Glutamine has been shown to influence endothelial-dependent relaxation and nitric oxide production in vitro, possibly by limiting arginine availability, but its effects in vivo have not been well studied. Hyperammonemia is a pathophysiological condition in which glutamine is elevated and contributes to depressed CO 2 reactivity of cerebral arterioles. We tested thehypothesis that acute hyperammonemia decreases pial arteriolar dilation to acetylcholine in vivo and that this decrease could be prevented by inhibiting glutamine synthetase with L-methionine-S-sulfoximine (MSO) or by intravenous infusion of L-arginine. Pial arteriolar diameter responses to topical superfusion of acetylcholine were measured in anesthetized rats before and at 6 h of infusion of either sodium or ammonium acetate. Ammonium acetate infusion increased plasma ammonia concentration from 3 0 to ~ 600 μM and increased cerebral glutamine concentration fourfold. Arteriolar dilation to acetylcholine was intact after infusion of sodium acetate in groups pretreated with vehicle or with MSO plus methionine, which was coadministered to prevent MSO-induced seizures. In contrast, dilation in response to acetylcholine was completely blocked in hyperammonemic groups pretreated with vehicle or methionine alone. However, MSO plus methionine administration before hyperammonemia, which maintained cerebral glutamine concentration at control values, preserved acetylcholine dilation. Intravenous infusion of L-arginine during the last 2 h of the ammonium acetate infusion partially restored dilation to acetylcholine without reducing cerebral glutamine accumulation. Superfusion of 1 or 2 mM L-glutamine through the cranial window for 1 h in the absence of hyperammonemia attenuated acetylcholine dilation but had no effect on endothelialindependent dilation to nitroprusside. We conclude that 1) hyperammonemia reduces acetylcholineevoked dilation in cerebral arterioles, 2) this reduction depends on increased glutamine rather than ammonium ions, and 3) increasing arginine partially overcomes the inhibitory effect of glutamine.
Keywordsarginine; cerebral circulation; endothelial-dependent dilation; hepatic encephalopathy; hyperammonemia; nitric oxide Patients with hepatic failure have been reported to have a depressed cerebrovascular response to hypercapnia (9). Depressed cerebral vasodilation to hypercapnia also has been observed in experimental models of acute hyperammonemia in a variety of species, including monkey, dog, cat, and rat (2,6,15,16,33 Hyperammonemia produces substantial increases in brain glutamine concentration (7). Inhibition of glutamine synthetase preserves cerebrovascular reactivity to hypercapnia and hypocapnia during acute hyperammonemia (13,15). Thus the loss of CO 2 reactivity is related to glutamine accumulation rather than to direct vascular effects of ammonium ions. Moreover, intravenous infusion of glutamine in the absence of hyperammonemia decreases hypercapnic vasodilation, although not to the same extent as hyperammonemia (22). The...