Sugimoto H, Koehler R C, Wilson D A, Brusilow S W, Traystman R J
Department of Anesthesiology/Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-4961, USA.
J Cereb Blood Flow Metab. 1997 Jan;17(1):44-9. doi: 10.1097/00004647-199701000-00006.
Hyperammonemia causes glutamine accumulation and astrocyte swelling. Inhibition of glutamine synthesis reduces ammonia-induced edema formation and watery swelling in astrocyte processes. Ordinarily, astrocytes tightly control extracellular K+ activity [K+]e. We tested the hypothesis that acute hyperammonemia interferes with this tight regulation such that [K+]e increases and that inhibition of glutamine synthetase reduces this increase in [K+]e. Ion-sensitive microelectrodes were used to measure [K+]e in parietal cortex continuously over a 6-h period in anesthetized rats. After i.v. sodium acetate infusion in eight control rats, plasma ammonia concentration was 33 +/- 26 mumol/L (+/- SD) and [K+]e remained stable at 4.3 +/- 1.6 mmol/L. During ammonium acetate infusion in nine rats, plasma ammonia increased to 594 +/- 124 mumol/L at 2 h and to 628 +/- 135 mumol/L at 6 h. There was a gradual increase in [K+]e from 3.9 +/- 0.7 to 6.8 +/- 2.7 mmol/L at 2 h and 11.8 +/- 6.7 mmol/L at 6 h. In eight rats, L-methionine-D,L-sulfoximine (150 mg/kg) was infused 3 h before ammonium acetate infusion to inhibit glutamine synthetase. At 2 and 6 h of ammonium acetate infusion, plasma ammonia concentration was 727 +/- 228 and 845 +/- 326 mumol/L, and [K+]e was 4.5 +/- 1.9 and 6.1 +/- 3.8 mmol/L, respectively. The [K+]e value at 6 h was significantly less than that obtained with ammonium acetate infusion alone but was not different from that obtained with sodium acetate infusion. We conclude that acute hyperammonemia impairs astrocytic control of [K+]e and that this impairment is linked to glutamine accumulation rather than ammonium ions per se.
高氨血症会导致谷氨酰胺蓄积和星形胶质细胞肿胀。抑制谷氨酰胺合成可减少氨诱导的水肿形成以及星形胶质细胞突起的水样肿胀。通常情况下,星形胶质细胞会严格控制细胞外钾离子活性[K⁺]e。我们检验了这样一个假说,即急性高氨血症会干扰这种严格调控,从而使[K⁺]e升高,并且抑制谷氨酰胺合成酶可减少[K⁺]e的这种升高。在麻醉大鼠中,使用离子敏感微电极在6小时内连续测量顶叶皮质中的[K⁺]e。八只对照大鼠静脉注射醋酸钠后,血浆氨浓度为33±26μmol/L(±标准差),[K⁺]e稳定在4.3±1.6mmol/L。在九只大鼠输注醋酸铵期间,血浆氨在2小时时升至594±124μmol/L,在6小时时升至628±135μmol/L。[K⁺]e从3.9±0.7mmol/L在2小时时逐渐升至6.8±2.7mmol/L,在6小时时升至11.8±6.7mmol/L。在八只大鼠中,在输注醋酸铵前3小时输注L-蛋氨酸-D,L-亚砜亚胺(150mg/kg)以抑制谷氨酰胺合成酶。在输注醋酸铵的2小时和6小时时,血浆氨浓度分别为727±228和845±326μmol/L,[K⁺]e分别为4.5±1.9和6.1±3.8mmol/L。6小时时的[K⁺]e值显著低于单独输注醋酸铵时的值,但与输注醋酸钠时的值无差异。我们得出结论,急性高氨血症会损害星形胶质细胞对[K⁺]e的控制,并且这种损害与谷氨酰胺蓄积有关,而非与铵离子本身有关。