The effect of free fatty acids on oxygen consumption in man: the free fatty acid hypothesis

Cardiac and plasma lipid profiles in response to acute hypoxia in neonatal and young adult rats

Background

The physiological and biochemical responses to acute hypoxia have not been fully characterized in neonates. Fatty acids and lipids play an important role in most aspects of cardiac function.

Methods

We performed comprehensive lipid profiling analysis to survey the changes that occur in heart tissue and plasma of neonatal and young adult rats exposed to hypoxia for 2 h, and following 2 h of recovery from hypoxia.

Results

Cardiac and plasma concentrations of short-chain acylcarnitines, and most plasma long-chain fatty acids, were decreased in hypoxic neonates. Following recovery from hypoxia, concentrations of propionylcarnitine, palmitoylcarnitine, stearoylcarnitine were increased in neonatal hearts, while oleylcarnitine and linoleylcarnitine concentrations were increased in neonatal plasma. The concentrations of long-chain fatty acids and long-chain acylcarnitines were increased in the hearts and plasma of hypoxic young adult rats; these metabolites returned to baseline values following recovery from hypoxia.

Conclusion

There are differential effects of acute hypoxia on cardiac and plasma lipid profiles with maturation from the neonate to the young adult rat. Changes to neonatal cardiac and plasma lipid profiles during hypoxia likely allowed for greater metabolic and physiologic flexibility and increased chances for survival. Persistent alterations in the neonatal cardiac lipid profile following recovery from hypoxia may play a role in the development of rhythm disturbances.

Effects of exogenous metabolic substrate modulation on exercise-induced myocardial ischemia

BACKGROUND

The aim of the study is to compare the impact of intravenous glucose versus lipid versus saline on exercise-induced myocardial ischemia in patients with stable angina.

METHODS

Twelve men with coronary artery disease and positive exercise tests performed a symptom-limited, modified Bruce electrocardiogram (ECG) exercise test at 3 sessions, 3 weeks apart. They randomly received, in double-blind design, at each session equal intravenous volumes of 10% glucose/insulin or Intralipid plus heparin or saline. We assessed the effects on (1) ischemic threshold (heart rate x systolic pressure at 1-mm ST-segment depression [STD]) and (2) maximum ST-depression (Max STD) corresponding to the highest heart rate x systolic pressure common to the 3 tests.

RESULTS

During glucose infusion, glycemia increased from 5.7 +/- 0.4 to 9.4 +/- 3.0 mmol/L but did not change during lipid or saline infusion. During lipid infusion, free fatty acids increased from 0.32 +/- 0.19 to 1.44 +/- 0.46 mmol/L but decreased during glucose infusion from 0.39 +/- 0.21 to 0.04 +/- 0.03 mmol/L and did not change during saline. Exercise times were 10.0 +/- 3.4, 9.8 +/- 3.4, and 10.3 +/- 3.5 minutes, during glucose, lipid, and saline infusions, respectively. Ischemic thresholds (x 10(-3)) were 16.5 +/- 2.8, 16.8 +/- 2.7, and 16.6 +/- 2.6, respectively. MaxSTD was 2.5 +/- 1.4, 2.5 +/- 1.0, and 2.5 +/- 1.0 mm, respectively.

CONCLUSION

Neither glucose-insulin nor lipid infusion modified exercise ischemic parameters compared with saline control, suggesting that marked and acute changes in exogenous energy substrate are unlikely to affect exercise-induced myocardial ischemia.

beta2-adrenergic receptor polymorphisms and salbutamol-stimulated energy expenditure

The beta-adrenergic system is involved in the control of energy metabolism and expenditure. The beta2-adrenergic receptor (beta2-AR) gene shows polymorphisms that have been associated with obesity in several studies. In vitro and in vivo studies suggest differences in beta2-AR-mediated function between these polymorphisms. The aim of this study was to investigate the influence of genetic variation in codon 16 of the beta2-AR gene on energy metabolism in humans. Thirty-four subjects were recruited [Gly16Gly (n = 13), Gly16Arg (n = 16), or Arg16Arg (n = 5)]. The beta2-AR was stimulated with two doses of salbutamol (50 and 100 ng/kg fat-free mass per minute) after blockade of the beta1-adrenergic receptors with atenolol. Energy expenditure and plasma substrate and hormone concentrations were measured. The increase in energy expenditure (DeltaEE) was significantly different among groups in which the Arg16Arg group showed the lowest increase (P < 0.05 vs. Gly carriers). In a multiple regression model, variations in the increase in nonesterified fatty acid concentration during salbutamol infusion (partial r = 0.51) and the polymorphism contributed significantly to the variation in DeltaEE. Thirty-five percent of the variation in DeltaEE was explained by these two factors. We conclude that subjects with the Arg16Arg polymorphism of the beta2-AR gene have a reduced thermogenic response to beta2-adrenergic stimulation. Although this relatively small study needs confirmation, the findings support a role for this polymorphism in the development and maintenance of overweight and obesity.

The effect of an increased free fatty acid concentration on thermogenesis and substrate oxidation in obese and lean men

OBJECTIVE

To examine whether a certain increase in plasma free fatty acid (FFA) concentration leads to similar increases in lipid oxidation and energy expenditure in obese and lean men.

DESIGN

The study protocol consisted of a 30 min baseline period after which subjects received an i.v. bolus of 1000 IE heparin. Then consecutive infusions of 4.9, 9.8 and 19.6 microl/kg fat-free mass (FFM).min of a lipid heparin mixture were started, each infusion for 30 min.

SUBJECTS

Eleven obese and 13 lean men with a mean body mass index (BMI) of 34.2+/-1.0 (+/-s.e.m.) and 23.9+/-0.5 kg/m(2) and age 46.0+/-1.0 and 42.6+/-1.5 y, respectively.

MEASUREMENTS

Energy expenditure, respiratory exchange ratio (RER) and carbohydrate and lipid oxidation were continuously measured by indirect calorimetry. At the end of each infusion period, a blood sample was taken for FFA, glycerol, insulin, beta-hydroxybutyrate, noradrenaline and adrenaline determination.

RESULTS

At baseline, plasma FFA levels were comparable in both groups. Lipid heparin infusion increased plasma FFA concentration by 301+/-47 micromol/l and 332+/-27 micromol/l in obese and lean men. Energy expenditure increased similarly in obese and lean men (0.34+/-0.08 vs 0.40+/-0.08 kJ/min, NS) during lipid heparin infusion, whereas RER decreased similarly in both groups. Lipid oxidation rates were comparable at baseline and increased similarly in obese and lean men (19+/-5 vs 13+/-4 mg/min, NS). Baseline plasma insulin levels were higher in the obese, but did not change during lipid heparin infusion. Plasma beta-hydroxybutyrate concentrations were similar at baseline, but increased significantly less in the obese during lipid heparin infusion. Baseline noradrenaline and adrenaline concentrations did not differ significantly between groups. During lipid heparin infusion, plasma noradrenaline levels decreased significantly, but plasma adrenaline levels remained unchanged in both groups.

CONCLUSION

A certain increase in plasma FFA concentration leads to similar increases in lipid oxidation and energy expenditure in obese and lean men. The accumulation of fat in obese subjects may therefore be more likely to be due to a defect in adipose tissue lipolysis than a defect in lipid oxidation. International Journal of Obesity (2001) 25, 33-38

Inhibition of lipolysis reduces beta1-adrenoceptor-mediated thermogenesis in man

The purpose of the study was to investigate whether the increase in energy expenditure and lipid oxidation during beta1-adrenergic stimulation is caused by the concomitant increase in lipolysis. Twelve healthy male subjects participated in three trials: no-LIP/-, inhibition of lipolysis by pretreatment with acipimox followed by saline infusion; -/BETA, no pretreatment, with dobutamine infusion to stimulate beta1-adrenoceptors; and no-LIP/BETA, pretreatment with acipimox followed by dobutamine infusion. Inhibition of lipolysis did not affect baseline energy expenditure, but decreased lipid oxidation and increased carbohydrate oxidation. Energy expenditure and lipid oxidation increased significantly during beta1-adrenergic stimulation, but this increase was significantly smaller when lipolysis was inhibited ([baseline v infusion period] energy expenditure: -/BETA, 5.15 +/- 0.16 v 6.11 +/- 0.26 kJ/min, P < .001; no-LIP/BETA, 5.28 +/- 0.17 v 5.71 +/- 0.19 kJ/min, P < .01; lipid oxidation: -/BETA, 0.059 +/- 0.004 v 0.073 +/- 0.006 g/min, P < .01; no-LIP/BETA, 0.034 +/- 0.005 v 0.039 +/- 0.006 g/min, P < .05). Baseline plasma glycerol and nonesterified fatty acid (NEFA) concentrations decreased after inhibition of lipolysis. Glycerol and NEFA increased significantly during beta1-adrenergic stimulation alone (glycerol, 65.0 +/- 5.3 v 117.0 +/- 10.9 micromol/L; NEFA, 362 +/- 24 v 954 /- 89 micromol/L; both P < .001). Concomitant administration of acipimox prevented a substantial part of the increase in lipolysis during beta1-adrenergic stimulation, but the increase in plasma glycerol and NEFA remained significant (glycerol, 40.4 +/- 2.2 v 44.8 +/- 2.2 micromol/L; NEFA, 118 +/- 18 v 160 +/- 19 micromol/L; both P < .05). In conclusion, a reduced availability of plasma NEFA was associated with a reduced increase in energy expenditure and lipid oxidation during beta1-adrenergic stimulation in man.

Possible role of alpha-1-microglobulin in mediating bacterial attachment to model surfaces

Urine proteins in the molecular weight range of 9-137 kDa deposit to an equal extent from pooled human urine onto glass (12.7 +/- 1.9 micrograms/cm) and polystyrene (11.8 +/- 1.8 micrograms/cm). Selective desorption of the proteins was achieved by washing with water or water/isopropanol mixtures. Irrespective of the washing process, proteins of molecular weight greater than 90 kDa remained associated with both surfaces while water washings alone removed most low molecular weight material. A 29 kDa protein, alpha-1-microglobulin, was removed from glass by water washing but required a 30% (v/v) isopropanol wash to desorb from polystyrene, implying attachment via hydrophobic bonding. The adhesion to polystyrene surfaces of Pseudomonas aeruginosa B4, a clinical isolate from a urinary tract infection (UTI), was strongly associated with the presence of alpha-1-microglobulin, which may be acting as a mediator of bacterial adhesion.

The effects of induced alkalosis on the metabolic response to prolonged exercise in humans

To examine the effects of alkalosis on the metabolic response to prolonged exercise, seven healthy males cycled for 1 h at approximately 70% of maximum oxygen uptake on two occasions, 1-week apart. Starting 3 h prior to exercise, subjects consumed either CaCO3 (placebo) or NaHCO3 (0.3 g.kg-1 body mass) over a 2-h period. Arterialised-venous blood samples were drawn before and during exercise for the determination of acid-base status and blood metabolites (lactate, glucose, glycerol and plasma free fatty acids). Expired gas was collected during exercise for determination of oxygen uptake (VO2) and respiratory exchange ratio to estimate fuel oxidation rates. Ratings of perceived exertion (RPE) and heart rates were also recorded. A significant (P < 0.01) alkalosis was observed at all times following bicarbonate ingestion. Blood lactate was significantly (P < 0.05) higher at all sample times throughout exercise following bicarbonate ingestion. Blood lactate concentration [mean (SEM)] reached peak values of 2.90 (0.16) and 4.24 (0.45) mmol.l-1 following 20 min of exercise following placebo and bicarbonate, respectively. No differences between treatments were noted at any time for the other metabolites. VO2 and RPE were significantly higher (P < 0.01) with the bicarbonate trial. At a constant power output increases in VO2 are generally associated with increases in fat oxidation, however, no evidence for an altered fuel oxidation was obtained in the present study. The differences in blood lactate indicate that induced alkalosis increased lactate efflux from muscle, but it cannot be confirmed whether this represents an increased rate of glycolysis within the muscle.

Spectroscopic characterization by photodiode array detection of human urinary and amniotic protein HC subpopulations fractionated by anion-exchange and size-exclusion high-performance liquid chromatography

A procedure for spectroscopic characterization and partial fractionation of human protein HC populations by high-performance liquid chromatography-photodiode array ultraviolet-visible detection is reported. Human protein HC from urine or amniotic fluid fractionated by anion-exchange HPLC in a protein Pak DEAE 5PW appeared to be heterogeneous as judged by the asymmetric elution pattern, consisting of a continuous irregular broad peak with several shoulders distributed along the whole chromatogram. Selected fractions containing shoulders were rechromatographed and finally six symmetrical homogeneous peaks with different retention times were obtained from each protein HC preparation. The direct automatic absorption spectra analyses at each peak maximum, indicated that all of the homogeneous peaks seemed to be protein HC, all of them associated to the same chromophore although with different stoichiometry ratios. Isoelectric focusing showed that each peak was composed of a limited number of subpopulations of protein HC with different isoelectric points. Size microheterogeneity has been also demonstrated in both urinary and amniotic protein HC preparations by a combination of size-exclusion HPLC on a TSK 3000 SW6 column and photodiode array detection. Partial fractionation of human albumin on an analytical anion-exchange Mono-Q PC 1.6/5 column, has allowed the identification of heterogeneous chromophore-containing populations displaying significant absorption in the visible region in resemblance to that of protein HC.

24-hour energy expenditure and substrate oxidation rates are unaffected by body fat distribution in obese women

Twenty-four-hour energy expenditure (EE) and nonprotein respiratory quotient (RQnp) were measured by indirect calorimetry in 19 upper-body-obese (UBO) and 15 lower-body-obese (LBO) women with similar body mass index (BMI) and body fat percent. The measurements were performed in a respiration chamber on a predetermined physical activity program and a controlled diet. No differences between the UBO and LBO groups were found in 24-hour, daytime, and sleeping EE after adjustment for differences in fat-free mass (FFM). Furthermore, no group effect was observed in RQnp, but a positive correlation was found between RQnp and age. Despite the fact that an increased free fatty acid (FFA) turnover has been found in UBO subjects, the present study does not support the contention that upper-body obesity is accompanied by an increased lipid oxidation.

Plasma lipolytic activity and substrate oxidation after intravenous administration of heparin and a low molecular weight heparin fragment

This study examines the effects of heparin and a low molecular weight heparin (LMWH) fragment on plasma lipolytic activity and substrate oxidation. Indirect calorimetry was performed continuously in healthy male subjects receiving a constant infusion of fat emulsion (0.2 g min-1) and glucose (0.8 g min-1) during a period of 4 h. After 2 h an infusion of heparin (n = 6) or LMWH (n = 6) (100 antifactor Xa units kg-1) or saline (n = 6) was given over 1 h. Plasma concentration of the fat emulsion decreased by 76 +/- 5% with heparin and by 12 +/- 7% with LMWH (P less than 0.01). In the case of LMWH the initial fall was followed by a consistent rise in fat emulsion concentration for the entire remaining study period. Compared to the control experiments, plasma FFA increased five times with heparin and three times with LMWH (P less than 0.05). The average respiratory quotient (RQ) and energy expenditure (EE) increased constantly during the study period and did not differ significantly between the groups. In all groups the average increase in glucose oxidation was 40-50%, while fat oxidation decreased to a comparable extent. Infusions of heparin and LMWH had no effect on RQ or EE. A microcalorimetric study on isolated rat adipocytes in buffer solutions containing glucose, fat emulsion, heparin or LMWH was also made. The heat output from the adipocytes was not influenced by the presence of heparin or LMWH. In conclusion, infusion of heparin resulted in a pronounced increase in FFA availability, whereas LMWH exerted a less marked lipolytic effect. However, the heparin-induced elevations in plasma FFA were not accompanied by measurable rises in lipid oxidation rate.

Characterization of an IgA receptor from group B streptococci: specificity for serum IgA

Some strains of group B streptococci express a cell surface protein which binds IgA. This report describes some properties of such an IgA receptor and compares it with a previously described IgA receptor from group A streptococci. The group B receptor was released in an almost pure form from bacteria incubated at elevated pH, and could be isolated by IgA-Sepharose affinity chromatography. The sequence of the N-terminal 19 amino acid residues was unique. The receptor preferentially binds IgA of human origin, as shown in immunoblotting experiments with purified IgA from nine different species. The affinity constant of the purified receptor for serum IgA was determined to be 3.5 x 10(8) M-1, but for secretory IgA it was too low to allow determination. This result indicates that secretory component and/or J chain interferes with the binding of IgA to this type of bacterial receptor, which may be one of the physiological functions of these polypeptides. A reduction in affinity was also observed for another complexed form of IgA, alpha 1-microglobulin-IgA. The group B receptor is antigenically unrelated to the IgA receptor from group A streptococci (protein Arp), but competitive inhibition experiments indicate that they bind to the same region in IgA. The implications of these findings, and the biological role of bacterial IgA receptors, are discussed.

Mitogenic effect of alpha 1-microglobulin on mouse lymphocytes. Evidence of T- and B-cell cooperation, B-cell proliferation, and a low-affinity receptor on mononuclear cells

Human alpha 1-m microglobulin (alpha 1-m), a low molecular weight plasma protein, was found to exert mitogenic effects on mouse lymphocytes from lymph nodes and spleen. The stimulatory effects appeared to be strain-restricted: alpha 1-m induced a varying degree of proliferation of lymphocytes from three strains, whereas one strain responded poorly. Experiments with lymphocyte subpopulations showed only weak stimulatory effects of alpha 1-m on purified T and B lymphocytes cultivated alone. The addition of mitomycin-treated cells of the other subpopulation could not restore the proliferative responses in either T or B lymphocytes. Strong stimulations were recorded only when both T and B lymphocytes were present, indicating that the T and B lymphocytes cooperate to achieve the proliferation. However, FACS studies on cultured splenocytes indicated that the proliferating cells are predominantly B lymphocytes. These data extend our earlier findings of a mitogenic effect of alpha 1-m on guinea pig lymphocytes. Furthermore, results were obtained indicating the presence of a receptor on mononuclear cells. Iodine-labelled alpha 1-m was bound to mononuclear cells prepared from spleens, and the binding could be blocked by an excess of non-labelled alpha 1-m. Scatchard plotting of the data gave an equilibrium constant of 0.7 x 10(5)/M for the binding between alpha 1-m and the receptor. Together with the documented inhibitory activity of alpha 1-m on antigen-driven proliferation of lymphocytes, these results suggest an immunoregulatory role for alpha 1-m.

Atherogenic risk in men suffering from occupational stress

Blue-collar workers suffering from chronic occupational stress exhibit significantly higher values of an atherogenic index (ratio between low density and high density lipoprotein cholesterol assessed by quantitative lipoprotein electrophoresis) as compared to men exposed to less stress at work. Chronic occupational stress is defined by interactions of objective (job instability, shift work) and subjective (perceived job insecurity, perceived increase of work load) indicators as assessed by structured interviews. Findings from a prospective epidemiologic study on 416 middle-aged men at entry covering a 2-year period of observation hold true after controlling for several confounding factors such as body weight, age, cigarette smoking and chronic alcohol consumption. Results are in line with experimental animal studies on the influence of chronic social stress on the development of atherosclerosis.

Post-operative substrate utilisation and gas exchange using two different TPN-systems: Glucose versus fat

Twenty patients were studied over the first 4 post-operative days following abdominal aortic surgery. Ten patients had 93% of their non-protein energy as glucose and insulin was given to keep blood glucose below 10 mmol/l. The other 10 patients had 80% of non-protein energy as fat (Intralipid). Amino acids corresponding to 12 g of nitrogen were given in both groups. Gas exchange, nitrogen balance, phosphate balance, vanillylmandelic acid (VMA) excretion, 1- and 3-methylhistidine in urine, acute phase proteins, immunoglobulins and albumin were followed. Substrate utilisation was calculated from indirect calorimetry data and nitrogen excretion. Metabolism in the early post-operative phase was found to adapt to the nutrition regimen given even though the composition was extreme either in fat or carbohydrate content. The glucose-insulin regimen had a better nitrogen sparing effect and based on the difference in 3-methylhistidine excretion it is suggested that mainly protein muscle benefitted from this. Regardless of the TPN-regimen given, those patients whose RQ deviated the most from the average in their group had the highest nitrogen excretion. The two groups showed no differences in plasma proteins and catecholamine excretion.

Fast protein liquid chromatography scale-up procedures for the preparation of low-molecular-weight proteins from urine

A system for the rapid isolation of low molecular weight proteins from urine has been devised, and illustrated by alpha 1-microglobulin, beta 2-microglobulin, retinol binding protein, lysozyme and monoclonal light chains. Urine proteins from patients with tubular dysfunction were concentrated, either by ultrafiltration or ammonium sulphate precipitation. This was followed by gel chromatography on Sephadex G-50. The appropriate fractions were then separated by chromatography on Pharmacia monobead columns. A Mono Q strong anion exchanger was used for beta 2-microglobulin, retinol binding protein, alpha 1-microglobulin and free monoclonal light chains. Lysozyme was separated on a Mono S cation exchanger. The chromatography was first optimized on HR 5/5 columns and then scaled up to HR 16/10 columns.

Chromatographic study of the interrelationships of immunoglobulin A and alpha 1-microglobulin in myelomatosis

The binding of alpha 1-microglobulin (alpha 1-m) to serum immunoglobulin A (IgA) myeloma proteins have been examined by analytical and preparative Superose high-performance gel chromatography. Enzyme immunoassays showed that in the serum alpha 1-m was bound to monomeric IgA, but not to the polymeric IgA, and was also present in a free form. The IgA-alpha 1-m complexes involved covalent and non-covalent bonds. Considerable variation in the ratio of bound to unbound forms of alpha 1-m was observed that appears to be a result of variation of the IgA alpha heavy chains. Reduction of monomeric IgA produced alpha 1-m-heavy chain complexes, free alpha 1-m, light and alpha heavy chains, and traces of alpha 1-m attached to IgA that was resistant to reduction.

The effect of non-esterified long-chain fatty acids on blood flow and thermogenesis in brown adipose tissue in the young dog

In vitro experiments have demonstrated that increasing the molar ratio of extracellular non-esterified fatty acids (NEFA) to albumin stimulates thermogenesis in brown adipocytes. To test these results, in vivo blood flow and local temperature were measured in perirenal brown adipose tissue (BAT) in puppies during thermogenesis induced by increasing the plasma NEFA: albumin ratio by injection of intralipid and heparin. Plasma NEFA concentration increased to 1.5 mmol X 1-I and plasma NEFA:albumin ratio to 4. Concomitantly, the whole body oxygen consumption rose on average about 100% above baseline level. Plasma noradrenaline concentration increased about three-fold and plasma adrenaline concentration about six-fold. The BAT temperature increased by an average of 0.9 degrees C. However, since BAT blood flow was simultaneously reduced by about 50%, it can be calculated that the local heat production was also reduced. Consequently, the increase in whole body oxygen consumption was not due to stimulation of BAT thermogenesis. It is concluded that in vivo assessment of BAT thermogenesis requires concomitant measurements of both local BAT temperature and blood flow.

The influence of sustained release theophylline therapy on free fatty acids in serum

The serum concentrations of theophylline, total free fatty acids (FFA) and subgroups were studied in ten healthy volunteers treated with sustained release theophylline twice daily during 9 days. Analyses were performed before and on day 1, 4 and 9 of treatment. Mean theophylline serum levels within the therapeutic range were obtained during the study, ranging from 62 +/- 7 to 82 +/- 10 mumol/l. The mean serum concentrations of total FFA and subgroups increased significantly during treatment, showing the highest levels on day 4. Comparing fasting total FFA concentrations, an increase of 123% and 48% from pretreatment levels were found on day 4 and 9, respectively. The subgroups were influenced to a different degree by theophylline intake. Arachidonic acid (20:4) was not increased, while among the others, saturated FFA increased less than the unsaturated.

Alpha 1-microglobulin glycopeptides inhibit antigen-specific stimulation of human peripheral blood leucocytes

Glycopeptides were prepared from proteolytically digested human and guinea pig alpha 1-microglobulin (alpha 1-m) by gel chromatography on Sephadex G-100 and affinity chromatography on concanavalin A-Sepharose. Amino acid analysis showed that the average glycopeptide was a tripeptide containing the amino acids aspartic acid/asparagine, isoleucine, and serine and/or threonine. It has earlier been shown that human alpha 1-m carries two or three N-glycosidically linked oligosaccharides of the high-mannose type. These preparations of glycopeptides inhibited the proliferative response of peripheral human blood leucocytes to the antigen purified protein derivative. The dose-response relationship of the inhibitions showed a greater specific activity of the glycopeptides than of whole alpha 1-m. Mild alkali treatment of human alpha 1-m did not affect its specific inhibitory activity, suggesting that the peptide backbone is of little importance for the immunosuppressive effect of alpha 1-m. No difference in inhibitory activity was seen between human and guinea pig native alpha 1-m or alpha 1-m glycopeptides. Human asialo alpha 1-m exerted a suppressive effect on the antigen-specific leucocyte proliferation similar to that of native alpha 1-m.

Proximal renal tubular function in myelomatosis: observations in the fourth Medical Research Council trial

Proximal renal tubular function was studied in 522 consecutive patients entered into the Medical Research Council's fourth myelomatosis trial. Assessment was made at presentation after a 48 h period of hydration but before administration of chemotherapy. The most common abnormalities in the urine other than light chain proteinuria were raised concentrations of the low molecular weight proteins alpha 1-microglobulin and alpha 1-acid glycoprotein. These were usually accompanied by increases in urinary beta-N-acetyl-D-glucosaminidase concentrations. The concentration of these substances in the urine directly correlated with urinary free light chain output. This tubular proteinuria was seen whether or not patients had impaired glomerular function, as assessed by a rise in serum creatinine concentration. Urinary concentrations of retinol binding protein, however, were generally increased only when serum creatinine concentrations were raised. This applied even when there were high concentrations of light chains, alpha 1-microglobulin, alpha 1-acid glycoprotein, and beta-N-acetyl-D-glucosaminidase in the urine. There is therefore a selective tubular proteinuria in myelomatosis which is seen in almost all patients with urinary light chain values greater than 1 u/l. This proteinuria is generally reversible, when light chains no longer appear in the urine. Patients whose serum creatinine was greater than 200 mumol/l, however, had increased urinary output of retinol binding protein in addition to increased excretion of alpha 1-microglobulin, alpha 1-acid glycoprotein, and beta-N-acetyl-D-glucosaminidase. Tubular proteinuria in many of these patients presenting in renal failure persisted even when light chain output was reduced after chemotherapy.

Synthesis of alpha 1-microglobulin by guinea-pig liver

Explants from perfused guinea-pig livers were found to release alpha 1-microglobulin into the culture medium. Tritiated leucine in the medium was incorporated into the protein, suggesting a de novo synthesis of alpha 1-microglobulin by the liver tissue. The size of the protein could not be distinguished from that of purified urinary alpha 1-microglobulin when tested with sodium dodecyl sulfate/polyacrylamide gel electrophoresis. After intravenous injections of tritiated leucine into guinea-pigs, the 105 000 X g pellet of homogenized liver rapidly increased its content of radioactive alpha 1-microglobulin, with a maximum after 20 min. 3H-Labelled alpha 1-microglobulin appeared in serum after a lag phase of 20 min, and by comparing the rate of accumulation with albumin, the synthesis of guinea-pig alpha 1-microglobulin could be estimated to 20 micrograms g liver-1 h-1.

Effect of diet on the utilization of blood-borne and intramuscular substrates during exercise in man

20 subjects were studied at rest and during a 25 min submaximal exercise (65% of VO2 max) on two occasions, the first preceded by a fat rich diet and the second by a carbohydrate rich diet. Oxygen uptake, respiratory exchange ratio (R) and arterial-femoral venous differences for glucose, lactate, beta-hydroxybutyrate and FFA (based on the fractional extraction of 3H-palmitate) were measured at rest and during exercise. Changes in intramuscular glycogen, triglyceride and lactate concentrations were determined in muscle biopsies taken before and immediately after exercise form m. quadriceps femoris. R was lower after the fat than after the carbohydrate diet and simultaneously the FFA extraction by the exercising leg was higher. The muscle triglycerides did not changes significantly during exercise after either diet. The glucose extraction was insignificantly greater after the fat diet. The glycogen reduction was numerically smaller after the fat diet, but the difference was uncertain and difficult to evaluate due to a large variation after the carbohydrate diet. However, muscle lactate accumulation and release by the exercising leg was smaller after the fat diet, indicating a slower rate of muscle glycogenolysis. It is concluded that a fat rich diet increases the relative contribution of fat to the oxidative metabolism, that this increase, to a great extent, is covered by plasma FFA and that the concomitant decrease in carbohydrate utilization concerns muscle glycogen rather than blood glucose.