of ethanol.