Capacity Of Urea Nitrogen Synthesis Research Articles

Potassium deficiency decreases the capacity for urea synthesis and markedly increases ammonia in rats.

Our study provides novel findings of experimental hypokalemia reducing urea cycle functionality and thereby severely increasing plasma ammonia. This is pathophysiologically interesting because plasma ammonia increases during hypokalemia by a hitherto unknown mechanism, which may be particular important in relation to the unexplained link between hypokalemia and hepatic encephalopathy. Potassium deficiency decreases gene expression, protein synthesis, and growth. The urea cycle maintains body nitrogen homeostasis including removal of toxic ammonia. Hyperammonemia is an obligatory trait of liver failure, increasing the risk for hepatic encephalopathy, and hypokalemia is reported to increase ammonia. We aimed to clarify the effects of experimental hypokalemia on the in vivo capacity of the urea cycle, on the genes of the enzymes involved, and on ammonia concentrations. Female Wistar rats were fed a potassium-free diet for 13 days. Half of the rats were then potassium repleted. Both groups were compared with pair- and free-fed controls. The following were measured: in vivo capacity of urea-nitrogen synthesis (CUNS); gene expression (mRNA) of urea cycle enzymes; plasma potassium, sodium, and ammonia; intracellular potassium, sodium, and magnesium in liver, kidney, and muscle tissues; and liver sodium/potassium pumps. Liver histology was assessed. The diet induced hypokalemia of 1.9 ± 0.4 mmol/L. Compared with pair-fed controls, the in vivo CUNS was reduced by 34% (P < 0.01), gene expression of argininosuccinate synthetase 1 (ASS1) was decreased by 33% (P < 0.05), and plasma ammonia concentrations were eightfold elevated (P < 0.001). Kidney and muscle tissue potassium contents were markedly decreased but unchanged in liver tissue. Protein expressions of liver sodium/potassium pumps were unchanged. Repletion of potassium reverted all the changes. Hypokalemia decreased the capacity for urea synthesis via gene effects. The intervention led to marked hyperammonemia, quantitatively explainable by the compromised urea cycle. Our findings motivate clinical studies of patients with liver disease.

P: 40 Potassium Deficiency Compromises Urea Synthesis and Markedly Increases Ammonia in Rats

BACKGROUND: Potassium deficiency decreases gene expression, synthesis of proteins, and growth in plants, bacteria, rodents and humans.1–4 The effect of hypokalemia on liver protein synthesis is scarcely described. Early studies have established an association between hypokalemia and development of hepatic encephalopathy in chronic liver disease.5,6 We investigated the effects of potassium deficiency on synthesis of liver proteins including urea cycle enzymes and the regulation of urea synthesis in rats. METHODS: Female Wistar rats were fed a K+-free diet for 13 days. Half of the rats were then repleted with K+ for one week following depletion. K+-depleted and -repleted rats were compared to free-fed and pair-fed controls. We examined the urea cycle enzyme mRNAs and proteins in liver tissue, the in vivo Capacity of Urea-Nitrogen Synthesis (CUNS) and plasma ammonia concentrations. Also, we measured hepatic albumin gene and protein expression, and potassium levels in plasma, liver, kidney and muscle tissues. RESULTS: The diet induced hypokalemia of 1.9 ± 0.4 mmol/L compared to pair-fed controls (3.6 ± 0.2 mmol/L). Muscle and kidney tissue potassium concentrations were decreased, but unchanged in liver tissue. Gene expression of albumin and two out of five urea cycle enzymes were moderately decreased, whereas protein expressions of albumin, the urea cycle enzymes, and glutamine synthetase were normal. However, CUNS was reduced by 33%. Plasma ammonia concentrations were eight-fold elevated to 235 (95% CI: 194–287) µmol/L compared to pair-fed controls 29 (95% CI: 26–32) µmol/L. Repletion of potassium normalized the changes. CONCLUSIONS: Hypokalemia markedly increased plasma ammonia concentrations. The capacity for urea synthesis was impaired, but only moderately so, and further studies are needed to fully explain the causes of hyperammonemia.

Experimental nonalcoholic steatohepatitis compromises ureagenesis, an essential hepatic metabolic function.

Nonalcoholic steatohepatitis (NASH) is increasing in prevalence, yet its consequences for liver function are unknown. We studied ureagenesis, an essential metabolic liver function of importance for whole body nitrogen homeostasis, in a rodent model of diet-induced NASH. Rats were fed a high-fat, high-cholesterol diet for 4 and 16 wk, resulting in early and advanced experimental NASH, respectively. We examined the urea cycle enzyme mRNAs in liver tissue, the hepatocyte urea cycle enzyme proteins, and the in vivo capacity of urea-nitrogen synthesis (CUNS). Early NASH decreased all of the urea cycle mRNAs to an average of 60% and the ornithine transcarbamylase protein to 10%, whereas the CUNS remained unchanged. Advanced NASH further decreased the carbamoyl phosphate synthetase protein to 63% and, in addition, decreased the CUNS by 20% [from 5.65 ± 0.23 to 4.58 ± 0.30 μmol × (min × 100 g)(-1); P = 0.01]. Early NASH compromised the genes and enzyme proteins involved in ureagenesis, whereas advanced NASH resulted in a functional reduction in the capacity for ureagenesis. The pattern of urea cycle perturbations suggests a prevailing mitochondrial impairment by NASH. The decrease in CUNS has consequences for the ability of the body to adjust to changes in the requirements for nitrogen homeostasis e.g., at stressful events. NASH, thus, in terms of metabolic consequences, is not an innocuous lesion, and the manifestations of the damage seem to be a continuum with increasing disease severity.

Unchanged capacity of urea synthesis during acute phase response in rats

The acute phase response presents a catabolic event related to increased waste of amino-N via hepatic urea synthesis despite an increased need for amino-N incorporation into acute phase proteins. In our previous studies, tumour necrosis factor-α (TNF-α) acutely up-regulated the in vivo capacity of urea-nitrogen synthesis (CUNS) in rats before the hepatic acute phase response was established. To extend these observations, this study aimed to clarify the regulation of N elimination via urea during the later stages of the acute phase response. Twenty-four hours after i.v. injection of 25 μg kg(-1) TNF-α or placebo, we determined the in vivo CUNS, hepatocyte urea cycle enzyme protein levels and mRNA levels of the urea cycle enzyme genes in pair-fed rats. In addition, serum acute phase proteins and their liver mRNA levels were measured. After TNF-α, CUNS and hepatocyte urea cycle enzyme protein expressions were unchanged while urea cycle enzyme mRNA levels decreased. Liver mRNA levels of α2MG, haptoglobin and α1AGP rose and their serum levels increased equally. Despite a fully established 24-h acute phase response, there was no change in the in vivo capacity for disposal of amino-N by urea synthesis or in the urea cycle enzyme proteins, although the expression of the urea cycle enzyme genes was decreased. Thus, in vivo urea synthesis was not orchestrated together with acute phase protein synthesis so as to limit N waste despite genetic regulation to this effect. This may contribute towards catabolism of inflammation.

Cirrhosis and endotoxin decrease urea synthesis in rats

In patients with cirrhosis, endotoxemia is frequent and the vitally important capacity for urea synthesis is impaired. The patients' mortality of infection is markedly increased, which could be related to adverse metabolic effects of endotoxins. The effects of endotoxins on in vivo urea synthesis and on urea cycle genes during cirrhosis are unknown. We examined the effects of a low dose of 0.5 mg/kg ip lipopolysaccharide (LPS) on the basal urea nitrogen synthesis rate (UNSR), the capacity of urea nitrogen synthesis (CUNS), liver tissue mRNA levels of urea cycle enzyme genes, and on the metabolic liver function measured by the galactose elimination capacity (GEC) in rats with cirrhosis induced by bile duct ligation and in control animals. LPS and cirrhosis + LPS decreased UNSR by 40% (P < 0.05). Cirrhosis and LPS each tended to decrease CUNS and cirrhosis + LPS decreased CUNS by 40% (P < 0.05). Cirrhosis and LPS each decreased the mRNA level of the gene for the flux-generating urea cycle enzyme carbamoyl phosphate synthetase (CPS) and the mRNA for the rate-limiting urea cycle enzyme arginine succinate synthetase (ASS) (P < 0.05). Cirrhosis + LPS left the mRNA level of CPS unchanged and decreased that of ASS (P < 0.05). The GEC did not differ among the study groups. Endotoxemia in rats with experimental cirrhosis markedly impaired the ability of the animals' livers to synthesize urea, suggesting a pathophysiological mechanism underlying the severe consequences of endotoxemia in human cirrhosis.

Opposite effects on regulation of urea synthesis by early and late uraemia in rats

Acute and chronic kidney failure lead to catabolism with loss of lean body mass. Up-regulation of hepatic urea synthesis may play a role for the loss of body nitrogen and for the level of uraemia. The aims were to investigate the effects of early and late experimental renal failure on the regulation of hepatic urea synthesis and the expression of urea cycle enzyme genes in the liver. We examined the in vivo capacity of urea nitrogen synthesis, mRNA levels of urea cycle enzyme genes, and N-balances 6 days and 21 days after 5/6th partial nephrectomy in rats, and compared these data with pair- and free-fed control animals. Compared with pair-fed animals, early uraemia halved the in vivo urea synthesis capacity and decreased urea gene expressions (P<0.05). In contrast, late uraemia up-regulated in vivo urea synthesis and expression of all urea genes (P<0.05), save that of the flux-generating enzyme carbamoyl phosphate synthetase. The N-balance in rats with early uraemia was markedly negative (P<0.05) and near zero in late uraemia. Early uraemia down-regulated urea synthesis, so hepatic ureagenesis was not in itself involved in the negative N-balance. In contrast, late uraemia up-regulated urea synthesis, which probably contributed towards the reduced N-balance of this condition. These time-dependent, opposite effects on the uraemia-induced regulation of urea synthesis in vivo were not related to food restriction and probably mostly reflected regulation on gene level.

Effect of lipopolysaccharide on in vivo and genetic regulation of rat urea synthesis

The acute phase response causes a negative nitrogen balance. It is unknown whether this involves regulation of hepatic urea synthesis. We examined the in vivo capacity of urea nitrogen synthesis (CUNS), mRNA levels of urea cycle enzyme genes and galactose elimination capacity (GEC) during moderate and severe acute phase response induced by low- and high-dose lipopolysaccharide (LPS) in rats. Low-dose LPS doubled CUNS (P<0.05), decreased the mRNA level of the rate-limiting urea cycle enzyme (arginino succinate synthetase (ASS) by 26% (P<0.05) and did not change GEC. High-dose LPS did not change CUNS, decreased the mRNA level of the flux-generating enzyme carbamoyl phosphate synthetase (CPS) by 11% (P<0.05) and the rate-limiting urea cycle enzyme (ASS) by 27% (P<0.05) and almost halved GEC (P<0.05). The moderate acute phase response up-regulated in vivo urea synthesis but had the opposite effect on gene level. The severe acute phase response decreased the functional liver mass that attenuated the increase in urea synthesis.

GH decreases hepatic amino acid degradation after small bowel resection in rats without enhancing bowel adaptation.

Growth hormone (GH) treatment in short bowel syndrome is controversial, and the mechanisms of a possible positive effect remain to be elucidated. Rats were randomly subjected to either an 80% jejunoileal resection or sham operation and were given either placebo (NaCl) or biosynthetic rat GH (brGH). The in vivo capacity of urea nitrogen synthesis (CUNS) and the expression of urea cycle enzymes were measured and related to changes in body weight and adaptive growth in ileal segments on days 7 and 14. Ileal segments were examined by unbiased stereological techniques. brGH treatment decreased CUNS among the resected rats by 19% (P<0.05) and 36% (P<0.05) on days 7 and 14, respectively. The mRNA levels of urea cycle enzyme genes were not influenced by brGH treatment. brGH treatment did not increase the adaptive growth in the ileal segments. In conclusion, we found that GH treatment decreased the accelerated postoperative hepatic amino acid degradation in experimental short bowel syndrome without enhancing the morphological intestinal adaptation.

Moderate hyperthyroidism reduces liver amino nitrogen conversion, muscle nitrogen contents and overall nitrogen balance in rats.

There are conflicting data on the effect of thyroid hormones on nitrogen metabolism. We determined the basal blood amino nitrogen (amino-N) concentrations, the urea nitrogen (urea-N) synthesis rate and the maximum hepatic capacity of urea nitrogen synthesis during saturating infusion of alanine, in moderately acutely (24 h) and chronically (7 days) hyperthyroid rats and compared this with changes in organ nitrogen contents in muscles and kidney, nitrogen excretion and nitrogen balance. Forty-three rats were made acutely hyperthyroid through administration of 5 microg 100 g(-1) triiodothyronine twice daily (T3: 2.2 +/- 0.7 vs. 0.87 +/- 0.04 nmol L(-1), P < 0.01). Fifty-one rats were made chronically hyperthyroid through administration of 12.5 microg 100 g(-1) thyroxine twice daily (T3: 2.63 +/- 0.18 vs. 0.87 +/- 0.04 nmol L(-1), P < 0.01). Weight gain was halved in this group. Both acute and chronic hyperthyroidism increased basal blood amino-N concentration in both groups by 16% (4.5 +/- 0.15 vs. 3.9 +/- 0.13 mmol L(-1) and 4.7 +/- 0.12 vs. 3.9 +/- 0.13 mmol L(-1), respectively, P < 0.01), and decreased basal urea-N synthesis rate in both groups by 30% [2.7 +/- 0.3 vs. 4.1 +/- 0.3 micromol (min x 100 g)(-1) and 3.1 +/- 0.3 vs. 4.1 +/- 0.3 micromol (min x 100g)(-1), respectively, P < 0.01]. The capacity of urea-N synthesis during saturation fell in both groups by 35% compared with controls [6.5 +/- 0.4 vs. 9.3 +/- 0.5 micromol (min x 100 g)(-1) and 5.7 +/- 0.5 vs. 9.3 +/- 0.6 micromol (min x 100g)(-1), respectively, P < 0.01]. Nitrogen contents in the muscles, soleus and extensor digitorum longus, of chronically hyperthyroid rats decreased by 22% and 11%, respectively, whereas kidney N-content increased by 12% (P < 0.05). N-balance and urinary urea-N excretion fell by 30%, whereas faeces-N excretion increased by 80% in hyperthyroid rats. Overall liver function assessed by galactose elimination capacity did not differ among groups. Both acute and chronic moderate hyperthyroidism increase blood amino-N and decrease basal and maximum rate of urea formation. Furthermore, chronic hyperthyroidism reduces N-contents of muscles, urinary urea-N excretion and N-balance. Thyroid hormones thus mobilize muscle-N, whereas amino-N in the liver is spared from irretrievable conversion into urea.

Xylitol normalizes the accelerated hepatic capacity for conversion of amino nitrogen to urea nitrogen in diabetic rats.

In diabetes, the capacity of urea nitrogen synthesis, ie, a substrate-independent measure of the hepatic conversion of amino nitrogen to urea nitrogen, is increased. Xylitol decreases urea synthesis in normal rats. Capacity of urea nitrogen synthesis and nitrogen balance were measured during intravenous alanine loading in control rats, rats with experimental diabetes (streptozocin 75 mg/kg), and rats with experimental diabetes infused with xylitol to 1 mmol/L. In control rats, capacity of urea nitrogen synthesis was 9.4 +/- 1.1 mumol/min per 100 g of body weight, and nitrogen balance -2.7 +/- 1.2 mumol/min per 100 g of body weight. In the diabetics, these values were markedly increased to 26.6 +/- 1.9 and -16.3 +/- 2.1 mumol/min per 100 g of body weight, respectively (p < 0.01). The infusion of xylitol normalized these values to 11.2 +/- 1.0 and -3.6 +/- 2.1 mumol/min per 100 g of body weight for capacity of urea nitrogen synthesis and nitrogen balance, respectively. Xylitol did not change glucagon or insulin. Xylitol improved the nitrogen economy of uncontrolled diabetic rats by decreasing urea synthesis. The mechanism is not settled, but it does not involve insulin or glucagon.

Blockade of glucocorticoid receptors prevents the increase in urea synthesis after hysterectomy in rats

The postoperative increase in hepatic conversion of amino nitrogen to urea nitrogen seems to be a primary cause of post-surgical catabolism. The importance of glucocorticosteroids for the spontaneous urea nitrogen synthesis rate (UNSR) and for the maximally amino acid-stimulated capacity of urea nitrogen synthesis (CUNS) was investigated 3 and 24 h postoperatively, respectively, in hysterectomized rats. Corticosteroid effects were neutralized by glucocorticoid receptor blockade by the pharmacological analogue RU486. Hysterectomy doubled UNSR from 3.16 +/- 0.20 to 6.12 +/- 0.27 mumol (per min per 100 g body weight) after 3 h (P less than 0.01) and increased CUNS by 40% from 7.47 +/- 0.30 to 10.29 +/- 0.41 mumol (per min per 100 g body weight) after 24 h (P less than 0.01). These changes were both normalized by the receptor blockade. Hysterectomy decreased total blood alpha-amino nitrogen concentration by 25% from 3.4 +/- 0.2 to 2.6 +/- 0.2 mmol l-1 (P less than 0.05) 3 h after surgery, which was normalized by glucocorticoid receptor blockade. Hysterectomized rats lost 10 +/- 1 g the first 24 h after surgery. The blockade reduced the weight loss to 6 +/- 1 g body weight (P less than 0.05) without changing food intake. The results indicate that glucocorticoid action plays a major role in the postoperative increase in hepatic amino nitrogen conversion.

Effect of Dietary Protein on the Capacity of Urea Synthesis in Rats

The in vivo capacity of urea nitrogen synthesis (CUNS) during alanine stimulation was measured within the blood amino acid concentration interval 7.3-11.6 mmol/l, where urea synthesis is at maximum and independent of substrate concentration. Three groups of rats were fed for 14 days, either a low protein diet (8%), a normal diet (17%), or a high protein diet (53%). Diet protein modified both CUNS and plasma glucagon concentration. CUNS was 5.86 +/- 2.93, 7.43 +/- 2.16, and 19.31 +/- 4.32 mumol/(min.100 g BW) (mean +/- SD, N = 6), respectively. The corresponding plasma glucagon concentrations after alanine stimulation were 222 +/- 400, 633 +/- 229, and 1700 +/- 627 ng/l, respectively. The in vivo kinetics of urea production is regulated by dietary protein, possibly via glucagon. This implies that the liver plays an active part in adaptation of whole body nitrogen homeostasis to dietary changes.

Strict insulin therapy normalises organ nitrogen contents and the capacity of urea nitrogen synthesis in experimental diabetes in rats

Rats with experimental diabetes due to streptozotocin (75 mg/kg body weight) and free access to food were divided into two groups. One group (n = 9) was optimally treated with insulin (glucosuria less than 4.0 mmol/24 h), using heat treated very long-acting ultralente insulin. The other group (n = 10) was poorly treated with insulin (glucosuria 20-30 mmol/24 h). The nitrogen balance and energy balance of optimally treated diabetic rats was positive and not different from the control group (n = 6). In the poorly treated diabetic rats the nitrogen balance was reduced whereas the energy balance was not different from that of control rats. After 4 weeks the fasting glucagon was: 50 +/- 21 ng/l (mean +/- SEM) in control rats, 62 +/- 18 ng/l in optimally treated diabetic rats and 249 +/- 58 ng/l in poorly treated diabetic rats (p less than 0.01). The capacity of urea nitrogen synthesis determined during alanine loading was: 9.6 +/- 1.0 mumol/(min 100 g body weight) in control rats, 10.6 +/- 1.7 mumol/(min 100 g body weight) in optimally treated diabetic rats and 17.3 +/- 1.3 mumol/(min 100 g body weight) in poorly treated diabetic rats (p less than 0.01). Nitrogen contents of carcass, heart, intestines, liver, and kidneys as determined by Kjeldahl analyses were identical in control rats and optimally treated diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of streptozotocin-induced diabetes and diet on nitrogen loss from organs and on the capacity of urea synthesis in rats.

Rats with experimental streptozotocin-induced diabetes (75 mg/kg) were divided into two groups. One group was free fed (n = 8), the other group (n = 7) pair fed to a group of control animals (n = 8). The nitrogen and energy balances of the control rats were positive. In the free-fed diabetic rats the nitrogen balance was neutral and the energy balance higher than in controls. In the pair-fed diabetic rats the nitrogen balance was negative and the energy balance reduced. After 4 weeks the capacity of urea-nitrogen synthesis was: 8.1 +/- 0.6 mumol/(min 100 g body weight) (mean +/- SEM) in controls and 22.2 +/- 2.2 mumol/(min 100 g body weight) in both groups of diabetic rats. Initially, the whole body nitrogen content was 453 +/- 9 mmol. Four weeks later it was 536 +/- 19 mmol in controls, 410 +/- 21 mmol in the free-fed diabetic rats, and 315 +/- 6 mmol in the pair-fed diabetic rats. The largest changes occurred in the muscles, initially containing 278 +/- 6 mmol, 4 weeks later 328 +/- 8 mmol, compared to 234 +/- 19 in the free-fed diabetic rats and 166 +/- 18 mmol in the pair-fed diabetic rats. In conclusion uncontrolled diabetes is characterised by loss of nitrogen from muscles and most other organs. The losses from some organs are preventable by increased food intake. Irrespective of food intake the hepatic dynamics of amino nitrogen conversion is changed in a way that favours protein catabolism.

Increased capacity of urea synthesis in streptozotocin diabetes in rats.

Diabetes was induced in Wistar rats by intravenous streptozotocin, 75 mg/kg. Four and 14 days after streptozotocin, fasting insulin decreased to about one-third, and fasting glucagon increased three-fold. The urea-N synthesis rate, stimulated by infusion of alanine, was measured at different amino acid concentrations 14 days after streptozotocin in 24 rats. The relationship was compatible with a barrier limited substrate inhibition kinetics. Data were examined accordingly by non-linear regression analysis. Among the estimated kinetic constants, only the 70% increase in Vmax was different from control values. In control rats the capacity of urea nitrogen synthesis, as measured within the amino acid concentration interval 7.3-11.6 mmol/l, was 10.2 +/- 1.1 mumol . (min 100 g BW)-1 (mean +/- SEM). The capacity was not different in 4 day diabetic rats, whereas it doubled in 14 day diabetic rats, 20.9 +/- 1.7 mumol (min 100 g BW)-1. The alanine elimination rate was 35% higher in the 14 day diabetic rats compared both to 4 day diabetic and control rats. The increase of urea synthesis is suggested to be due to enzyme induction by glucagon. The net nitrogen balance was negative at amino acid concentrations up to 25 mmol/l, indicating that the urea synthesis was increased at the expense of amino nitrogen.

A method for determination of the capacity of urea synthesis in the rat.

The relationship between total blood alpha-amino nitrogen concentration and urea synthesis rate was investigated with alanine as nitrogen source in 24 rats. Alanine was given as prime-continuous doses for 70 min so that constant amino acid concentration was attained between 5.5 and 34 mmol/l. Urea synthesis rate was assessed as accumulation in body water, corrected for intestinal hydrolysis. There was a positive correlation between nitrogen balance and alpha-amino nitrogen concentration. Urea synthesis rate in relation to amino acid concentration suggested barrier-limited substrate inhibition kinetics and data were examined accordingly by non-linear regression analysis. The estimated kinetic constants (mean +/- standard deviation) were: Vmax: 19.2 +/- 3.3 mumol (min X 100 g BW)-1, Km: 1.74 +/- 0.5 mmol/l, Ki: 6.84 +/- 1.9 mmol/l, and the barrier: 5.4 +/- 0.13 mmol/l. Because of the substrate inhibition, saturation cannot be attained, but the maximum synthesis rate, i.e. the capacity of urea nitrogen synthesis (CUNS), can be measured within 95% of the theoretical maximum in the concentration interval 7.3-11.6 mmol/l. CUNS was 9.16 +/- 0.81 mumol (min X 100 g BW)-1 (mean +/- standard deviation). Substrate-independent regulation of urea synthesis, e.g. by changes in liver mass or hormonal concentration, can be studied by this measure.

The capacity of UREA nitrogen synthesis in intact rats

The capacity of UREA nitrogen synthesis in intact rats