Detection of deep venous thrombosis by DMP 444, a platelet IIb/IIIa antagonist: a preliminary report.

BACKGROUND: We report a method for detection of deep venous thrombosis with a technetium 99m-labeled peptide (DMP 444). The N-methyl-arginine-glycine-aspartic acid sequence on DMP 444 binds the glycoprotein IIb/IIIa receptor on activated platelets (inhibition constant [IC50] for fibrinogen binding = 6 nmol/L). METHODS: DMP 444 (23 to 27 mCi) was injected into 11 patients with clinical suspicion of deep venous thrombosis, diagnostic confirmation by ultrasound, and a positive D-dimer test result. Planar images in the anterior and posterior projections were obtained at 10 to 40 minutes, 50 to 80 minutes, and 120 to 150 minutes after injection. RESULTS: No clinically significant adverse effects were noted after DMP 444 administration. One patient (excluded from the analysis) withdrew consent, so image acquisition was not complete. By 10 to 40 minutes after injection, 8 of 10 patients demonstrated an area of increased activity that was clearly related to the abnormality noted on ultrasound. Most patients were taking warfarin (Coumadin) and heparin (n = 8) or heparin (n = 1) and warfarin (n = 1) alone at the time of the imaging. The average time from onset of symptoms to injection of DMP 444 was 5 days (range 1 to 18 days). CONCLUSION: These preliminary human studies indicate that DMP 444 is safe and may be of value in the diagnosis of deep venous thrombosis.

Biodistribution of 99Tcm-labelled 5-thio-D-glucose.

We studied the biodistribution and tumour localization of 99Tcm-labelled-5-thio-D-glucose (99Tcm-TG). 5-Thio-D-glucose was labelled with 99Tcm by direct stannous ion reduction. The biodistribution of 99Tcm-TG was investigated in normal rabbits and in mice bearing experimental tumours. In rabbits, the plasma and clearance of 99Tcm-TG was 14.5 +/- 2.0 and 11.3 +/- 3.0 ml.min-1 respectively. Urinary excretion at 1 h was 53 +/- 5%. 99Tcm-TG was injected intravenously in mice bearing MC26 colon carcinoma and tissue samples were analysed by gamma scintillation counting at various times. Uptake of 99Tcm-TG in tumour at 1 and 3 h was 1.6 +/- 0.3% and 1.2 +/- 0.3%; the tumour to muscle ratios were 2.7:1 and 4:1 respectively. The autoradiographic biodistribution of 99Tcm-TG in MX-1 human breast xenografted nude mice showed more persistent tumour uptake of 99Tcm-TG than 14C-2-deoxyglucose (14C-DG). 99Tcm-TG accumulated in the centre of the tumours; 14C-DG was decreased in this central region probably because of zones of infarction on necrosis. The discordance between the tumour uptake of 99Tcm-TG and 14C-DG indicates that 99Tcm-TG does not act like a glucose analog, suggesting 99Tcm-TG avidity for zones of infarction or necrosis. The further study of 99Tcm-TG in tumours and ischaemic injury is warranted.

Targeting of glucose transport proteins for tumor imaging: is it feasible?

UNLABELLED: If glucose transport proteins (Glut) are elevated in tumors they may be good targets for tumor imaging. For targeting, the overexpression of Glut should be a general characteristic of tumors. Moreover agents which bind to Glut should accumulate selectively in tumors. METHODS: To test this, we quantitated Glut in isolated membranes from three human tumor xenografts, two murine tumor models and normal murine tissues using direct binding studies. Additionally, the biodistribution of two compounds which bind to Glut, 7-[[(2-(3-(125I-p-hydroxyphenyl)propionyl)aminoethyl)amino]carbonyl]-7-+ ++desacetyl-forskolin([125I]HPP forskolin) and [3H]cytochalasin B, were studied in a tumor model which overexpressed Glut. RESULTS: There were multiple classes of binding sites for [3H]cytochalasin B and a percentage of these sites were competitive with D-glucose but not L-glucose. The rank potency and IC50 values for [3H]cytochalasin B binding were: 2-deoxy-D-glucose (4.5 mM) > or = D-glucose (7 mM) > mannose (25 mM) > galactose (35 mM) > rhamnose (1-3 mM) > sorbitol (1-3 mM) and were similar to reported values for transport. The average density of Glut in four tumor models and normal tissues was between 0.7 and 4 pmole/mg protein, but Kd values were not significantly different (69 nM). In LX-1 human lung tumor xenograft (LX-1) Glut were 10-to-20-fold higher than other tissues (21.6 +/- 0.6 pmole/mg protein, p<0.01). Immunostaining of Glut-1 was more prominent in LX-1 than other xenograft tumors, consistent with the binding data. Glut density was highest in poorly vascularized regions suggesting that Glut upregulation was related to a biofeedback mediated event. Iodine-125 HPP-forskolin and [3H]cytochalasin B did not localize in LX-1 tumors. CONCLUSION: Glut overexpression was not a common characteristic of the five tumors tested. Iodine-125 HPP-forskolin and [3H]cytochalasin B did not localize in LX-1 tumors, indicating that these agents did not target tumors with upregulated Glut. Results suggest that Glut are not a promising target for tumor imaging.

The interaction among glucose transport, hexokinase, and glucose-6-phosphatase with respect to 3H-2-deoxyglucose retention in murine tumor models.

The development of new diagnostic/therapeutic modalities for cancer requires a specific understanding of how tumors differ from normal tissues. Though the key components involved in the selective accumulation of 2-deoxy-D-glucose (2-DG) analogs in tumors are known, the relative importance of each is controversial. For this reason glucose transport protein (GLUT) density, hexokinase/glucose-6-phosphatase (GP) activity, and 2-DG biodistribution were measured together in four tumor models and normal murine tissues. Direct binding studies with 3H-cytochalasin B showed that GLUT density was elevated 20-fold in LX-1 tumors. Immunohistochemically in all tumors, the expression of GLUT-1 was highest in the necrotic/ perinecrotic foci and similar in cells not adjacent to necrotic foci. As the retention of 3H-2-DG was similar in all tumors, these data suggest that the GLUT-1 in perinecrotic tumor cells were not rate limiting for 3H-2-DG uptake. Kidney, liver, and lung had high GP activity and rapid clearance of 3H-2-DG. Sodium orthovanadate (5 mumol), a GP inhibitor, increased the concentration of 3H-2-DG in these tissues, suggesting that GP is a rate-limiting enzyme for 3H-2-DG clearance. All tumor homogenates had low GP activity, and hexokinase activity was not elevated compared to normal tissues. Thus, in the tumors studied, the selective accumulation of 3H-2-DG consistently occurred in the absence of significant GP activity without the marked overexpression of hexokinase or GLUT.

Autoradiography and radioscintigraphy of technetium-99m-sestamibi in c-neu transgenic mice.

UNLABELLED: Intratumor distribution patterns of 99mTc-sestamibi and 14C-2-deoxy-D-glucose were compared in the c-neu OncoMouse, a transgenic mouse that spontaneously develops breast tumors. METHODS: Thirty or 60 min after intravenous injection of 5 muCi 14C-2-deoxy-D-glucose and 3 mCi 99mTc-sestamibi into mice (n = 3 per time point) bearing mammary tumors (0.3-1.5 cm), the animals were analyzed for organ and tumor distribution using dual-label, whole-body autoradiography. The retention patterns of the two compounds were related to tumor morphology and viability, based on H&E-stained adjacent sections. For imaging studies, the transgenic mice (n = 9) were anesthetized with pentobarbital, injected intravenously with 5-20 mCi 99mTc-sestamibi and imaged for 60 min using a gamma camera equipped with a 1-mm pinhole collimator. RESULTS: All positively stained tumors retained both agents, with a mean 99mTc-sestamibi tumor retention of 0.38% +/- 0.2% ID/g at 30 min compared to 4.18% +/- 0.62% ID/g for 14C-2-deoxy-D-glucose. Tumor retention of the agents remained the same at 60 min, and neither compound localized within necrotic or cystic regions of the neoplasms. Repeat imaging at 2-8-day intervals indicated a predicted sensitivity to detect a 30% difference in tumor retention of a test versus reference compound in preclinical screening. CONCLUSION: The c-neu OncoMouse is a useful model for in vivo imaging and provides a spontaneous tumor model for preclinical screening of breast tumor imaging agents.

Early scintigraphic detection of experimental myocardial infarction in dogs with technetium-99m-glucaric acid.

Recent data have generated some interest in technetium-99m-(99mTc) glucaric acid as an in vivo viability marker. We studied 99mTc-glucaric acid retention in canine models of myocardial ischemia (20-min occlusion of the LAD/40-min reperfusion), acute myocardial infarction (MI) (90-min LAD occlusion/3-hr reperfusion), and chronic MI (90-min occlusion and either 48-hr or 10-day reperfusion). Regional myocardial blood flow was measured by radiolabeled microspheres. No preferential uptake of glucaric acid was observed in ischemic but viable myocardium. The compound showed high affinity for necrotic myocardial tissue for several days following injury. The preferential uptake in infarcted tissue disappeared by 10 days following injury. This study shows that 99mTc-glucaric acid acts exclusively as a marker of necrosis in canine models of MI. Technetium-99m-glucaric acid may have clinical utility in early cardiac imaging of myocardial infarction and in differentiating recent from old injuries.

Regional cerebral blood flow and distribution of [99mTc]ethyl cysteinate dimer in nonhuman primates.

Increases in regional cerebral blood flow have been described in a variety of cerebral pathologic states, including stroke and seizure disorders. The usefulness of technetium-99m-labeled cysteinate dimer as a marker in the measurement of regional cerebral blood flow was tested in five cynomolgus monkeys. To expand the range of blood flow to beyond the normal limits, 40 mg/kg i.v. of the carbonic anhydrase inhibitor acetazolamide was administered. Regional cerebral blood flow in all five monkeys was measured using radiolabeled microspheres (before and after acetazolamide) and the marker (after acetazolamide) in 60-70 samples from 12 brain regions. Acetazolamide significantly increased the mean +/- SEM regional cerebral blood flow measured using microspheres from 0.56 +/- 0.21 to 1.71 +/- 0.9 ml/min/g (p less than 0.01 for each region). A significant positive correlation was found between regional cerebral blood flow values calculated using microspheres and the marker after normalizing the values to those in the cerebellum (r = 0.773, p less than 0.0001). The mean +/- SEM regional cerebral blood flow determined using the marker in a single monkey (1.21 +/- 0.04 ml/min/g) did not differ significantly from that determined in the same monkey using microspheres (1.13 +/- 0.04 ml/min/g). These data support the potential use of this new brain perfusion imaging agent to assess regional cerebral blood flow over a clinically relevant range of blood flows.

pH dependence of histidine affinity for blood-brain barrier carrier transport systems for neutral and cationic amino acids.

The effects of pH (3.5-7.5) on the brain uptake of histidine by the blood-brain barrier (BBB) carriers for neutral and cationic amino acids were tested, in competition with unlabeled histidine, arginine, or phenylalanine, with the single-pass carotid injection technique. Cationic amino acid ( [14C]arginine) uptake was increasingly inhibited by unlabeled histidine as the pH of the injection solution decreased. In contrast, the inhibitory effect of unlabeled histidine on neutral amino acid ( [14C]phenylalanine) uptake decreased with decreasing pH. Brain uptake indices with varying histidine concentrations indicated that the neutral form of histidine inhibited phenylalanine uptake whereas the cationic form competed with arginine uptake. Since phenylalanine decreased [14C]histidine uptake at all pH values whereas arginine did not, it was concluded that the cationic form of histidine had an affinity for the cationic carrier, but was not transported by it. We propose that the saturable entry of histidine into brain is, under normal physiological circumstances, mediated solely by the carrier for neutral amino acids.

Interlaboratory standardization of enzyme results: the Richmond project.

Three concentrations of proficiency monitoring material and two concentrations of secondary standard calibrating material were prepared and stored frozen. The materials were prepared in buffer containing amylase from human saliva, aspartate aminotransferase from human liver, creatine kinase from human muscle, human serum albumin (20 g/L), and cofactors. The proficiency monitoring material was assayed by 10 methods in nine laboratories for 15 days to establish baseline performance. Each laboratory then used the secondary standard calibrating material to calibrate their instruments' responses to that of a standardization method, and repeated the assay of the proficiency monitoring material for 15 days. For amylase before calibration, between-laboratory mean values for the three concentrations of proficiency monitoring material were 29% lower than the standardization method, and the between-laboratory CV was 28%. After calibration the mean amylase values were 4% lower and the CV was 6%. For aspartate aminotransferase, the pre-calibration between-laboratory mean values were 24% higher than the standardization method (CV 14%) but only 3% higher (CV 6%) after calibration. CK activity deteriorated at storage temperatures above -70 degrees C. This study demonstrates that, by using a common secondary standard, laboratories can improve calibration of enzyme results.

Two-day starvation does not alter the kinetics of blood--brain barrier transport and phosphorylation of glucose in rat brain.

The blood-brain barrier (BBB) transport and brain phosphorylation of glucose were assessed in conscious rats subjected to 2 days of starvation. Although plasma glucose decreased, no significant changes in brain blood flow, BBB glucose transport, or 2-deoxy-D-glucose phosphorylation were observed. The data suggest that adaptive changes of brain glucose metabolism previously observed in starvation are located beyond the initial steps of brain entry and phosphorylation.

In vitro estimation of the rate of hexose phosphorylation, by sequential pulsing with [3H]- and [14C]2-deoxy-D-glucose.

The rate of phosphorylation of 2-deoxy-D-glucose (2dGlc) was determined by incubating Schistosoma mansoni in vitro in [3H]2-deoxy-D-glucose; 60 sec after exposure to the [3H]dGlc, [14C]dGlc was added to the medium, and metabolic activity was arrested at 2 min by immersion of the tissue in ice-cold silicone oil. Column chromatographic separation of the neutral [3H]- and [14C]dGlc from the [3H]- and [14C]2-deoxy-D-glucose-6-phosphate permitted estimation of the quantity of [3H]dGlc phosphorylated in 2 min, and the proportion of [14C]dGlc phosphorylated in 1 min; thus a phosphorylation rate was determined from a single tissue sample. In male schistosomes derived from mouse infections 4.4 +/- 0.8% of the dGlc was phosphorylated each minute, and 4.2 +/- 0.9% in the females. Lower rates of phosphorylation were measured in schistosomes taken from hamsters where males phosphorylated 2.4 +/- 1.1% of the dGlc each minute, and in females 2.7 +/- 1.0%. These studies suggest the high rate of hexose utilization by schistosomes compares to the conscious rat brain, where 11% of the dGlc is phosphorylated each minute.

Relationship between urinary dopamine production and natriuresis after acute intravascular volume expansion with sodium chloride in dogs.

The role of renal production of dopamine in mediating the natriuretic response to acute vascular volume expansion was investigated. The effect of infusion of 0.9% saline (30 ml/kg X h) over 2 h on urine excretion of sodium and catecholamines, as well as other hemodynamic and renal function parameters, was examined in seven dogs during control and carbidopa (1 mg/kg every 8 h for 24 h before saline infusion) treatment periods. Acute vascular volume expansion with saline resulted in a rise (P less than 0.01) in the renal excretion of dopamine and a depression (P less than 0.01) in renal excretion of norepinephrine which paralleled the natriuretic response to saline infusion. Epinephrine excretion was not altered by saline infusion. Carbidopa treatment was not associated with changes in left ventricular filling pressure, arterial blood pressure, glomerular filtration rate, renal blood flow, renal excretion of norepinephrine or epinephrine. However, carbidopa eliminated the increase in renal production of dopamine and markedly attenuated the natriuretic response to saline infusion. Since carbidopa blocks tissue conversion of dopa to dopamine, it appears that renal production of dopamine is an important mechanism mediating the natriuretic response to acute volume expansion.

Rapid, transient drop in brain glucose after intravenous phloretin or 3-0-methyl-D-glucose.

Rats were injected intravenously with either phloretin (100 mg/kg) or 3-0-methyl glucose (2 g/kg) to reduce the carrier-mediated flux of glucose into brain. Plasma glucose and brain free glucose (BFG), lactate, and glycogen were measured over a 16 min time course. Injection of these substances caused a rapid drop in BFG to 60% of control at one minute and a minimum (50% of control values) at 4 min., followed by a gradual rise to control levels at 16 min. While plasma glucose fell, and then increased after injection, brain lactate and glycogen content was unaffected. Repeated injections of phloretin eventually caused a drop in brain glycogen; but with either competitor, BFG never fell below 50% of normal values. The i.v. injection of the glucose analog, 3-0-methyl glucose (the less toxic of the two drugs) is proposed as a possible means of cutting off the potentially hazardous supply of blood glucose to the postischemic brain.

Blood-brain barrier transport of basic amino acids is selectively inhibited at low pH.

The transport of amino acids across the blood-brain barrier was measured with the single-pass carotid injection method. The pH of the injected bolus varied between 4.5 and 8.5. Arginine and lysine uptakes were inhibited 24% at pH 5.5 and 59% at pH 4.5. The uptakes of 2-aminobicyclo (2,2,1) heptane-2-carboxylic acid and phenylalanine were unaffected at this pH. There were also no changes observed in choline, glucose, or butanol transport. The Ki of arginine transport inhibition by H+ was 2.4 +/- 0.5 microM; i.e., pH 5.6 +/- 0.1. No change with pH occurred in the Km of arginine transport, while a significant decrease (p less than 0.01) was observed in the Vmax (10.2 +/- 2.3 nmol min-1 g-1 and 5.6 +/- 2.3 nmol min-1 g-1 at pH 7.5 and pH 5.5, respectively). This noncompetitive inhibition was found to be transient as arginine uptake at pH 7.5; it was measured by carotid injection 30 sec following a previous bolus which was buffered to pH 4.5, and was not significantly different from the control. This selective inhibition of the blood-brain barrier basic amino acid carrier demonstrates the advantage of the carotid injection approach in exposing the capillary exchange site to extreme alterations in chemical composition which could not be tolerated systemically.

Kinetics of transport and phosphorylation of 2-fluoro-2-deoxy-D-glucose in rat brain.

UNLABELLED: The kinetics of transport across the blood-brain barrier and metabolism in brain (hemisphere) of [14C]2-fluoro-2-deoxy-D-glucose (FDG) were compared to that of [3H]2-deoxy-D-glucose (DG) and D-glucose in the pentobarbital-anesthetized adult rat. Saturation kinetics of transport were measured with the brain uptake index (BUI) method. The BUI for FDG was 54.3 +/- 5.6. Nonlinear regression analysis gave a Km of 6.9 +/- 1.2 mM and a Vmax of 1.70 +/- 0.32 mumol/min/g. The Ki for glucose inhibition of FDG transport was 10.7+/-44 mM. The kinetic constants of influx (k1) and efflux (k2) for FDG were calculated from the Km2, Vmax, and glucose concentrations of the hemisphere and plasma (2.3 +/- 0.2 mumol/g and 9.9 +/- 0.4 mM, respectively). The transport coefficient (k1 FDG/k1 glucose)was 1.67 +/- 0.07 and the phosphorylation constant was 0.55 +/- 0.16. The predicted lumped constant for FDG was 0.89, whereas the measured hexose utilization index for FDG was 0.85 +/- 0.16. CONCLUSION: The value for the lumped constant can be predicted on the basis of the known kinetic constants of FDG and glucose transport and metabolism, as well as brain and plasma glucose levels. Knowledge of the lumped constant is crucial in interpreting data obtained from 18FDG analysis of regional glucose utilization in human brain in pathological states. We propose that the lumped constant will rise to a maximum equal to the transport coefficient for FDG under conditions of transport limitation (hypoglycemia) or elevated glycolysis (ischemia, seizures), and will fall to a minimum equal to the phosphorylation coefficient during phosphorylation limitation (extreme hyperglycemia).

Measurement of cerebral glucose utilization using washout after carotid injection in the rat.

The carotid injection technique, used previously to quantitate the kinetics of blood-brain barrier transport of metabolic substrates, may be modified to analyze the rate of cerebral glucose utilization. A 0.2-ml solution of [14C]glucose (GF) and [3H]methylglucose (M), an internal reference, is rapidly injected into the carotid artery, followed by microwave fixation of brain at various times up to 4 min after injection. The brain radioactivity is separated into a fraction containing neutral hexoses (GF and M) and a fraction containing metabolites of glucose. The GF/M ratio is related to the rate constant (k3) of brain glucose utilization by the simple, linear equation: 1n(GF/M) = ln(GF0/0)--k3t, where GF0/M0 = the brain uptake index of glucose, relative to methylglucose, at 5--15 s after injection, and t = the time after carotid injection, e.g., 1--4 min. It is assumed that (a) the rate of influx due to recirculation of label is minimal during the 4-min circulation period; and (b) the rate constants of glucose efflux (k2) and methylglucose efflux (k2*) are identical. Independent estimates of k2 and k2* showed these parameters to be identical: k2 = 0.14 +/- 0.08 min-1; k2* = 0.14 +/- 0.02 min-1. A logarithmic plot of GF/M ratios versus time was linear (r = 0.99), and was described by the slope k3 = 0.21 +/- 0.02 min-1. Assuming glucose is uniformly distributed in brain, then the glycolytic rate = k3 x brain glucose = (0.21 min-1) (2.6 mumol g-1) = 0.55 mumol min-1 g-1 for the cortex of the barbiturate-anesthetized rat. These studies provide the basis for a simple method of measurement of regional brain glycolysis that does not require either the use of correction factors, e.g., the lumped constant, or the use of differentially labeled glucose.

Kinetics of regional blood-brain barrier transport and brain phosphorylation of glucose and 2-deoxyglucose the barbiturate-anesthetized rat.

Recent studies indicate the lumped constant (LC), which defines the relative rates of brain utilization of glucose and 2-deoxyglucose (2-DG), doubles to values greater than 1.0 under conditions of hypoglycemia. Since changes in the LC should be predictable given the kinetic parameters of blood-brain barrier (BBB) transport and brain phosphorylation of glucose and 2-DG, the present studies were designed to measure the necessary kinetic parameters. The carotid injection technique ws used to determine cerebral blood flow and the Km, Vmax, and KD of glucose and 2-DG transport through the BBB in seven brain regions in rats anesthetized with 50 mg/kg i.lp. pentobarbital. Regional glucose transport through the BBB was characterized by an average Km = 6.3 mM, average Vmax = 0.53 mumol min-1g-1, and average KD = 0.022 ml min-1g-1.l The nonsaturable route of transport of glucose represented on the average 40% of the total glucose influx into brain regions at an arterial glucose concentration of 10 mM. In addition, the rate constants of phosphorylation of glucose and 2-DG were measured for each region. Substitutions of the measured kinetic parameters for sugar transport and phosphorylation into equations defining the LC confirm the observation that the LC would be expected to vary under extreme conditions such as hypoglycemia and to exceed values of 1.0 under these conditions.

Nomogram for 2-deoxyglucose lumped constant for rat brain cortex.

The quantitation of local cerebral metabolic rate of glucose with the 2-deoxyglucose technique of Sokoloff requires the use of a correction factor, or lumped constant. We have shown previously (Pardridge et al., 1982) that a simple model may be formulated to predict changes in the lumped constant that occur due to alterations in the distribution of glucose and 2-deoxyglucose in brain. Given experimentally observed values for brain and plasma glucose concentrations, the 2-deoxyglucose lumped constant may be determined from a nomogram constructed from knowledge of the blood-brain barrier transport constants (KM, Vmax, KD) for glucose and for 2-deoxyglucose. However, the nomogram is constructed from transport constants determined in the barbiturate-anesthetized state. The applicability of the nomogram to other physiologic states was examined in the present studies. Large changes in blood-brain barrier hexose transport constants do not appreciably alter the shape of the nomogram, if the changes in KM or Vmax for glucose or for 2-deoxyglucose are the same. Moreover, glucose and 2-deoxyglucose are both transported by the same hexose carrier, and selective changes in the transport of only one hexose have not been reported. Therefore, it is probable that the nomogram constructed from transport constants measured under barbiturate anesthesia is useful in predicting the lumped constant in a variety of physiologic states.

Reduction in brain glucose utilization rate after tryptophol (3-indole ethanol) treatment.

3-Indole ethanol has been recently identified as the hypnotic agent in trypanosomal sleeping sickness, and because it is formed in vivo after ethanol or disulfiram treatment, is also associated with the study of alcoholism. When administered intraperitoneally to rats (250 mg/kg) tryptophol induced a sleep-like state that lasted less than an hour (no righting reflex was apparent 2 min after injection, but it returned at 11 min in bovine serum albumin solution, and 47 min in 40% ethanol solution). In ethanol solutions, tryptophol reduced brain cortical glucose utilization by 55% to the basal brain metabolic rate, and this effect lasted less than 1 h. Synergistic effects of tryptophol and ethanol were suggested by the observation that in albumin solution, tryptophol reduced brain glucose utilization by 35%, but a normal rate was not observed until 2 h postinjection.

The interaction of transport and metabolism on brain glucose utilization: a reevaluation of the lumped constant.

The relative cerebral cortical metabolism of glucose (GLU) and 2-deoxy-D-glucose (DG) was measured in vivo in control and insulin-treated hypoglycemic rats. The ratio of the utilization rate constants for the two hexoses, i.e., KDG/KGLU is defined as the Hexose Utilization Index (HUI). The HUI was found to be invariant in rats whose cerebral glucose content exceeded 1 mumol . g-1 wet weight (HUI = 0.48 +/- 0.07). Severe hypoglycemia (plasma glucose less than 2 mM) effected a shift in the HUI to 1.04 +/- 0.21. The results are consistent with a model in which the interpretation of the HUI is determined by the rate of transport into brain, or subsequent phosphorylation, as the rate-limiting step for hexose utilization.