Rao V L, Audet R M, Butterworth R F
Neuroscience Research Unit, Hôpital Saint-Luc (University of Montreal), Quebec, Canada.
J Neurochem. 1995 Sep;65(3):1221-8. doi: 10.1046/j.1471-4159.1995.65031221.x.
Portal-systemic encephalopathy (PSE) is characterized by neuropsychiatric symptoms progressing through stupor and coma. Previous studies in human autopsy tissue and in experimental animal models of PSE suggest that alterations in levels of brain amino acids may play a role in the pathogenesis of PSE. To assess this possibility, levels of amino acids were measured using in vivo cerebral microdialysis in frontal cortex of portacaval-shunted rats administered ammonium acetate (3.85 mmol/kg, i.p.) to precipitate severe PSE. Sham-operated rats served as controls. Portacaval shunting resulted in significant increases of levels of extracellular glutamine (threefold, p < 0.001), alanine (38%, p < 0.01), aspartate (44%, p < 0.05), phenylalanine (170%, p < 0.001), tyrosine (140%, p < 0.001), tryptophan (63%, p < 0.001), leucine (75%, p < 0.001), and serine (60%, p < 0.001). Administration of ammonium acetate to sham-operated animals led to a significant increase in extracellular glutamine and taurine content, but this response was absent in shunted rats. The lack of taurine release into extracellular fluid following ammonium acetate administration in portacaval-shunted rats could relate to the phenomenon of brain edema in these animals. Ammonium acetate administration resulted in significant increases in the extracellular concentrations of phenylalanine and tyrosine in both sham-operated and portacaval-shunted rats. Severe PSE was not accompanied by significant increases in extracellular fluid concentrations of glutamate, aspartate, GABA, tryptophan, leucine, or serine, suggesting that increased spontaneous release of these amino acids in cerebral cortex is not implicated in the pathogenesis of hepatic coma.
门体性脑病(PSE)的特征是神经精神症状逐渐发展为昏迷和昏睡。先前对人体尸检组织和PSE实验动物模型的研究表明,脑氨基酸水平的改变可能在PSE的发病机制中起作用。为了评估这种可能性,在接受乙酸铵(3.85 mmol/kg,腹腔注射)以诱发严重PSE的门腔分流大鼠的额叶皮质中,使用体内脑微透析法测量氨基酸水平。假手术大鼠作为对照。门腔分流导致细胞外谷氨酰胺水平显著升高(三倍,p < 0.001)、丙氨酸(38%,p < 0.01)、天冬氨酸(44%,p < 0.05)、苯丙氨酸(170%,p < 0.001)、酪氨酸(140%,p < 0.001)、色氨酸(63%,p < 0.001)、亮氨酸(75%,p < 0.001)和丝氨酸(60%,p < 0.001)。对假手术动物注射乙酸铵导致细胞外谷氨酰胺和牛磺酸含量显著增加,但分流大鼠没有这种反应。在门腔分流大鼠中,注射乙酸铵后牛磺酸未释放到细胞外液中,这可能与这些动物的脑水肿现象有关。在假手术和门腔分流大鼠中,注射乙酸铵均导致细胞外苯丙氨酸和酪氨酸浓度显著增加。严重PSE并未伴有细胞外液中谷氨酸、天冬氨酸、GABA、色氨酸、亮氨酸或丝氨酸浓度的显著增加,这表明这些氨基酸在大脑皮质中自发释放增加与肝昏迷的发病机制无关。