Role of the Liver in Regulation of Ketone Body Production during Sepsis.
Abstract
During caloric deprivation, the septic host may fail to develop ketonemia as an adaptation to starvation. Since the plasma ketone body concentration is a function of the ratio of hepatic production and peripheral utilization, a pneumococcal sepsis model was utilized in rats to measure the complex metabolic events that could account for this failure, including the effects of infection on lipolysis and esterification in adipose tissue, fatty acid transport in plasma and the rates of hepatic ketogenesis and whole body oxidation of ketones. Some of the studies were repeated using tularemia as the model infection. From these studies, it was concluded that during pneumococcal sepsis, the failure of rats to become ketonemic during caloric deprivation was the result of reduced ketogenic capacity of the liver and a possibly decreased hepatic supply of fatty acids. The latter appeared to be a secondary consequence of a severe reduction in circulating plasma albumin, the major transport protein for fatty acids, with no effect on the degree of saturation of the albumin with free fatty acids. Also, the infection had no significant effect on the rate of lipolysis or release of fatty acids from adipose tissue. Ketone body utilization (oxidation) was either unaffected or reduced during pneumococcal sepsis in rats. Thus, a reduced rate of ketone production in the infected host was primarily responsible for the failure to develop starvation ketonemia under these conditions. The liver of the infected rat host shuttled the fatty acids away from Beta-oxidation and ketongenesis and toward triglyceride production, with resulting hepatocellular fatty metamorphosis. (Author)
Document Details
- Document Type
- Technical Report
- Publication Date
- Nov 28, 1978
- Accession Number
- ADA062985
Entities
People
- Francis A. Beall
- Judith G. Pace
- Richard E. Dinterman
- Robert W. Wannemacher Jr.
- Vance J. Petrella
Organizations
- United States Army Medical Research Institute of Infectious Diseases