Abstract

BackgroundIt has been demonstrated that administration of exogenous ketone supplement ketone salt (KS) and ketone ester (KE) increased blood ketone level and delayed the onset of isoflurane-induced anesthesia in different rodent models, such as Wistar Albino Glaxo Rijswijk (WAG/Rij) rats. The modulatory effect of adenosinergic system may have a role in the ketone supplementation-evoked effects on isoflurane-generated anesthesia. Thus, we investigated whether adenosine receptor antagonists can modulate the effect of exogenous ketone supplements on the onset of akinesia induced by isoflurane.MethodsTo investigate the effect of exogenous ketone supplements on anesthetic induction we used ketone supplement KE, KS, KEKS (1:1 mix of KE and KS), KSMCT and KEMCT (1:1 mix of KS and KE with medium chain triglyceride/MCT oil, respectively) in WAG/Rij rats. Animals were fed with standard diet (SD), which was supplemented by oral gavage of different ketone supplements (2.5 g/kg/day) for 1 week. After 7 days, isoflurane (3%) was administered for 5 min and the time until onset of isoflurane-induced anesthesia (time until immobility; light phase of anesthesia: loss of consciousness without movement) was measured. Changes in levels of blood β-hydroxybutyrate (βHB), blood glucose and body weight of animals were also recorded. To investigate the putative effects of adenosine receptors on ketone supplements-evoked influence on isoflurane-induced anesthesia we used a specific adenosine A1 receptor antagonist DPCPX (intraperitoneally/i.p. 0.2 mg/kg) and a selective adenosine A2A receptor antagonist SCH 58261 (i.p. 0.5 mg/kg) alone as well as in combination with KEKS.ResultsSignificant increases were demonstrated in both blood βHB levels and the number of seconds required before isoflurane-induced anesthesia (immobility) after the final treatment by all exogenous ketone supplements. Moreover, this effect of exogenous ketone supplements positively correlated with blood βHB levels. It was also demonstrated that DPCPX completely abolished the effect of KEKS on isoflurane-induced anesthesia (time until immobility), but not SCH 58261.ConclusionsThese findings strengthen our previous suggestion that exogenous ketone supplements may modulate the isoflurane-induced onset of anesthesia (immobility), likely through A1Rs.

Highlights

  • It has been demonstrated that administration of exogenous ketone supplement ketone salt (KS) and ketone ester (KE) increased blood ketone level and delayed the onset of isoflurane-induced anesthesia in different rodent models, such as Wistar Albino Glaxo Rijswijk (WAG/Rij) rats

  • Effects of exogenous ketone supplements on blood βHB and glucose levels and body weight A significant increase in blood βHB levels was demonstrated after the final (7th) treatment by all exogenous ketone supplements (KE, KS, (mix of KS and medium chain triglyceride (MCT) oil) (KSMCT), KEKS and (mix of KE and MCT oil) (KEMCT); group 2–6), compared to both control (SD; p < 0.01 for KS; p < 0.001 for KSMCT; p < 0.0001 for KE, KEKS and KEMCT) and baseline (p < 0.001 for KS; p < 0.0001 for KE, KSMCT, KEKS and KEMCT) levels (Fig. 1a; Table 1)

  • Effect of exogenous ketone supplements on isofluraneinduced anesthesia: delay in the latency to onset of immobility Treatments by all exogenous ketone supplements (KE, KS, KSMCT, KEKS and KEMCT; group 2–6) caused a significant increase in the number of seconds required before anesthetic induction, compared to control

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Summary

Introduction

It has been demonstrated that administration of exogenous ketone supplement ketone salt (KS) and ketone ester (KE) increased blood ketone level and delayed the onset of isoflurane-induced anesthesia in different rodent models, such as Wistar Albino Glaxo Rijswijk (WAG/Rij) rats. We investigated whether adenosine receptor antagonists can modulate the effect of exogenous ketone supplements on the onset of akinesia induced by isoflurane. It has been demonstrated that exogenous ketone (ketogenic) supplements, such as ketone ester (KE), increase the level of ketone bodies (e.g., β-hydroxybutyrate/ βHB) [1,2,3,4,5], and maintain blood levels of ketone bodies in both animals and humans [2, 3, 6]. Exact mechanism(s) of action of exogenous ketone supplement-generated ketosis on CNS diseases and other pathophysiological and physiological processes are largely unknown

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