Direct administration and utilization of [1-13C]glucose by fetal brain and liver tissues under normal and ischemic conditions: 1H, 31P, and 13C NMR studies.

Three distinct, maternal-independent routes (e.g. intraamniotic, intraperitoneal and intracerebral), for [1-13C]glucose utilization by fetal brain and liver tissues, were examined by multinuclear magnetic resonance (NMR) spectroscopy before and after vascular occlusion of the maternal-fetal blood flow. Labeled lactate was the major glycolytic product by all routes, but in addition labeled TCA cycle products were also generated. Fractional 13C enrichment in both glucose and lactate were always higher in the ischemic state compared to controls using either one of the three routes studied. After intraperitoneal injection total glucose in the fetal brain was decreased by 85% after 20 min reperfusion following 20 min ischemia, but was elevated up to 170% after 60 min. [1-13C]glucose increased continuously by up to 370% after 60 min. Total glucose in the fetal liver remained unchanged while [1-13C]glucose increased up to 380%. Total lactate level in brain was 50-80% above the control apart from a transient increase (140%) notable after 40 min reperfusion. The kinetics of [3-13C]lactate followed a similar time course. At the same time when lactate was transiently increased in fetal brain, total lactate as well as 13C-labeled lactate showed a transient decrease in liver after 40 min. While the ways of mobilization of energy substrates for maintaining adequate metabolic activity in the fetal brain remain still unclear, the present 13C NMR studies suggest that both liver glucose and lactate can contribute to brain metabolism particularly under ischemic stress.