Guide to drug dosage in hepatic disease.
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Biomedical subjects
Publications and source records attributed to N M Bass.
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By means of Sephadex G-50 column chromatography, a Mr 12,000 fatty acid binding protein (FABP) was found to be present in all three types of skeletal muscle. FABP concentrations in muscle cytosols (105,000g supernatant) were fiber type specific with binding levels (expressed as pmole [14C]oleate bound/mg protein) of 70 +/- 7 in fast-twitch white (FTW) (heart FABP = 469 +/- 33). Cytosols from all three fiber types cross-reacted with antibody to pure heart FABP on Ouchterlony immunodiffusion analysis. FABP content, determined by radial immunodiffusion, followed the same pattern in the muscle types as that in the binding assay. The values (in micrograms/mg protein) were 3.3 +/- 0.1 in FTW, 17.0 +/- 0.4 in FTR, and 31.7 +/- 1.4 in STR fibers (heart = 55). Disc gel electrophoresis revealed a protein band in each fiber type that had migration identical to that of pure heart FABP and was proportional to the amounts determined by Sephadex G-50 chromatography and immunoassay. In addition, Western blots of tissue cytosols, using antibody to heart FABP, detected single protein bands identical in size to pure heart FABP in all three types of skeletal muscle. These results show the presence of a FABP in all skeletal muscle types with an immunologic and electrophoretic characterization identical to that of heart FABP.
When lean and obese Zucker rats were fed a low-fat diet (6.5 percent lipid-derived energy) their hepatic fatty acid binding protein (FABP) concentrations and activities were comparable. After 18 days of fat-feeding (57 percent lipids) FABP concentration and activities were significantly increased to the same extent in both genotypes. Thus hepatic FABP levels are subject to modulation by dietary lipids but not by genetic obesity.
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In a double-blind trial of streptokinase for acute myocardial infarction, 219 consecutive patients presenting with infarction within four hours (mean, 3.0 +/- 0.8) of the onset of chest pain were randomly assigned to treatment with streptokinase (1.5 million units) or placebo, given intravenously over 30 minutes. The primary end point of the study was left ventricular function in patients with first infarctions. Patients who could undergo beta-blockade also received intravenous propranolol. Heparin (for 48 hours) and a combination of low-dose aspirin and dipyridamole were administered to both groups until cineangiography was performed at three weeks. In the patients with first infarctions treated with streptokinase, the left ventricular ejection fraction was 6 percentage points higher (streptokinase vs. placebo, 59 +/- 10.5 vs. 53 +/- 13.5 percent; P less than 0.005), with benefit to patients with either anterior infarction (57 +/- 11.9 vs. 49 +/- 15.9 percent; P less than 0.05) or inferior infarction (60 +/- 9.1 vs. 55 +/- 11.3 percent; P less than 0.05). Left ventricular function was improved regardless of whether concomitant propranolol was given. Survival (at 30 days) was improved with streptokinase: 2 deaths occurred among 79 patients who received this drug, as compared with 12 deaths among 93 patients who received placebo (2.5 vs. 12.9 percent, P = 0.012). Rates of reinfarction (streptokinase vs. placebo, 3 vs. 1 percent) and requirements for surgery or angioplasty (7 vs. 5 percent) were similar in the two groups. We conclude that administration of intravenous streptokinase (1.5 million units) to patients with a first myocardial infarction results in improved left ventricular function and short-term survival.
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Proctopexy using synthetic mesh is a popular method of treating rectal prolapse. Suturing the graft to the presacral fascia is time-consuming and can lead to complications. With the fascial stapler, two parallel rows of three staples are used to quickly and securely anchor the Marlex sling to the sacrum, thus avoiding hemorrhage from the presacral veins. Fourteen patients have been treated with no complications.
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Three structurally different 14-15 kDa fatty acid binding proteins have have been purified from rat liver, small intestinal epithelium, and heart muscle, and were quantitated using specific antisera in rat tissues. Heart muscle fatty acid binding protein comprised 5% of heart muscle cytosol protein and was also expressed in stomach, muscle, testis, ovary, kidney, brain, and adipose tissue, a pattern distinct from both liver protein (expressed in liver, small and large intestinal epithelium, and adipose tissue) and intestinal protein (expressed in small and large intestinal epithelium and stomach). Distinctive patterns of tissue expression of the three different fatty acid binding proteins suggest that they may perform different specific functions in fatty acid transport and metabolism.
Monospecific antisera to purified hepatic fatty acid-binding protein (hFABP) and gut fatty acid-binding protein (gFABP) have been used to localize these two proteins in the small intestine of fed rats at the light microscopic level. Pieces of duodenum, jejunum, and ileum were removed from 4-, 10-, 20-, 22-, and 60-day-old Sprague-Dawley rats. Both cryostat and paraffin sections were studied for the presence of hFABP or gFABP by the avidin-biotin immunoperoxidase method. Slides were graded blind for the intensity of staining. Despite the structural and immunological differences between these two proteins, we showed no major differences between their staining patterns or their staining intensity throughout the intestine during postnatal development. The staining for both fatty acid-binding proteins was cytoplasmic. No brush border staining was found. Staining was more intense in the proximal rather than distal intestine, in the villus rather than crypt cells, and in the apex rather than the base of intestinal cells. Shifts in staining patterns, and staining intensity occurring during development may be related to variations in dietary fat intake, rates of cell proliferation, intestinal anatomy, and mechanisms for fat absorption.
Two structurally different fatty acid binding proteins (FABP) have been isolated from rat liver and small intestinal epithelium. hFABP is a 14 184 Da protein found in abundance in both liver and small intestine, whereas gFABP (15 063 Da) is abundantly present only in small intestine. This review discusses studies which have provided insight into the physiological functions of these proteins. These include analyses of endogenous and exogenous ligand binding to FABP in vitro; examination of the modulating effect of FABP preparations on enzyme activities in vitro; exploration of relationships between alterations in cytosolic FABP content in response to hormonal, pharmacological, and dietary manipulations and changes in the rates of cellular fatty acid uptake and utilization; and studies of hFABP turnover and the mechanisms of FABP regulation. These experiments provide compelling evidence for a broad role of the FABPs in the transport, utilization and cellular economy of free fatty acids in the liver and small intestine, and also in protecting several aspects of cellular function against the modulatory effects of fatty acids, fatty acyl-CoA esters, and other ligands. Studies of FABP regulation also suggest a role in long-term rather than short-term modulation of hepatic fatty acid metabolism and indicate that hFABP and gFABP may perform different functions in the small intestine.
Rat hepatic fatty acid binding protein (hFABP) may play an important role in the intracellular transport and metabolism of fatty acids. Recent reports have suggested a substantial circadian variation in the amount of hFABP in liver, and a half-life of less than 2 h for this protein has been inferred. In the present study, the kinetics of hFABP turnover were examined directly. hFABP half-life measured after pulse labeling with NaH14CO3 was 3.1 days compared with 2.9 days for total cytosol protein. Following double-isotope labeling, the charge isoforms of hFABP showed similar rates of turnover, all of which were slower relative to whole cytosol protein turnover. Following a 48-h fast, total liver hFABP measured by immunoassay fell 65%, paralleling a 60% fall in total cytosol protein. Refeeding for 24 h did not lead to a significant recovery of either hFABP or total cytosol protein content. No significant change was observed in hFABP abundance between mid-light and mid-dark periods of a 24-h light-dark cycle. These studies showed that hFABP has a relatively slow rate of turnover and that it is not acutely modulated by dietary or diurnal influences.