R.A.F.M. Chamuleau

Amino Acid Release from Cerebral Cortex in Experimental Acute Liver Failure, Studied by In Vivo Cerebral Cortex Microdialysis

Abstract: Both increased γ‐aminobutyric acid (GABA)‐ergic and decreased glutamatergic neurotransmission have been suggested relative to the pathophysiology of hepatic encephalopathy. This proposed disturbance in neurotransmitter balance, however, is based mainly on brain tissue analysis. Because the approach of whole tissue analysis is of limited value with regard to in vivo neurotransmission, we have studied the extracellular concentrations in the cerebral cortex of several neuroactive amino acids by application of the in vivo microdialysis technique. During acute hepatic encephalopathy induced in rats by complete liver ischemia, increased extracellular concentrations of the neuroactive amino acids glutamate, taurine, and glycine were observed, whereas extracellular concentrations of aspartate and GABA were unaltered and glutamine decreased. It is therefore suggested that hepatic encephalopathy is associated with glycine potentiated glutamate neurotoxicity rather than with a shortage of the neurotransmitter glutamate. In addition, increased extracellular concentration of taurine might contribute to the disturbed neurotransmitter balance. The observation of decreasing glutamine concentrations, after an initial increase, points to a possible astrocytic dysfunction involved in the pathophysiology of hepatic encephalopathy.

In vivo 1H-NMR procedure to determine several rat cerebral metabolite levels simultaneously, undisturbed by water and lipid signals

Methods developed for in vivo 1H-NMR spectroscopy are evaluated and applied using conscious rats. Good quality 1H-spectra of the brain are obtained using a surface coil and a spin echo pulse sequence with the binomial 1-1 and 2-2 water suppression pulses. However, comparing spectra from various rats with each other the water and lipid signals, which cause spectral overlap problems, may differ while the other spectral peaks agree well. Spatially one- and two-dimensional 1H spectroscopic imaging of the rat brain shows that the former signals stem from distinct spatial regions localized close to the rf coil. From a spectroscopic image, a spectrum over a limited spatial region is constructed in which the water signals are strongly reduced, the lipid signals are eliminated and lactic acid can be observed clearly simultaneously with other metabolites.

Liver Regeneration after Partial Hepatectomy in Rats with Defective Bilirubin Conjugation or Biliary Excretion

The role of conjugated bilirubin in liver regeneration after partial hepatectomy (PH) was studied in Gunn rats, in transport-mutant (TR−) rats, and in rats with extrahepatic biliary obstruction. Ornithine decarboxylase (ODC) and thymidine kinase (TK) activities in liver homogenates and immunohistochemistry ofin vivo bromodeoxyuridine (BrdU) incorporation in hepatic DNA were followed as regeneration parameters at 24 and 48 hr after PH. The results relative to TK activity and BrdU incorporation were consistent with significantly delayed hepatic DNA synthesis in Gunn rats in comparison to control Wistar and TR− rats. This delay in DNA synthesis was not reflected in the hepatic ODC activity. After one week of complete common bile duct obstruction (CBO), an increased TK activity and BrdU incorporation was seen. PH following CBO resulted in a further increase in ODC activity and BrdU incorporation. TK activity did not change, however. These data relative to the regulation of hepatic DNA synthesis after PH in Gunn rats and in rats with extrahepatic biliary obstruction suggest a possible stimulatory role for conjugated bilirubin in hepatic regeneration; however, the normal hepatic DNA synthesis in TR− rats studied before PH and the subnormal DNA synthesis seen 24hr after PH in TR− rats and in rats with CBO indicate that conjugated bilirubin does not stimulate hepatic DNA synthesis.

Brain 31P NMR spectroscopy in the conscious rat

Using a home-built head-body holder (HBH) which enables in vivo 31P NMR spectroscopy measurements on conscious rats, no significant changes were observed in the cerebral relative concentrations of ATP, phosphocreatine, phosphomonoesters, inorganic phosphate and intracellular pH during pentobarbital anesthesia in normal rats as compared to their conscious state.

The relationship between plasma free fatty acids and experimentally induced hepatic encephalopathy in the rat

Two experimental models of hepatic encephalopathy in the rat have been investigated in order to study the postulated relationship between plasma free fatty acids concentration (C6 - C22:0) and the degree of hepatic encephalopathy. As a model of chronic hepatic encephalopathy, porta caval shunted rats were studied for 15 weeks, whereas rats with acute liver ischemia were used as a model for acute hepatic encephalopathy. In porta caval shunted rats only a minor degree of hepatic encephalopathy developed, whereas plasma ammonia concentration increased significantly (82 +/- 8 to +/- 440 +/- 32 mumol/l). Acute liver ischemia induced severe grades of hepatic encephalopathy associated with high levels of plasma ammonia (+/- 1 200 mumol/l). Since no significant changes in plasma free fatty acids were observed during both chronic and acute hepatic encephalopathy no correlation between plasma free fatty acids and the stage of hepatic encephalopathy was found. Our data do not support an important role of free fatty acids in the pathogenesis of acute or chronic hepatic encephalopathy in the rat.