The effect of sustained endotoxemia on expression of the acid-labile subunit (ALS) in relation to hepatic markers of altered GH and insulin sensitivity was examined. Juvenile rats were injected with endotoxin twice daily for 48 h, causing reduced food intake and attenuated growth. In pair-fed controls, food restriction caused marked suppression of ALS gene expression and circulating levels within 12 h, and endotoxemia augmented this effect. This acute effect of endotoxin corresponded temporally with transient induction of suppressor of cytokine signaling (SOCS)-3, cytokine-inducible SH2-containing protein (CIS), phosphoenolpyruvate carboxykinase (PEPCK), and insulin-like growth factor-binding protein (IGFBP)-1 and suppression of GH receptor (GHR). During the subsequent 36 h of sustained endotoxin treatment, expression of ALS recovered to, and then rose above, that of their pair-fed controls. This effect was paralleled by other ternary complex components. The inductive effect of sustained endotoxemia relative to pair-fed controls could not be explained by differences in expression of GHR, SOCS-3, or CIS but coincided with normalized PEPCK and IGFBP-1 levels, suggesting better hepatic insulin sensitivity in these animals. These data may indicate that, in sustained endotoxemia, ALS levels are regulated through modulation of hepatic insulin sensitivity. insulin sensitivity; insulin-like growth factor-binding protein-5; ternary complexes; liver THE ACID-LABILE SUBUNIT (ALS) of the 150-kDa insulinlike growth factor-binding protein (IGFBP) complex is an 85-kDa glycoprotein that is thought to regulate the bioavailability of IGFs in the serum, and possibly other tissue compartments, by sequestering them in a ternary complex with either IGFBP-3 or 6,13,22,48). Prolonged critical illness is characterized by severe wasting of lean body mass that has been attributed partly to suppression of the IGF axis (3,5,47,50). Concordantly, serum levels of ALS and other ternary complex components have been found to be decreased in critically ill patients (2,5,11,49).Circulating levels of ALS have been found to correlate strongly with IGFBP-3 and IGFBP-5 serum concentrations (7) and consequently would be expected to affect the bioavailability and metabolic activity of the IGFs in serum. ALS and IGF-I are expressed predominantly in the liver, and their expression is regulated at the level of transcription by GH (12,23,39). Additionally, we have found that insulin modulates hepatic expression of ALS (17, 18). Altered hepatic sensitivity to GH and insulin would be expected to modulate circulating levels of ALS and, consequently, other components of the ternary complexes.The effects of sustained endotoxemia on ALS expression have not yet been studied. Sustained endotoxemia in rats provides a model of inflammation-induced catabolism different from endotoxemic shock and very acute responses measured within hours of administration of a potentially lethal dose of lipopolysaccharide. We have used the model of sustained endotoxemia described by P...