Energy metabolism and cellular pH in normal and pathological conditions. A new look through 31phosphorus nuclear magnetic resonance.

Cellular energetics can be studied non-invasively using 31P nuclear magnetic resonance (NMR). Besides the concentration of the major phosphorus-containing metabolites, enzyme-catalysed fluxes and intracellular pH can be obtained from the NMR measurement. Metabolic acidosis in the ischaemic myocardium has been studied in the perfused rat heart. Comparison of the pH, measured from the position of the inorganic phosphate (Pi) resonance, with the pH obtained from the resonance of 2-deoxyglucose 6-phosphate (accumulated after perfusion with 2-deoxyglucose) demonstrates that cytoplasmic pH values are being obtained. The pH changes during ischaemia are quantitatively related to the glycogen leads to lactate conversion. Preperfusion with insulin enhanced the lactate production but resulted in the maintenance of ATP for a longer period during ischaemia, even though acidosis was enhanced. In acute renal acidosis, the decrease in intracellular pH is smaller than might have been expected, as demonstrated in the perfused rat kidney. The importance of acidosis in relation to renal preservation was examined in human kidneys prior to transplantation. 31P NMR studies on human forearm muscle have been done. The pH changes measured during aerobic and anaerobic exercise demonstrate the importance of glycogenolysis in providing energy for ATP production. In a patient with suspected McArdle's syndrome, 31P NMR was used to detect the lack of glycogenolysis since during both aerobic and anaerobic exercise a pH rise was observed together with the rapid breakdown of phosphocreatine.