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PubMed1992

Metabolic fate of hypoxanthine and inosine in cultured cardiomyocytes.

The metabolic fate of labeled hypoxanthine and inosine, degradation products of adenine nucleotides, was studied in cultured beating cardiomyocytes, in order to assess the physiological significance of their contribution to salvage nucleotide synthesis in the heart. Inosine and hypoxanthine were found to be incorporated into nucleotides by a similar rate, but in the presence of 8-aminoguanosine, a potent inhibitor of purine nucleoside phosphorylase (EC 2.4.2.1), the rate of inosine incorporation into nucleotides was markedly reduced (by 75%), indicating that inosine incorporation to IMP (inosinic acid) occurs following its degradation to hypoxanthine. The proportion of hypoxanthine converted to IMP by hypoxanthine-guanine phosphoribosyltransferase (EC 2.4.2.8) is markedly greater than that degraded to xanthine and uric acid by xanthine oxidase (EC 1.3.2.3). However, close to 50% of the IMP formed was degraded to inosine by IMP 5'-nucleotidase (EC 3.1.3.5). The results demonstrate the activity of the following futile cycle in the cardiomyocytes: hypoxanthine----IMP----inosine----hypoxanthine. The rational for the activity of this energy consuming cycle is yet unclear.

Cells, Cultured↗

PubMed1988

The effect of inosine on the post ischemic heart as bio-energy recovering factor in 31P-MRS.

Perfused guinea-pig hearts, which were analyzed by 31P-MRS, were subjected to 30 and 60 minute ischemia and reperfused using two perfusates, one containing 200 microM inosine, and the other without inosine. After 4 hour reperfusion with inosine, ATP levels increased to 95.5% of preischemic value (30 minute ischemia) and 76.2% (60 minute ischemia). However, after 4 hour reperfusion without inosine, ATP levels increased only to 72.2% (30 minute ischemia) and to 48.2% (60 minute ischemia). In 60 minute ischemic hearts reperfused with inosine, left ventricular maximal positive dp/dt (LV dp/dt) was improved significantly to 82.4% after 6 hour reperfusion in contrast to hearts reperfused without inosine (43.1%). Administration of inosine was very useful for increasing myocardial gross energy product and improving cardiac performance.

Adenosine Triphosphate↗

PubMedDate not supplied

Characterization of N1- and N6-adenosine adducts and N1-inosine adducts formed by the reaction of butadiene monoxide with adenosine: evidence for the N1-adenosine adducts as major initial products.

1,3-Butadiene is a known human mutagen and possible human carcinogen; however, the molecular mechanisms of its activity are poorly understood. We have previously shown that the primary metabolite, butadiene monoxide (BM), reacts with guanosine to form N1-, N2-, and N7-guanosine adducts. In this study we characterize the reaction of BM with adenosine; ten adducts identified as diastereomeric pairs of N1-(1-hydroxy-3-buten-2-yl)adenosine,N1-(2-hydroxy-3-buten-1 -yl)adenosine, N6-(1-hydroxy-3-buten-2-yl)adenosine,N6-(2-hydroxy-3-buten-+ ++1yl)adenosine, and N1-(1-hydroxy-3-buten-2-yl)inosine are characterized. The N6-adenosine and N1-inosine adducts were characterized by their UV spectra, 1H NMR, FAB/MS, and stability studies. The N6-adenosine and N1-inosine adducts were stable for up to 168 h at 37 degrees C in phosphate buffer (pH 7.4). The N1-adenosine adducts, which were unstable at pH 7.4 at 37 degrees C (half-life of 7 and 9.5 h for the two regioisomers), were characterized by their UV spectra and their ability to undergo the Dimroth rearrangement to yield the corresponding N6-adenosine adducts, or undergo deamination to yield the corresponding N1-inosine adducts. Upon the reaction of BM with adenosine in phosphate buffer (pH 7.4) at 37 degrees C, the N1-adenosine adducts were the first to be detected, with the N6-adenosine and N1-inosine adducts. showing a lag in formation possibly due to the time needed for rearrangement/deamination. Reaction of adenosine with an excess of BM in phosphate buffer (pH 7.4) at 37 degrees C, followed by extraction of the reaction mixture with ethyl ether to remove excess unreacted BM and incubation at 80 degrees C for 1 h, resulted in complete conversion of N1-adenosine adducts to the corresponding N6-adenosine and N1-inosine adducts. Under these conditions, adduct formation exhibited pseudo-first-order kinetics, with the combined N6-adenosine adducts being formed 3-fold more favorably than the combined N1-inosine adducts. When incubations were carried out at lower BM concentrations, the N6-adenosine adducts remained the major detectable adducts at all concentrations. These results show that adenosine, in addition to guanosine, can lead to multiple adducts when incubated with BM, and may be useful in development of biomarkers for exposure to 1,3-butadiene. Characterization of the N1-adenosine adducts and their rearrangement/deamination products may also contribute to the understanding of mutagenic and carcinogenic mechanisms of 1,3-butadiene.

Adenosine↗

PubMedDate not supplied

Blood storage XXIII: 2,3-DPG maintenance for six weeks in a CPD-adenine-inosine preservative with and without methylene blue.

In a pilot study the optimal concentration of inosine for 2,3-DPG maintenance in a CPD-adenine (0.25 mM) preservative was confirmed to be at lease 10 mM. In these experiments, 2,3-DPG maintenance was nearly normal for six weeks of storage in CPD-adenine-inosine (10 mM) preservative with or without methylene blue. The control preservative lacking inosine showed a statistically significant decrease in 2,3-DPG concentrations after the 3rd week. Finally, 2,3-DPG levels were significantly better maintained in CPD-adenine preservatives that contained 15 mM concentrations of inosine, whether methylene blue was present or not (10(-6)M), compared to CPD-adenine-inosine preservatives that contained 5 mM inosine, with or without methylene blue. The methylene blue effect, while it can be demonstrated in most experiments to help the red blood cell maintain 2,3-DPG during prolonged blood storage, is judges to be a slight value. However, inosine is of great value in maintaining 2,3-DPG for prolonged (five to six weeks) liquid storage.

Adenine↗

PubMed1987

Myocardial and circulatory effects of inosine.

The action of inosine (2.5, 5, or 10 mg.kg-1.min-1 iv) was investigated in open chest rats (n = 46) and guinea pigs (n = 16). Left ventricular and aortic pressures, dP/dtmax, and stroke volume were measured. Additionally, isovolumic peak pressure and peak dP/dtmax were measured during short occlusions of the aorta for assessing myocardial performance independent of circulatory changes. In rats inosine caused a dose dependent decrease in dP/dtmax (-5%, -21%, -40% of preinfusion values), heart rate (-7%, -23%, -55%), and mean aortic pressure. Additionally, a subgroup of seven rats was paced at their initial preinfusion heart rate, but independently from the heart rate there was a reduction in dP/dtmax (-15%). The isovolumic measurements confirmed the negative inotropic effect of inosine in rats. Peak dP/dtmax was reduced to 85% of preinfusion values with a dose of 2.5 mg.kg-1 min-1 (to 70% of preinfusion values with 10 mg.kg-1.min-1). Similarly, the maximum isovolumic pressure for a defined filling volume was decreased by 30 mmHg (at 350 microliter; 5 mg.kg-1.min-1; p less than 0.05). The mean aortic pressure decreased with 2.5 mg.kg-1.min-1 inosine indicating vasodilative properties. In contrast to the significant effects in rats even 10 mg.kg-1.min-1 inosine did not have an effect on heart rate, mean aortic pressure, or dP/dtmax in guinea pigs. The isovolumic peak left ventricular pressure in guinea pigs was also unchanged after inosine infusion. Thus the haemodynamic effects of inosine were species dependent.

Animals↗

PubMed1990

Hemodynamic effects of inosine in combination with positive and negative inotropic drugs: studies on rats in vivo.

Inosine applied as a continuous i.v. infusion of 400 mg/kg/h for 20 min had a negative chronotropic and inotropic effect in closed-chest, anesthetized rats. In the presence of adenosine deaminase (ADA, 133 U/kg/h), the reduction in heart rate was abolished indicating that adenosine is responsible for that effect. However, the negative inotropic effect persisted. It was characterized by a 38 and 56% decrease in left ventricular systolic pressure (LVSP) and diastolic aortic pressure, respectively, a 24% decline in LV dp/dtmax and a 16% fall in cardiac output. Total peripheral resistance was diminished by 38%. Inosine in combination with ADA antagonized the noradrenaline-induced positive inotropic effect and the increase in cardiac output. On the other hand, i.v. bolus injection of noradrenaline in rats pretreated with inosine and ADA did not increase blood pressure and total peripheral resistance. Inosine administered in animals pretreated with the beta-receptor blocker metoprolol or with the calcium antagonist verapamil aggravated the negative inotropic effect. Inosine in combination with ADA caused a decline in cardiac output in metoprolol-pretreated rats that was more pronounced than that induced by inosine alone. However, in rats pretreated with verapamil, inosine did not cause a reduction in cardiac output.

Adenosine Deaminase↗

PubMed1976

Germination of unactivated spores of Bacillus cereus T. Effect of preincubation with L-alanine or inosine on the subsequent germination.

Heat-activated spores of Bacillus cereus T germinate rapidly in the presence of L-alanine alone or inosine alone. In contrast, unactivated spores can not germinate in the presence of either germinant alone but rapidly in the presence of both germinants. The highest level of cooperative action of L-alanine and inosine on the germination was observed when they were present in a ratio 1:1. Preincubations of unactivated spores with L-alanine or inosine had opposite effects on the subsequent germination in the presence of both germinants: preincubation with L-alanine stimulated the initiation of subsequent germination, while preincubation with inosine inhibited it. These results suggest that germination of unactivated spores initiated by L-alanine and inosine includes two steps, the first initiated by L-alanine and the second prompted by inosine. The effect of preincubation of unactivated spores with L-alanine was not diminished by washings. The pH dependence of the preincubation of unactivated spores was not so marked as that of the subsequent germination in the presence of inosine.

Alanine↗

PubMed1979

The protective action of inosine on isolated arteries in hypoxia.

1 The pressor responses to injected noradrenaline (NA) of isolated perfused femoral or renal arteries of the rabbit were studied.2 Vascular smooth muscle is relatively resistant to hypoxia. A combination of hypoxia and dinitrophenol (DNP) respiratory uncoupling was necessary to abolish the pressor response to NA. Loss of the pressor response was assumed to result from decreased capacity of arteries to form adenosine 5'-triphosphate (ATP). Reperfusion of the hypoxic arteries with oxygenated medium resulted in recovery of the pressor response to NA.3 Inclusion of inosine (10 mM) in the hypoxic perfusion medium increased significantly the rate and extent of post-hypoxic recovery of the pressor response to NA.4 Whereas the presence of inosine in the hypoxic perfusion medium aided post-hypoxic recovery, inosine had no direct action on the pressor dose response to NA. Therefore, the action of inosine was protective as opposed to direct.5 The protective action of inosine did not involve potentiation of NA binding to NA-adrenoceptor sites (the equilibrium coefficient, K(eq) for NA-receptor interaction was unaltered by hypoxia and/or inosine).6 The results are discussed in terms of a presumptive mechanism whereby inosine is believed to act by maintaining intracellular adenine nucleotide concentrations in hypoxia.

Adenine Nucleotides↗

PubMed1995

Cloning of a guanosine-inosine kinase gene of Escherichia coli and characterization of the purified gene product.

We attempted to clone an inosine kinase gene of Escherichia coli. A mutant strain which grows slowly with inosine as the sole purine source was used as a host for cloning. A cloned 2.8-kbp DNA fragment can accelerate the growth of the mutant with inosine. The fragment was sequenced, and one protein of 434 amino acids long was found. This protein was overexpressed. The overexpressed protein was purified and characterized. The enzyme had both inosine and guanosine kinase activity. The Vmaxs for guanosine and inosine were 2.9 and 4.9 mumol/min/mg of protein, respectively. The Kms for guanosine and inosine were 6.1 microM and 2.1 mM, respectively. This enzyme accepted ATP and dATP as a phosphate donor but not p-nitrophenyl phosphate. These results show clearly that this enzyme is not a phosphotransferase but a guanosine kinase having low (Vmax/Km) activity with inosine. The sequence of the gene we have cloned is almost identical to that of the gsk gene (K.W. Harlow, P. Nygaard, and B. Hove-Jensen, J. Bacteriol. 177:2236-2240, 1995).

Amino Acid Sequence↗

PubMed1985

Adenine nucleotide synthesis from inosine during normoxia and after ischaemia in the isolated perfused rat heart.

[14C]inosine in a range of concentrations of 20 microM to 1 mM was administered to the isolated perfused rat heart for 30 min. The incorporation of the nucleoside into myocardial adenine nucleotides increased for extracellular concentrations of the precursor up to 50 microM, reaching a plateau at 60 nmol . g-1 X 30 min-1 with concentrations ranging between 50 and 200 microM. The supply of 500 microM and 1 mM of inosine induced a further increase in cardiac adenine nucleotide synthesis to about 200 nmol . g-1 X 30 min-1. When supplied during low flow ischaemia (0.5 mL . min-1, 30 min.), 1 mM of inosine protected the heart against ATP degradation, while 100 microM of inosine was inefficacious. In the presence of 1 mM of inosine on reperfusion the adenine nucleotide content of the heart was similar to that observed in the absence of the nucleoside. The incorporation of [14C]inosine into adenine nucleotides was, in this last condition, below the value measured before ischaemia. Inosine administration was effective in protecting the heart against ischaemic breakdown of glycogen and favoured postischaemic restoration of glycogen stores.

Adenine Nucleotides↗

PubMed1980

Inosine: alternative or adjunct to regional hypothermia in the prevention of post-ischemic renal failure?

Inosine administered into the renal artery improves renal ischemic tolerance. The study was designed to establish the limitations of this measure by comparing its effectiveness with that of regional hypothermia and to test the possibility of combining inosine and hypothermia in prolonged renal hypothermia. In uninephrectomized dogs, the remaining kidney was subjected to 2 h of ischemia under inosine protection; perfusion cooling, or no protection (experiment A), or to 90 min of warm ischemia plus inosine plus 90 min of cold ischemia; 90 min of warm plus 90 min of cold ischemia, or 180 min of cold ischemia (experiment B). Whereas perfusion cooling reliably prevented permanent loss of renal function even after 180 min of ischemia, inosine was clearly inadequate for protection against warm ischemia exceeding 90 min, but effective in shorter periods of ischemia with some unreliability in borderline cases. Inosine protection can be combined with hypothermia in a sequential manner if extended ischemia becomes necessary unexpectedly. For clinical use, however, it seems safer to commence with hypothermia after 60 min of inosine-protected warm ischemia. Simultaneous balloon occlusion of the renal artery and transcatheter perfusion cooling facilitates the clinical applicability of these results.

Acute Kidney Injury↗

PubMed2004

Neuroprotective effect of inosine on axotomized retinal ganglion cells in adult rats.

PURPOSE: To explore the potential survival-promoting effect of inosine on axotomized retinal ganglion cells (RGCs) of adult rats in vivo. METHODS: The left optic nerves (ON) in the subject rats were transected at 1.5 mm from the optic disc. Repeated intraperitoneal injections or single intraocular injection of inosine were administered. The RGCs were retrogradely labeled with a gold fluorescent dye and the density of surviving RGCs in number per square millimeter of retina was calculated in wholemounted retinas. The functional integrity of the blood-retinal barrier (BRB) after ON transection was evaluated with an intravenous injection of Evans blue. RESULTS: In control animals, the mean density of surviving RGCs (number per square millimeter) of the whole retina was 2007 +/- 68 at 2 days (taken as the normal value), 927 +/- 156 at 7 days, and 384 +/- 33 at 14 days after surgery. Repeated intraperitoneal injections (75 mg/kg for each injection) of inosine significantly enhanced RGC survival at 14 days after ON transection (500 +/- 38), whereas no significant difference in the densities was detected at 7 days (974 +/- 101), even when the dosage of inosine was doubled (1039 +/- 61). At this time point, however, a single intraocular injection of inosine significantly increased the density of surviving RGCs (1184 +/- 156). Moreover, more RGCs around the optic disc were rescued when inosine, administered either intraperitoneally or intraocularly, showed a beneficial effect on RGC survival. No breakdown of the BRB after ON transection was detected with the method used in the study. CONCLUSIONS: These findings demonstrate that inosine could protect axotomized RGCs in vivo after ON transection.

Animals↗

PubMed2006

Protective effects of inosine on mice subjected to lethal total-body ionizing irradiation.

Mammals can barely survive total-body ionizing irradiation greater than 10 Gy. To date, there are few drugs available for radioprotective therapy under such circumstances. Inosine, a natural derivative of adenosine, has been known to provide powerful protection for many kinds of cells and tissues against various insults both in vitro and in vivo. In the present study, we examined whether inosine was also beneficial for mammals subjected to an absolutely lethal total-body ionizing irradiation. Immediately after adult Balb/c mice were exposed to (60)Co gamma-rays at a single dose of 12 Gy, a moiety of them were administered daily with inosine or adenosine, either at doses of 375 or 750 micromol/kg up to death, and their body weight and survival time were recorded. Some irradiated mice were administered inosine or adenosine daily at doses of 750 micromol/kg and assessed for spatial memory abilities using the Morris water maze. The results demonstrated that, although inosine could not prevent body weight loss in irradiated mice, it was able to significantly prolong their survival time at doses of 750 micromol/kg. Moreover, inosine but not adenosine could suppress spatial memory deficit in irradiated mice. The data suggested that inosine had protective effects on mammals suffering from total-body ionizing irradiation at a single lethal dose.

Animals↗

PubMed1975

The potentiation of the activity of adenosine on coronary blood flow, blood pressure and heart rate by inosine in the dog.

The activity of adenosine and inosine on coronary blood flow and arterial blood pressure was investigated in anaesthetized and thoracotomized dogs. The following results were obtained. 1. Individual adenosine administration caused an increase in coronary blood flow. However, this adenosine activity was significantly strengthened when the same dose of adenosine was applied simultaneously with inosine in doses of 3.2, 5.6 and 10.0 mg/kg body weight i.v. The duration of the effect of adenosine on the coronary blood flow was also potentiated by inosine. 2. The hypotensive effect resulting from 0.2 mg adenosine/kg i.v. was significantly strengthened by simultaneous inosine application (3.2, 5.6 and 10.0 mg/kg i.v.). The activities on the blood pressure of increments in the individual adenosine dosages (0.2, 0.4 and 0.6 mg/kg i.v.) were significantly potentiated by 10 mg inosine/kg body weight i.v. 3. The heart rate was not modified by 0.2 mg adenosine/kg i.v. However, the same adenosine dosage plus inosine (3.2, 5.6 and 10.0 mg/kg i.v.) applied simultaneously led to bradycardia. Increasing adenosine doses (0.2, 0.4 and 0.6 mg/kg i.v.) applied simultaneously with inosine (10.0 mg/kg body weight i.v.) led to a dose dependent retardation of the heart rate. 4. The possible reasons for the potentiation of the effect of adenosine by inosine were discussed.

Adenosine↗

PubMed2005

Inosine improves islet xenograft survival in immunocompetent diabetic mice.

BACKGROUND: Inflammation is likely to be one of the factors responsible for early islet xenograft rejection. In this study, we have used a novel anti-inflammatory compound, inosine, to investigate the role of anti-inflammatory blockade in protecting rat pancreatic islets from xenograft rejection in diabetic balb/c mice. Inosine is a safe, naturally occurring purine, which appears to be nontoxic to humans, that has recently been shown to be an immunomodulator and anti-inflammatory agent. METHODS: For the transplantation model rat islets were placed under the renal capsule of streptozotocin diabetic balb/c mice and inosine -- (200 mg kg (-1) d (-1) or vehicle- treatment started the day of islet transplantation. RESULTS: In vehicle-treated mice rat islet xenografts were rejected within 2 - 11 days after transplantation. In contrast, in inosine-treated mice graft survival was markedly prolonged for up to 3 weeks. Furthermore, immunohistochemistry and morphometric analyses revealed that early islet graft infiltration by leukocytes (CD45(+)) is significantly reduced in the grafts from inosine-treated diabetic mice compared to vehicle-treated mice. As suggested from the graft survival data, inosine-treated mice had also a significantly better preserved beta-cell mass. CONCLUSIONS: These results clearly demonstrate that inosine treatment markedly reduced the early inflammatory reaction elicited by an islet xenograft and substantially prolongs the graft survival. Therefore, such an approach may form an important future component of therapeutic regimens applied in clinical islet xenotransplantation.

Animals↗

PubMed1976

Effects of uridine and inosine on glucose metabolism in skeletal muscle and activated lipolysis in adipose tissue.

In a first series of experiments, the effects of uridine and inosine on glucose metabolism in rat diaphragm muscle incubated in Krebs-bicarbonate buffer were studied. Uridine in concentrations of 10(-4) to 10(-6) M stimulated the uptake of glucose and increased the content of glycogen, but had no effect on the production of lactate. When diaphragm muscles were incubated in the buffer without glucose, uridine (10(-4)-10(-6) M) had no effects on the content of glycogen and on the production of lactate. On the other hand, inosine in concentrations of 10(-4) to 10(-6) M stimulated the uptake of glucose and the production of lactate, but had no effect on the content of glycogen in the muscle. In a second series of experiments, uridine (10(-4)-10(-5) M) and inosine (10(-4)-10(-7) M) inhibited the relase of glycerol from isolated rat epididymal adipose tissue in Krebs-bicarbonate buffer. Uridine and inosine in concentrations of 10(-4) M inhibited the epinephrine (10(-5) M)-, the norepinephrine (10(-5) M)- and the theophylline (10(-3) M)-stimulated lipolysis. Dibutyryl 3',5'-adenosine monophosphate-stimulated lipolysis was further activated in the presence of 10(-4) M uridine or inosine. Dose-response curves studies suggested that inosine, but not uridine, has a common receptor site with epinephrine in adipose tissue. These results demonstrated that both nucleosides stimulated the glucose uptake, but only uridine increased the synthesis of glycogen in the muscle. Both nucleosides also inhibited lipolysis in adipose tissue. The mechanism of antilipolytic action of these nucleosides is unknown, but one of the receptor sites for inosine might be adenylate cyclase.

Adipose Tissue↗

PubMed1986

Inosine increases anoxic tolerance and postischaemic restitution of the heart: experimental studies on possible mechanism(s) of action.

Various experimental models were utilized to determine the in vivo cardiac actions underlying the presumptive therapeutic benefit of the naturally occurring adenine nucleoside, inosine. 1. In pentobarbital-anaesthetized dogs coronary vasodilator responses to arterial hypoxia were augmented and postanoxic depression of cardiac contractile force was prevented by i.v. infusion of inosine (5 mg X kg-1 X min-1). 2. Thermographic observations demonstrated in the in situ dog heart a significant inosine-induced epicardial warming (coronary flow increase) which was resistant to P1-purinergic blockade (aminophylline). 3. Following total cardiopulmonary bypass and cardioplegic cardiac arrest of 90 min duration in the dog, inosine administration (5 mg X kg-1 X min-1) evoked a lasting increase in myocardial contractile force and cardiac output. 4. In Langendorff perfused guinea pig hearts subjected to normothermic ischaemia of 1 hour duration and treated with inosine (0.05 mg X min-1), the release of cytoplasmatic enzymes (CK-MB, alpha-HBDH) and myoglobin was significantly less than in untreated ischaemic controls. In the two latter series of experiments (3 and 4) the inosine action was contrasted by the deleterious effect of catecholamines (noradrenaline and isoproterenol) administered in moderate or small doses, respectively. It was concluded that inosine has cardioprotective actions partly related to and partly independent of its influence on coronary blood supply, suggesting that administration of the nucleoside may be useful in various surgical attempts directed to myocardial salvage.

Animals↗

PubMed1979

Myocardial release of inosine, hypoxanthine and lactate during pacing-induced angina in humans with coronary artery disease.

The applicability of the adenosine triphosphate (ATP) catabolites, inosine and hypoxanthine as markers of myocardial ischemia in humans with coronary artery disease has been investigated. Inosine and hypoxanthine were assayed enzymatically after separation by a new column chromatographic method. The myocardial lactate extraction at rest (17 +/- 13%) changed to production values (-23 +/- 28%) during pacing-induced angina (P less than 0.0005). Coronary venous inosine values increased from 535 +/- 185 nmol/l at rest to 1030 +/- 740 nmol/l during angina (P less than 0.005), the arterial values amounted to 770 +/- 325 nmol/l and 805 +/- 515 nmol/l respectively (P, NS). The calculated myocardial uptake of inosine at rest (27 +/- 16%) changed to production values (-25 +/- 29%) during angina (P less than 0.0005). Coronary venous hypoxanthine increased from 1000 +/- 760 nmol/l at rest to 1235 +/- 800 nmol/l during angina (P, NS), the arterial values amounted to 1300 +/- 1040 nmol/l and 1235 +/- 800 nmol/l respectively (P, NS). The myocardial extraction changed from 20 +/- 18% at rest to -5.4 +/- 29% during angina (P less than 0.0025). The significant positive correlation (r = 0.61, P less than 0.0025) between myocardial release and uptake of inosine and lactate during severe angina demonstrates that anaerobic glycolysis is accompanied by ATP breakdown. During a second pacing period at less increased pressure--rate product after nitroglycerin, lactate production (-1.7 +/- 22%) already occurred whereas extraction of inosine (19 +/- 19%) and hypoxanthine (24 +/- 15%) did not change. In conclusion, lactate functions as a sensitive marker of myocardial ischemia and inosine is useful in detecting ischemic myocardial energy deficiency by the indication of insufficient glycolytic ATP supply.

Adenosine Triphosphate↗