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C J Rebouche

Publications and source records attributed to C J Rebouche.

At least 37 records · Page 2Linked to original sources

Measurement of epsilon-N-trimethyllysine in human blood plasma and urine.

A method for measurement of epsilon-N-trimethyllysine in human blood plasma and urine is described. An internal standard, delta-N-trimethylornithine, was added to plasma and urine specimens and the mixtures were deproteinized and/or hydrolyzed. Preliminary purification of epsilon-N-trimethyllysine and delta-N-trimethylornithine was achieved by sequential cation-exchange--anion-exchange chromatography. Amino acids in the column eluates were derivatized with o-phthalaldehyde and mercaptoethanol, and were separated by isocratic reversed-phase high-performance liquid chromatography in the presence of an ion-pairing reagent. Quantitation was achieved by post-column fluorometry. The limit of detection was 5 pmol of epsilon-N-trimethyllysine injected into the chromatograph. The procedure was suitable for determination of epsilon-N-trimethyllysine in 1 ml of plasma or 0.2-0.4 ml of urine. The method was applied to measurements of epsilon-N-trimethyllysine in plasma and urine of four systemic carnitine deficiency patients and six normal subjects. Plasma epsilon-N-trimethyllysine concentration was significantly lower in systemic carnitine deficiency patients compared to normal individuals, but no significant difference in urinary epsilon-N-trimethyllysine excretion was observed between the two groups.

Amino Acids↗

Bioavailability of dietary urea nitrogen in the infant.

Because the human body has no enzymes capable of hydrolyzing urea, nitrogen from this source becomes bioavailable only by release of ammonia from urea by bacterial hydrolysis in the intestines, with subsequent absorption and utilization of ammonia. To explore extent to which urea ingested in milk becomes bioavailable, we fed di-15N-urea (both nitrogen atoms in the form of the stable isotope 15N) and determined urinary excretion of di-15N-urea (excreted without having become bioavailable) and mono-15N-urea (urea containing only one atom of 15N and therefore reflecting excretion of absorbed ammonia). The largest percentage of the ingested di-15N-urea was excreted promptly in the urine still in the form of di-15N-urea. We conclude that most of the urea ingested by a normal infant is not bioavailable.

Animals↗

Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants.

Nuclear magnetic resonance (NMR) spectroscopy was used to quantitate abundance of 2H in body water of human infants. This method provides precise measurement of total-body water without the extensive sample preparation requirements of previously described methods for determination of 2H content in body fluids. 2H2O (1 g/kg body weight) was administered to infants and saliva and urine were collected for up to 5 h. An internal standard was added directly to the fluid specimen and 2H enrichment in water was measured by NMR spectroscopy. Working range of deuterium abundance was 0.04-0.32 atom %. Coefficients of variation for saliva samples at 0.20 atom % 2H was 1.97%. 2H content in urine and saliva water reached a plateau by 4 h after administration, and amounts in the two fluids were virtually identical. Mean total-body water determination for six infants was 58.3 +/- 5.8% of body weight (range 53-66%).

Body Fluids↗

gamma-Butyrobetaine hydroxylase activity is not rate limiting for carnitine biosynthesis in the human infant.

Carnitine biosynthesis was assessed in human infants by measuring changes in plasma carnitine concentration and rates of urinary carnitine excretion after infants were fed carnitine-free formulas with and without added epsilon-N-trimethyl-L-lysine or gamma-butyrobetaine. This study was undertaken to test the hypothesis that carnitine biosynthesis in the human infant is regulated by substrate availability rather than activity of gamma-butyrobetaine hydroxylase, the final enzyme in the carnitine biosynthetic pathway. Ten infants were fed carnitine-free formula supplemented with either 500 microM epsilon-N-trimethyl-L-lysine or 500 microM gamma-butyrobetaine for 14 d. Plasma carnitine concentration and rate of urinary carnitine excretion were measured in infants before and after this period. Plasma carnitine concentration increased twofold when infants were fed either epsilon-N-trimethyl-L-lysine and increased threefold when infants were fed gamma-butyrobetaine. The rate of carnitine excretion doubled when infants were fed epsilon-N-trimethyl-L-lysine and increased 30-fold when infants were fed gamma-butyrobetaine. Absorption of epsilon-N-trimethyl-L-lysine was verified by demonstrating increased urinary excretion of epsilon-N-trimethyl-L-lysine in infants fed this substrate. We conclude that gamma-butyrobetaine hydroxylase activity is not rate limiting for carnitine biosynthesis in the human infant. Development of renal and hepatic gamma-butyrobetaine hydroxylase activity was determined in necropsy tissue from individuals of various ages. It was verified that gamma-butyrobetaine hydroxylase activity is developmentally regulated in the liver, but not in the kidney. The clinical relevance of this observation is diminished in view of the results of the in vivo studies of carnitine biosynthesis in infants.

Adolescent↗

epsilon-N-trimethyllysine availability regulates the rate of carnitine biosynthesis in the growing rat.

Rates of carnitine biosynthesis in mammals depend on the availability of substrates and the activity of enzymes subserving the pathway. This study was undertaken to test the hypothesis that the availability of epsilon-N-trimethyllysine is rate-limiting for synthesis of carnitine in the growing rat and to evaluate diet as a source of this precursor for carnitine biosynthesis. Rats apparently absorbed greater than 90% of a tracer dose of [methyl-3H]epsilon-N-trimethyllysine, and approximately 30% of that was incorporated into tissues as [3H]carnitine. Rats given oral supplements of epsilon-N-trimethyllysine (0.5-20 mg/d), but no dietary carnitine, excreted more carnitine than control animals receiving no dietary epsilon-N-trimethyllysine or carnitine. Rates of carnitine excretion increased in a dose-dependent manner. Tissue and serum levels of carnitine also increased with dietary epsilon-N-trimethyllysine supplementation. There was no evidence that the capacity for carnitine biosynthesis was saturated even at the highest level of oral epsilon-N-trimethyllysine supplementation. Common dietary proteins (casein, soy protein and wheat gluten) were found to be poor sources of epsilon-N-trimethyllysine for carnitine biosynthesis. The results of this study indicate that the availability of epsilon-N-trimethyllysine limits the rate of carnitine biosynthesis in the growing rat.

Administration, Oral↗

Carnitine metabolism and function in humans.

It is apparent from the foregoing discussion that carnitine plays an essential role in human intermediary metabolism. The question of a dietary requirement for carnitine, particularly for the human infant, is of significant theoretical and practical interest. Aberrant carnitine metabolism resulting from abnormal genetic or acquired conditions may have serious consequences for the affected individual. At present many of the treatment modalities for carnitine deficiency are empirical. Further clarification of the mechanisms by which carnitine depletion is manifest in these conditions is essential for designing treatment programs. Moreover, therapeutic use of carnitine in several human diseases not involving carnitine deficiency per se has been indicated. Before such treatment becomes generally accepted, we must determine precisely the role of this amino acid in the biochemical and physiological events that participate in the pathogenesis of each disease.

Absorption↗

L-Carnitine dissimilation in the gastrointestinal tract of the rat.

Results of previous studies in this laboratory and others have suggested that L-carnitine is degraded in the gastrointestinal tract of the rat, perhaps by the action of indigenous flora. L-[methyl-14C]Carnitine was administered to rats either orally or intravenously in doses of 86 nmol or 124 mumol, and expired air, 48-h urine and fecal collections, and selected tissues at 48 h after isotope administration were examined for radiolabeled carnitine and metabolites. Urine and feces of rats receiving oral L-[methyl-14C]carnitine consistently contained two radiolabeled metabolites which were identified as trimethylamine N-oxide (primarily in urine) and gamma-butyrobetaine (primarily in feces). In these rats, these metabolites accounted for up to 23% and 31% of the administered dose, respectively. By contrast, for rats receiving intravenous L-[methyl-14C]carnitine or germ-free rats receiving the isotope orally or intravenously, virtually all of the radioactivity recovered was in the form of carnitine. Analyses for 14CO2 and [14C]trimethylamine in expired air revealed little or no (less than 0.1% of dose) conversion to these compounds, regardless of size of dose or route of administration. Results of this study demonstrate conclusively that L-carnitine is degraded in the gastrointestinal tract of the rat and that indigenous flora are responsible for these transformations.

Animals↗

Carnitine metabolism and inborn errors.

Current knowledge of the metabolic role, biosynthesis, cellular uptake, excretion and turnover of carnitine is reviewed. The clinical spectrum and possible aetiology of the primary muscle and primary systemic carnitine deficiency syndromes are considered and the various genetic defects of intermediary metabolism which can give rise to secondary carnitine deficiency are indicated.

Carnitine↗

Sodium gradient-stimulated transport of L-carnitine into renal brush border membrane vesicles: kinetics, specificity, and regulation by dietary carnitine.

L-Carnitine transport by rat renal brush border membrane vesicles was stimulated by a Na+ gradient (extravesicular greater than intravesicular). Total carnitine entry was 2.7 and 3.2 times higher at 15 S in the presence of a 100 mM NaCl gradient than when the vesicles were incubated isoosmotically in buffered 100 mM KCl or buffered mannitol, respectively. Specific carnitine transport (total entry minus contribution from diffusion) was stimulated 3.6- and 5.7-fold, respectively. An "overshoot" was observed for total carnitine entry in the presence of a Na+ gradient but not in the presence of a K+ gradient or in the absence of an ion gradient. L-Carnitine transport was saturable. KT and Vmax for total carnitine transport were 0.11 mM and 11.6 pmol S-1 mg protein-1, respectively, and for Na+-gradient-dependent carnitine transport, 0.055 mM and 5.09 pmol S-1 mg protein-1, respectively. The transport process was structure-specific for a quaternary nitrogen and carboxyl groups attached by a 4- to 6-carbon chain, but without other charged functional groups. Other evidence for a carrier-mediated process included trans-stimulation of transport by intravesicular carnitine and a peak of activity at near physiological temperature. Kinetic data derived from this study, coupled with data from previous physiological studies from this laboratory, suggests that carnitine transport by the brush border membrane is not limiting for carnitine reabsorption. Dietary carnitine (1% of diet for 10 days) reduced by 52% the rate of carnitine transport across the brush border membrane in vitro, without affecting rates of D-glucose, L-lysine, L-glutamic acid, or L-alanine transport. Down-regulation of carnitine transport may prevent excessive or toxic accumulation of L-carnitine in renal tubular cells exposed to high extracellular carnitine concentrations.

Animals↗

Kinetic compartmental analysis of carnitine metabolism in the human carnitine deficiency syndromes. Evidence for alterations in tissue carnitine transport.

The human primary carnitine deficiency syndromes are potentially fatal disorders affecting children and adults. The molecular etiologies of these syndromes have not been determined. In this investigation, we considered the hypothesis that these syndromes result from defective transport of carnitine into tissues, particularly skeletal muscle. The problem was approached by mathematical modeling, by using the technique of kinetic compartmental analysis. A tracer dose of L-[methyl-3H]carnitine was administered intravenously to six normal subjects, one patient with primary muscle carnitine deficiency (MCD), and four patients with primary systemic carnitine deficiency (SCD). Specific radioactivity was followed in plasma for 28 d. A three-compartment model (extracellular fluid, muscle, and "other tissues") was adopted. Rate constants, fluxes, pool sizes, and turnover times were calculated. Results of these calculations indicated reduced transport of carnitine into muscle in both forms of primary carnitine deficiency. However, in SCD, the reduced rate of carnitine transport was attributed to reduced plasma carnitine concentration. In MCD, the results are consistent with an intrinsic defect in the transport process. Abnormal fluctuations of the plasma carnitine, but of a different form, occurred in MCD and SCD. The significance of these are unclear, but in SCD they suggest abnormal regulation of the muscle/plasma carnitine concentration gradient. In 8 of 11 subjects, carnitine excretion was less than dietary carnitine intake. Carnitine excretion rates calculated by kinetic compartmental analysis were higher than corresponding rates measured directly, indicating degradation of carnitine. However, we found no radioactive metabolites of L-[methyl-3H]carnitine in urine. These observations suggest that dietary carnitine was metabolized in the gastrointestinal tract.

Adult↗

Kinetic compartmental analysis of carnitine metabolism in the dog.

This study was undertaken to quantitate the dynamic parameters of carnitine metabolism in the dog. Six mongrel dogs were given intravenous injections of L-[methyl-3H]carnitine and the specific radioactivity of carnitine was followed in plasma and urine for 19-28 days. The data were analyzed by kinetic compartmental analysis. A three-compartment, open-system model [(a) extracellular fluid, (b) cardiac and skeletal muscle, (c) other tissues, particularly liver and kidney] was adopted and kinetic parameters (carnitine flux, pool sizes, kinetic constants) were derived. In four of six dogs the size of the muscle carnitine pool obtained by kinetic compartmental analysis agreed (+/- 5%) with estimates based on measurement of carnitine concentrations in different muscles. In three of six dogs carnitine excretion rates derived from kinetic compartmental analysis agreed (+/- 9%) with experimentally measured values, but in three dogs the rates by kinetic compartmental analysis were significantly higher than the corresponding rates measured directly. Appropriate chromatographic analyses revealed no radioactive metabolites in muscle or urine of any of the dogs. Turnover times for carnitine were (mean +/- SEM): 0.44 +/- 0.05 h for extracellular fluid, 232 +/- 22 h for muscle, and 7.9 +/- 1.1 h for other tissues. The estimated flux of carnitine in muscle was 210 pmol/min/g of tissue. Whole-body turnover time for carnitine was 62.9 +/- 5.6 days (mean +/- SEM). Estimated carnitine biosynthesis ranged from 2.9 to 28 mumol/kg body wt/day. Results of this study indicate that kinetic compartmental analysis may be applicable to study of human carnitine metabolism.

Animals↗

Effect of dietary carnitine isomers and gamma-butyrobetaine on L-carnitine biosynthesis and metabolism in the rat.

Oral supplementation with L-carnitine or DL-carnitine for treatment of primary and secondary carnitine deficiency syndromes is becoming increasingly popular, yet little is known about the systemic manifestations of oral intake of large doses of those compounds, particularly the D-isomer of carnitine. To determine the possible beneficial and/or toxic effects or oral carnitine isomers and the carnitine precursor, gamma-butyrobetaine, in the rat, groups of male, weanling rats were fed a carnitine-free diet (control) supplemented with various amounts of L-carnitine, D-carnitine, DL-carnitine or gamma-butyrobetaine for 32 days. Rats fed diets supplemented with L-carnitine (0.1-1.0%) had increased L-carnitine concentrations in serum and all tissues studied. Mean L-carnitine concentrations in serum and tissues (except liver) from rats fed equivalent amounts of L-carnitine, as the racemic mixture DL-carnitine, were greater than controls but were consistently lower than in rats fed L-carnitine alone. D-Carnitine (1% of diet) significantly reduced serum and heart L-carnitine concentrations from control levels, and the effects of gamma-butyrobetaine depended on the level of dietary supplementation. Dietary L-carnitine, D-carnitine and gamma-butyrobetaine (1%) reduced carnitine biosynthesis from epsilon-N-trimethyl-L-lysine in vivo. However, this decrease probably resulted from effects on transport of gamma-butyrobetaine into tissues, rather than on the biosynthetic pathway per se. Other than mild diarrhea with high levels of some supplements, no toxic effects of these compounds were observed under the conditions employed and within the time frame of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Carnitine metabolism and deficiency syndromes.

L-Carnitine is an essential cofactor in transfer of long-chain fatty acids across the inner mitochondrial membrane. L-Carnitine is present in living systems in free form and as short-chain and long-chain fatty acylcarnitine esters. In recent years, several clinical syndromes due to or associated with carnitine deficiency have been described. They include 2 primary types--systemic and muscle (or myopathic) carnitine deficiency--and at least 15 syndromes in which carnitine deficiency seems to be secondary to genetic defects of intermediary metabolism or to other conditions. Possible beneficial effects of exogenous carnitine in ischemic heart disease have been the focus of intensive research in recent years. Free carnitine and esterified carnitine are measured by a sensitive enzymatic-radiochemical method. In some cases, the diagnosis of carnitine deficiency can be made by assay of total (free plus esterified) carnitine in plasma or serum. Proper diagnosis, however, often depends on determination of total carnitine in skeletal muscle or liver (or both). Since the first clinical description of carnitine deficiency in 1973, considerable progress has been made in defining and classifying the carnitine deficiency syndromes. Recent efforts in basic and clinical research have provided important clues about the molecular causes of these syndromes.

Adolescent↗

Carnitine transport in cultured muscle cells and skin fibroblasts from patients with primary systemic carnitine deficiency.

L-Carnitine transport was studied in cultured muscle cells and skin fibroblasts of patients with primary systemic carnitine deficiency and control subjects. In both cell culture types, two systems for carnitine transport were identified. The kinetic parameters for carnitine transport were remarkably similar in cultured muscle cells and skin fibroblasts. Normal rates and kinetic properties of carnitine transport were observed for both cell lines from patients with systemic carnitine deficiency. These studies do not rule out a defect in carnitine transport in vivo.

Biological Transport, Active↗

Sites and regulation of carnitine biosynthesis in mammals.

Although the pathway of carnitine biosynthesis in mammals is known, the location of active synthesis of carnitine and regulation of the pathway have not been clearly defined. Studies in several laboratories have shown that the enzymes that collectively convert epsilon-N-trimethyllysine (epsilon-N-TML) to gamma-butyrobetaine are found in all tissues studied in rats and humans, but distribution of the final enzyme of the pathway, gamma-butyrobetaine, 2-oxoglutarate dioxygenase (gamma-butyrobetaine hydroxylase) is variable from one species to another. Evidence from studies in rats and humans indicates that uptake and metabolism of epsilon-N-TML by the kidney is necessary for carnitine biosynthesis from circulating epsilon-N-TML. Limited data now available suggest that some of the intracellularly derived epsilon-N-TML is metabolized to gamma-butyrobetaine and carnitine in the tissue of origin, and some is released into the circulation. epsilon-N-TML in mammals is apparently derived from lysine residues in proteins, which are methylated and later released by protein hydrolysis. This source probably provides sufficient substrate for carnitine biosynthesis. Carnitine biosynthesis from epsilon-N-TML is not regulated by end-product feedback mechanisms. Hepatic gamma-butyrobetaine hydroxylase activity in rats and humans is developmentally regulated, and is increased by dietary L-thyroxine in adult rats. No other mechanisms for regulation of carnitine biosynthesis have been identified.

Adult↗

Primary systemic carnitine deficiency: I. Carnitine biosynthesis.

[Methyl-3H]epsilon-N-trimethyl-L-lysine was administered to patients with primary systemic carnitine deficiency and to controls. In both groups, labeled carnitine appeared in blood and urine within 2 hours, and the specific radioactivity of urinary carnitine peaked between 2 and 6 hours. The specific radioactivity of serum carnitine peaked at 6 hours in the controls and in one patient, but in the other patient it rose sharply in the first 2 hours, fell slightly, and then gradually increased to a maximum at 48 hours. The 48-hour excretion of [methyl-3H]-L-carnitine was 4.4 to 6.0 muCi for the controls and 24.2 and 5.6 muCi for patients A and B, respectively. Eight other radioactive metabolites were found in urines of all subjects. Each metabolite was present in comparable amounts. Primary systemic carnitine deficiency in these patients did not result from defective biosynthesis or abnormal degradation of carnitine.

Adult↗