Growth hormone (GH) activity is associated with increased serum oestradiol and reduced anti-Müllerian hormone in healthy male volunteers treated with GH and a GH antagonist.

Growth hormone (GH) and insulin-like growth factor I (IGF-I) receptors are present on pituitary gonadotrophs and on testicular Leydig and Sertoli cells. Thus, the GH/IGF-I system may modulate the pituitary-gonadal axis in males. This is a randomized cross-over study. Eight healthy male volunteers (mean age 35, range 29-46 years) were treated with GH for 3 weeks (1st week 0.01, 2nd week 0.02, 3rd week 0.03 mg/day/kg) or a GH receptor antagonist (Pegvisomant) (1st week 10, last 2 weeks 15 mg/day), separated by 8 weeks of washout. Before and after the two treatment periods, concentrations of luteinizing hormone (LH), follicle-stimulating hormone, testosterone, oestradiol, sex hormone-binding globulin, inhibin B and Anti-Müllerian Hormone (AMH) were measured. During GH treatment, IGF-I increased [(median (IQR)] 166 (162-235) vs. 702 (572-875) µg/L, p < 0.001) together with oestradiol [(mean ± SD) 78 ± 23 vs. 111 ± 30 pm, p = 0.019], and the oestradiol/testosterone ratio (p = 0.003). By contrast, AMH (42 ± 14 vs. 32 ± 7 pm, p = 0.018), Inhibin B (211 (146-226) vs. 176 (129-204) ng/L, p = 0.059) and LH (3.8 ± 1.5 vs. 3.2 ± 1.2 U/L, p = 0.096) decreased. During pegvisomant treatment IGF-I (204 (160-290) vs. 106 (97-157) µg/L, p = 0.001) and oestradiol (86 ± 28 vs. 79 ± 25 pm, p = 0.060) decreased. No significant changes or trends in the other reproductive hormones occurred during the two treatment regimens. GH/IGF-I activity was positively associated with serum oestradiol, suggesting that GH/IGF-I stimulates aromatase activity in vivo. As a novel observation, we found that high GH activity was associated with reduced levels of the Sertoli cell marker AMH. Further studies are needed to evaluate possible effects of GH on Sertoli cell function and/or spermatogenesis.

Acute presentation of craniopharyngioma in children and adults in a Danish national cohort.

We aimed to study the occurrence of acute-onset symptoms at initial presentation in a national Danish cohort of patients with childhood- or adult-onset craniopharyngioma, and to investigate potential risk factors for acute presentation. Medical records of 189 consecutive patients (39 children, 150 adults) presenting with craniopharyngioma during the period 1985-2004 were reviewed, and data regarding initial symptoms, neuroimaging results, vision and pituitary function were systematically collected. Acute symptoms preceding hospital admission were noted. Subgroup analyses were based on age, gender and calendar year period. Potential risk factors for acute presentation were analysed through uni- and multivariate analyses. Acute symptoms were reported in 24 (13%) patients. Acute visual symptoms, headache, nausea or vomiting were most frequently reported, and acute symptoms were more frequent among children (28%) than among adults (9%) (P < 0.01). There were no differences according to sex or calendar year period. Hydrocephalus was present in half of childhood cases and one-fifth of adult patients (P < 0.001). Intra-tumour haemorrhage was seen in two cases. Acute symptoms were more frequent among patients with tumours occupying the third ventricle (P < 0.01), radiologic signs of calcification (P < 0.05) or hydrocephalus (P < 0.01). In multivariate analysis, however, only childhood onset (P < 0.05) and calcification (P < 0.05) were independent risk factors for acute presentation. Craniopharyngioma presented with acute symptoms in 13% of patients. Childhood onset and radiologic signs of calcification were independent risk factors for acute presentation. Intra-tumour haemorrhage was rare.

Incidence of craniopharyngioma in Denmark (n = 189) and estimated world incidence of craniopharyngioma in children and adults.

We studied the incidence of craniopharyngioma in Denmark during the period 1985-2004 and estimated worldwide incidence rates (IR) of craniopharyngioma based on a literature review. Craniopharyngioma patients diagnosed during the period 1985-2004 were identified from the Danish National Patient Registry, the Danish Cancer Registry and regional registries. Medical records were reviewed. Danish population data were obtained from Statistics Denmark. European and World population data were obtained from EU and WHO homepages. Prior studies providing data on craniopharyngioma IRs were identified via PubMed and, if appropriate, were included in a weighted analysis estimating overall and children's IRs of craniopharyngioma. IRs are given as new cases per million per year. We identified 189 patients with new verified (162) or probable craniopharyngioma. The overall WHO World-standardised incidence rate was 1.86 (1.60-2.14) for all ages and 2.14 (1.53-2.92) for children (age <15 years). Peak incidence rates were observed in age groups 5-9 and 40-44 years. Fifteen prior studies (including 1,232 craniopharyngioma cases) were identified. Seven and 11 studies, respectively, were eligible for weighted all-ages and childhood population IR analyses, yielding summary IRs of 1.34 (1.24-1.46) (all ages) and 1.44 (1.33-1.56) (children). We have provided a detailed survey of the incidence of craniopharyngioma in Denmark during a recent 20-year period. Overall IR of craniopharyngioma in Denmark was 1.86 (1.60-2.14) as compared to 2.14 (1.53-2.92) among children. Weighted estimates of craniopharyngioma world IRs were 1.34 (1.24-1.46) in all ages and 1.44 (1.33-1.56) among children.

Sweat secretion rates in growth hormone disorders.

BACKGROUND: While increased sweating is a prominent symptom in patients with active acromegaly, reduced sweating is gaining status as part of the growth hormone deficiency (GHD) syndrome. DESIGN AND SUBJECTS: Sweat secretion rate (SSR), as measured by pilocarpine iontophoresis represents the maximal capacity for stimulated sweat secretion in a localized skin area. SSR was studied in 37 patients with a history of acromegaly, 20 adult patients with GHD before and during long-term GH substitution of GHD adults, and 58 control subjects. RESULTS: Acromegaly: Patients with acromegaly had significantly higher SSR than healthy controls (Z-score + 1.9 (+/- 1.1) mean (+/- SD) (P < 0.001)). SSR was increased irrespective of current clinical disease activity. Thus, the SSR Z-scores in 16 clinically inactive patients were + 2.1 (+/- 1.2), in 10 slightly or doubtfully active patients + 1.5 (+/- 0.7) and in 11 active patients + 1.8 (+/- 1.3). There was no correlation between SSR and IGF-I. GHD: Twenty adult patients participated in an 18-month randomised, placebo controlled, double blinded study of physiological dose GH substitution, followed by 18 months of open GH treatment. SSR at baseline was reduced in male but not in female GHD patients. Mean SSR (95% confidence interval) for 11 male patients was 89.0 mg/30 minutes (51.9-126.1) as compared to 133.5 mg/30 minutes (59.2-259.9) (P = 0.01) in 24 male controls, and for 11 female patients 48.2 mg/30 minutes (25.9-70.6) as compared to 49.2 mg/30 minutes (12.6-93. 9) in 34 female controls. GH treatment in physiological substitution doses for up to 36 months had no effect on SSR. CONCLUSION: We have demonstrated that longstanding GH hypersecretion in patients with acromegaly induces irreversible changes of sweat gland function, with persistently elevated SSR despite treatment and clinical cure. In GHD patients, SSR was reduced in males but not in females, which together with the established gender difference in normal controls emphasises the role of androgen deficiency as a cofactor for reduced sweating in hypopituitary patients. Sweat gland development seems to be more susceptible to lack of hormones in childhood and adolescence than in adulthood, whereas growth hormone excess can modify sweat function later in life.

Serum levels of the cytokines IL-1beta, IL-6 and ICAM-1 after 131I-treatment of Graves' disease and nodular goiter.

Cytokines might be involved in the immunological flare up, seen in some patients after 131I-treatment. Therefore, we measured serum levels of interleukin-6 (IL-6), interleukin-1beta (IL-1beta), interleukin-6 soluble receptor (IL-6sR) and Intercellular-adhesion-molecule-1 (ICAM-1) as well as tumor necrosis factor (TNF-alpha) after 131I-treatment of Graves' disease and nodular goiter. Seven patients with Graves' disease, eight with toxic nodular goiter and seven with non-toxic nodular goiter, were followed after 131I-treatment. The patients were treated in the euthyroid state. Blood samples were drawn at day 0, 4, 7, 21 and after 3 months. Significant increases were seen in free T4 index (FT4I), free T3 index (FT3I) and thyroglobulin (Tg) within the first weeks, and TSH simultaneously decreased. None of the cytokines demonstrated any change during follow-up, neither in the entire group nor in subgroups. FT4I and FT3I correlated significantly to ICAM-1. In conclusion, our data suggest that there does not seem to be prolonged cytokine activation after 131I-treatment for thyroid disorders.

Lymphocyte glucocorticoid receptor mRNA correlates negatively to serum leptin in normal weight subjects.

OBJECTIVE: The aim of the present study was to test the hypothesis that glucocorticoid receptor mRNA concentrations decreased with increasing fatness in normal subjects. MEASUREMENTS: Serum leptin concentrations, fat distribution parameters, lymphocyte glucocorticoid (GCR) mRNA, beta2-adrenoceptor mRNA and c-fos mRNA concentrations measured by RT-PCR-HPLC. SUBJECTS: Fifteen healthy non-obese young subjects with a mean body mass index (BMI) of 23. 5+/-0.3 (+/-s.e.m.) kg/m2. RESULTS: Lymphocyte GCR and beta2-adrenoceptor mRNA concentrations averaged 4.2+/-0.2 (+/-s.e.m. ) amol/microg total RNA and 1.4+/-0.1 amol/microg total RNA, respectively. There was a significant negative correlation between serum leptin and lymphocyte GCR mRNA (P<0.01). Serum leptin correlated positively with the waist-hip ratio (P<0.03), whereas lymphocyte GCR mRNA correlated negatively to the waist-hip ratio (P<0.04). Serum cortisol correlated with the weight of the subjects but not the waist-hip ratio or GCR mRNA. CONCLUSIONS: It is suggested that the decrease in lymphocyte GCR mRNA concentration with increasing serum leptin concentrations is a counterregulatory response to an increased body fat content. Further studies are warranted, especially to elucidate the relationship between GCR mRNA in lymphocytes and in fat cells and to clarify the mechanism of the decrease in GCR mRNA.

Quality of self-care in patients on replacement therapy with hydrocortisone.

OBJECTIVES: To assess the quality of self-care in patients receiving replacement therapy with hydrocortisone for primary or secondary adrenal insufficiency. DESIGN: A questionnaire-based survey. SETTING: The outpatient Clinic of Endocrinology at the University Hospital in Herlev, Denmark. SUBJECTS: Ninety-seven patients identified from the case reports of the clinic. All patients had received repeated oral information about hydrocortisone treatment and dose adjustments. Eighty-four (87%) patients completed the questionnaire. MAIN OUTCOME MEASURES: Ability to act appropriately in case of physical stress, possession of a 'Steroid warning card', number and nature of episodes of physical stress during the past year and self-experienced level of information was recorded. RESULTS: Thirty-nine (46%) of the patients were not sufficiently skilled in coping with physical stress. This was more prominent in the elderly patients. Seventeen (20%) did not possess a 'steroid warning card'. Thirty-seven (44%) had experienced at least one febrile episode and 24 (29%) had been admitted to hospital during the past year. Fifty (60%) felt themselves to be well informed, but this did not correlate with the ability to act appropriately. CONCLUSIONS: The study shows the need for continuous education of patients with adrenal insufficiency. Oral instructions should be supplemented with written information or a more detailed and structured education.

Is calculation of the dose in radioiodine therapy of hyperthyroidism worth while?

OBJECTIVE: The persistent controversy as to the best approach to radioiodine dose selection in the treatment of hyperthyroidism led us to perform a study in order to compare a fixed dose regime comprising doses of 185 370 or 555 MBq based on gland size assessment by palpation only, with a calculated 131I dose based on type of thyroid gland (diffuse, multinodular, solitary adenoma), an accurate thyroid volume measurement, and a 24-hour 131I uptake determination. DESIGN: Prospective randomized study. PATIENTS: Two hundred and twenty-one consecutive hyperthyroid patients referred for 131I treatment. Four Patients who died for reasons unrelated to hyperthyroidism, 7 lost to follow-up and 47 who did not receive antithyroid drugs after treatment, were excluded. The remaining 163 patients (143 women) were studied, divided into subgroups according to the type of gland. They all received antithyroid drugs prior to 131I treatment and this was resumed 7 days after treatment for a period of 3 weeks. MEASUREMENTS: Thyroid function variables were determined approximately 2 weeks before 131I treatment, and again 1, 2, 3, 6, 9 and 12 months after treatment. Prior to 131I therapy the size of the thyroid gland was determined by ultrasound and a 24-hour uptake of 131I was carried out. Thyroid volume was also estimated 12 months after 131I therapy in 78 of the 163 patients. Twelve months after the initial 131I dose patients could be classified as euthyroid, hyperthyroid or hypothyroid. RESULTS: Neither in the group of 163 patients nor within the three subgroups of hyperthyroidism could any significant difference in outcome between the two treatment regimes be demonstrated. Thirty-two of 78 patients (41%) in the calculated dose group and 30 of 85 patients (35%, NS) in the fixed group were classified as hyperthyroid. Seven of 78 (9%) in the calculated dose group and 6 out of 85 (7%, NS) in the fixed dose group were classified as permanently hypothyroid. Finally, 39 of 78 (50%) in the calculated dose group and 49 of 85 (58%, NS) in the fixed group were euthyroid at 12 months after 131I treatment. One year after 131I therapy thyroid volume was reduced from 59.3 +/- 9.2 (mean +/- SEM) to 36.2 +/- 6.6 ml (average reduction 39%) in the calculated dose group (P < 0.001). This reduction did not differ significantly from the fixed dose group where thyroid volume declined from 61.6 +/- 6.1 to 41.17 +/- 4.7 ml (average reduction 32%) (P < 0.001). CONCLUSIONS: A semiquantitative approach is probably as good as the more elaborately calculated radioiodine dose for treatment of hyperthyroidism. It is clearly more cost effective and allows the use of predetermined standard doses.

Surgical treatment of primary hyperparathyroidism.

One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one was cured by percutaneous ethanol injection and one was reoperated and cured in another hospital. Three patients with persistent hypercalcaemia refused reoperation. Transitory hypocalcaemia with a median duration of 15 days was found in 36 patients, and permanent hypocalcaemia in two patients (1.9%). Permanent paralysis of the recurrent nerve occurred in three patients (2.9%). Twenty-one patients developed other postoperative complications from which they all recovered without sequelae. No postoperative deaths occurred. Our results show that surgical treatment of primary hyperparathyroidism--including bilateral neck exploration and attempted biopsies of all parathyroid glands--is safe with a high cure rate.

Long-term follow-up of thyroid scintigraphies after 131I therapy of solitary autonomous thyroid nodules.

The aim of the present study was to assess thyroid scintigraphies after 131I treatment of autonomous thyroid nodules with respect to evolution of the hot nodules as well as the extranodular tissue. A 99mTc pertechnetate scintigraphy was carried out 1-16 years (median 8 years) after 131I treatment of a solitary autonomous nodule in 66 patients remaining euthyroid. At the time of diagnosis, 9 of the patients were euthyroid and 57 were hyperthyroid, of whom 27 received antithyroid drug therapy prior to 131I treatment. The scintigraphies were evaluated twice by 4 specialists (3 endocrinologists and 1 specialist in nuclear medicine). There was total agreement between the 4 observers in 50 and 52% in the first and second evaluation, respectively. The interobserver variation was evaluated by means of omega coefficients and omega ranged from 0.18 to 0.76 indicating poor to substantial agreement. A solitary autonomous nodule with suppression of the extranodular thyroid tissue persisted in 50% of the patients, whereas a solitary cold nodule, homogeneous uptake or inhomogeneous uptake was found in 15, 22, and 13%, respectively. We conclude that although euthyroidism is achieved by radioiodine treatment, a hot nodule suppressing the 99mTc pertechnetate in the extranodular tissue is still found in 50% of the patients even when serum TSH has been normal for years. Antithyroid drug therapy prior to 131I treatment was more frequent in this group of patients.

Impaired receptor binding and decrease in isoelectric point of lactoferrin after interaction with human monocytes.

The iron-binding glycoprotein lactoferrin binds to specific receptors on human monocytes as an initial step implicated in monocytic iron deposition. In this study, the properties of lactoferrin were studied after its interaction with human monocytes. Rebinding of lactoferrin to its monocytic receptor was grossly impaired and a small decrease in isoelectric point from 8.9 to 8.8 was observed. In contrast, antigenic and iron-binding properties of lactoferrin were preserved, the molecular weight by SDS-polyacrylamide gel electrophoresis was unchanged and no low-molecular fragments were detected by gel-filtration. These findings indicate that lactoferrin molecules cannot operate in a cyclic manner to deposit iron. Furthermore, these results might contribute towards explaining the complex disappearance kinetics observed for lactoferrin in plasma.

Decrease in ureagenesis by partial hepatectomy does not influence acid-base balance.

It has been suggested that urea synthesis participates directly in body pH homeostasis by removal of bicarbonate. To elucidate this hypothesis sodium bicarbonate or sodium chloride was infused (11.5 mumol/min) for 90 min into control rats and into rats that had undergone an 85% hepatectomy immediately before starting the infusion. Urea synthesis rate was 2.6 +/- 0.3 mumol/min (mean +/- SE) in controls, and was significantly (P less than 0.01) reduced to 1.0 +/- 0.2 mumol/min in partially hepatectomized rats. At the start of bicarbonate infusion, pH was 7.38 and 7.34 in control and partially hepatectomized rats, respectively, and at the end of infusion, pH was 7.56 and 7.51. Standard bicarbonate at start of bicarbonate infusion was 21.9 and 21.3 mM in controls and partially hepatectomized, respectively, and it increased to 32.7 and 29.9 mM at end of infusion. In saline-infused rats a slight decrease of approximately 0.05 pH units was observed during the experiment, but again no difference emerged between control and partially hepatectomized rats. It is concluded that a major role of the liver in the regulation of acid-base balance is unlikely.

Lactoferrin-mediated transfer of iron to intracellular ferritin in human monocytes.

Interactions of 125I-59Fe-lactoferrin with human monocytes were studied. After 4 hours of incubation, the uptake of 59Fe exceeded that of 125I. In dissociation studies the cellular 59Fe-activity was only partly dissociable during 16 h, whereas the 125I-activity could be released nearly completely. Disruption of the cells and studies on the cytosolic phase were performed employing gel-filtration and affinity chromatography. An appreciable amount of lactoferrin was found in the cytosolic phase. About 50% of the cytosolic 59Fe-activity was bound to ferritin. The results suggest that lactoferrin is internalized into monocytes and that iron is transferred to ferritin. These cellular events may contribute to an understanding of the accumulation of iron in the monocyte/macrophage system observed during inflammatory conditions.

Associations between transports of alanine and cations across cell membrane in rat hepatocytes.

Alanine transport across the liver cell membrane is a regulated key process in the amino acid metabolism of the body. The majority of alanine influx in hepatocytes is Na+ dependent and is stimulated by intracellular negativity. The molar ratio between cotransported Na+ and alanine is 1:1. Alanine efflux is stimulated by intracellular Na+, whereas the role of the membrane potential is unclear. The transmembrane Na+ electrochemical gradient seems to be the exclusive driving force for cellular alanine accumulation. At a physiological Na+ gradient, intracellular alanine can exceed the extracellular concentration about 20-fold, but metabolism will exert a conspicuous sink effect. Na+-coupled uptake of alanine appears to be a challenge that triggers a sequence of regulatory events: increased cellular Na+ leads to an increase in active Na+-K+-pumping and thus in K+ influx; influx of alanine and cations tends to increase the cellular content of osmotically active substances implying a tendency to water uptake; cell swelling, even when modest, induces an increase in the permeability of a conductive pathway for K+ leading to net efflux of K+ (with accompanying anions) and cellular hyperpolarization. Net efflux of K+ prevents excessive cell volume increase during amino acid accumulation, whereas hyperpolarization tends to support the driving force for alanine influx (and anion efflux). The pathway for K+ efflux needs further characterization, but it may involve single-file diffusion with Ca2+ as an activator. This model suggests that cell volume regulatory processes mainly serve to compensate for changes in intracellular content of ions and metabolites during activation of specialized cellular processes.

Effects of perturbation of the Na+ electrochemical gradient on influx and efflux of alanine in isolated rat hepatocytes.

Transmembrane alanine transport was studied in hepatocytes isolated from 48-h fasted rats. Aminooxyacetate was used to render alanine nonmetabolizable. Gramicidin D eliminated the transmembrane Na+ electrochemical gradient. At 135 mM Na+ and 0.1 mM alanine gramicidin D decreased the steady-state intracellular-to-extracellular alanine distribution ratio from 20.2 to 0.9. The underlying kinetic changes appeared to be a decrease in alanine influx to one-third of the control value and an increase in the rate constant of alanine efflux by a factor of 9. Analogous changes were observed when the Na+ gradient was decreased by ouabain. The inhibitory effect of gramicidin D on alanine influx was confined to the Na+-dependent, saturable component which showed a prominent increase in the apparent Km for alanine and a small decrease in the apparent Vmax. The effect of gramicidin D on alanine efflux was related to the increased cytosolic Na+ concentration: the rate constant of alanine efflux was increased by cytosolic Na+ with half-maximal stimulation at 30 mM; voltage-sensitive alanine efflux could not be demonstrated.

The onset of liver glycogen synthesis in fasted-refed rats. Effects of streptozocin diabetes and of peripheral insulin replacement.

The mechanism of liver glycogen synthesis after refeeding has been investigated in diabetic rats, diabetic insulin-treated rats, and in control rats fasted for 48 h. The accumulation of liver glycogen was the same in diabetic rats and in control rats after 2 h of feeding, but did not proceed any further in the diabetic group during the next 2 h. Insulin-treated diabetic rats synthesized five times more hepatic glycogen than the control rats after 1 h of refeeding, but the amount accumulated at the end of the refeeding period was the same. Feeding resulted in a transient activation of glycogen synthase in untreated as well as in treated diabetic rats. In control rats, however, glycogen synthase was already partially in the active form before access to food, and the onset of glycogen synthesis occurred without further activation of the enzyme. A transient inactivation of phosphorylase was observed in all groups during the meal, but was very slight in the untreated diabetic rats in which phosphorylase a values were already reduced before the access to food. Peripheral glycemia was markedly increased upon refeeding in treated and untreated diabetic rats, but remained normal in control rats. Peripheral insulinemia was increased by feeding in the control rats and remained low in the diabetic rats and high in the insulin-treated diabetic rats. The results indicate that, in normal controls in contrast to diabetic rats, synthase activation is not a prerequisite for the initiation of glycogen synthesis after a meal; phosphorylase inactivation may be of major importance in normal controls, but also appears to play a role in the diabetic animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Volume-regulatory K+ efflux during concentrative uptake of alanine in isolated rat hepatocytes.

Changes in cell volume and 42K+ efflux associated with concentrative alanine uptake were studied in isolated rat hepatocytes suspended in Krebs-Ringer bicarbonate buffer. After addition of 10 mM-alanine, cellular water volume increased by 15% and the rate constant of 42K+ efflux by 250%. Alanine-induced 42K+ efflux was abolished by quinine and was strongly decreased when the cell-volume increase was counteracted by sucrose. The results suggest that K+ efflux during alanine uptake is implicated in a volume-regulatory response.

Receptor binding of lactoferrin by human monocytes.

The binding of iron-saturated 125I-lactoferrin to human monocytes was studied at pH 7.4 and 37 degrees C. Monocytes in suspension bound 125I-lactoferrin by a reversible, saturable and specific binding indicating the presence of a receptor. The dissociation constant (KD) of the binding was estimated at about 4.5 x 10(-9) M and the number of receptors was about 1.6 x 10(6) per monocyte. The affinity of native lactoferrin (20% iron saturated) was only slightly below that of iron-saturated lactoferrin (KD about 7.9 x 10(-9) M). Human transferrin, horse cytochrome c and human immunoglobulin G were without inhibitory effect on the binding of 125I-lactoferrin. The majority of cell-bound 125I-lactoferrin was dissociable. The dissociation rate was not affected by addition of unlabelled lactoferrin to the dissociation medium. The binding of 125I-lactoferrin to adherent mononuclear blood cells showed an about 100-fold lower affinity (KD about 2.5 x 10(-7) M) than to cells in suspension, but the specificity of the binding was the same. These results are compatible with the idea that lactoferrin exerts a biological effect mediated by an interaction with cells of the monocyte/macrophage lineage.

Concentrative uptake of alanine in hepatocytes from fed and fasted rats.

The transport of alanine across the liver cell membrane was studied in hepatocytes isolated from fed and 48-h-fasted rats. Aminooxyacetate was used to render alanine nonmetabolizable. The steady-state intracellular-to-extracellular distribution ratio of alanine was maximal at extracellular concentrations below 0.5 mM and was increased from about 10 to about 20 by fasting. This increase was the net effect of a two- to threefold increase in the alanine influx and about a 50% increase in the rate constant of alanine efflux. The results suggest that alanine efflux occurred partly via the transport system mediating Na+-dependent alanine influx and partly by another pathway. The transmembrane Na+ electrochemical gradient remained unchanged by fasting and could apparently account for a maximal distribution ratio of alanine well above 20. In both nutritional states, the simplest kinetic model adequately describing the alanine influx implicated one saturable component besides a passive component. The apparent Vmax of the former was doubled by fasting while the apparent Km was insignificantly decreased. At low extracellular alanine concentrations, the rate of alanine consumption (aminooxyacetate absent) was only 40% of the alanine influx in the fed state but was increased at least fivefold by fasting and thereby balanced with the increased alanine influx. These results suggest a rate limitation at the transport level in the fasted state.

Coupling ratio of electrogenic Na+-alanine cotransport in isolated rat hepatocytes.

Na+-alanine cotransport across the cell membrane in isolated rat hepatocytes was studied. Changes in the cell membrane potential associated with the transport of alanine interfere with determination of the Na+-alanine coupling ratio of the cotransport. With valinomycin present to 'clamp' the cell membrane potential, a coupling ratio of 1:1 for the Na+-alanine influx was obtained.