Bak Lasse K, Iversen Peter, Sørensen Michael, Keiding Susanne, Vilstrup Hendrik, Ott Peter, Waagepetersen Helle S, Schousboe Arne
Department of Pharmacology and Pharmacotherapy, Faculty of Pharmaceutical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
Metab Brain Dis. 2009 Mar;24(1):135-45. doi: 10.1007/s11011-008-9123-4. Epub 2008 Dec 10.
Hepatic encephalopathy is a severe neuropathological condition arising secondary to liver failure. The pathogenesis is not well understood; however, hyperammonemia is considered to be one causative factor. Hyperammonemia has been suggested to inhibit tricarboxylic acid (TCA) cycle activity, thus affecting energy metabolism. Furthermore, it has been suggested that catabolism of the branched-chain amino acid isoleucine may help curb the effect of hyperammonemia by by-passing the TCA cycle block as well as providing the carbon skeleton for glutamate and glutamine synthesis thus fixating ammonia. Here we present novel results describing [U-(13)C]isoleucine metabolism in muscle and brain analyzed by mass spectrometry in bile duct ligated rats, a model of chronic hepatic encephalopathy, and discuss them in relation to previously published results from neural cell cultures. The metabolism of [U-(13)C]isoleucine in muscle tissue was about five times higher than that in the brain which, in turn, was lower than in corresponding cell cultures. However, synthesis of glutamate and glutamine was supported by catabolism of isoleucine. In rat brain, differential labeling patterns in glutamate and glutamine suggest that isoleucine may primarily be metabolized in the astrocytic compartment which is in accordance with previous findings in neural cell cultures. Lastly, in rat brain the labeling patterns of glutamate, aspartate and GABA do not suggest any significant inhibition by ammonia of TCA cycle activity which corresponds well to findings in neural cell cultures. Branched-chain amino acids including isoleucine are used for treating hepatic encephalopathy and the present findings shed light on the possible mechanism involved. The low turn-over of isoleucine in rat brain suggests that this amino acid does not serve the role of providing metabolites pertinent to TCA cycle function and hence energy formation as well as the necessary carbon skeleton for subsequent ammonia fixation in hyperammonemia. The higher metabolism of isoleucine in muscle could, however, contribute to ammonia fixation and thus likely be of value in the treatment of hepatic encephalopathy.
肝性脑病是继发于肝功能衰竭的一种严重神经病理状态。其发病机制尚未完全明确;然而,高氨血症被认为是一个致病因素。有研究表明,高氨血症会抑制三羧酸(TCA)循环活性,从而影响能量代谢。此外,有观点认为,支链氨基酸异亮氨酸的分解代谢可能有助于抑制高氨血症的影响,其方式是绕过TCA循环阻滞,以及为谷氨酸和谷氨酰胺的合成提供碳骨架,从而固定氨。在此,我们展示了通过质谱分析胆管结扎大鼠(一种慢性肝性脑病模型)肌肉和大脑中[U-(13)C]异亮氨酸代谢的新结果,并结合先前神经细胞培养的已发表结果进行讨论。[U-(13)C]异亮氨酸在肌肉组织中的代谢比在大脑中高约五倍,而大脑中的代谢又低于相应的细胞培养。然而,异亮氨酸的分解代谢支持了谷氨酸和谷氨酰胺的合成。在大鼠大脑中,谷氨酸和谷氨酰胺的差异标记模式表明,异亮氨酸可能主要在星形胶质细胞区室中代谢,这与先前神经细胞培养的结果一致。最后,在大鼠大脑中,谷氨酸、天冬氨酸和γ-氨基丁酸的标记模式并未表明氨对TCA循环活性有任何显著抑制,这与神经细胞培养的结果相符。包括异亮氨酸在内的支链氨基酸被用于治疗肝性脑病,目前的研究结果揭示了其中可能涉及的机制。大鼠大脑中异亮氨酸的低周转率表明,这种氨基酸在高氨血症中并不起到提供与TCA循环功能相关的代谢物、从而形成能量以及后续氨固定所需碳骨架的作用。然而,肌肉中异亮氨酸较高的代谢可能有助于氨的固定,因此在肝性脑病的治疗中可能具有价值。