The Lactic Acid of the Blood in Hepatic Disease 1

Abstract

LITERATUREThe relation of the liver to the metabolism of carbohydrates has attracted the attention of investigators since Minkowski (1886) demonstrated a decrease in blood sugar and an increase of excretion of lactic acid in the urine of hepatectomized geese. It is now recognized that in the normal resting organism some lactic acid passes from the muscles to the blood, and small amounts (7 to 18 mgm. each hour) appear in the urine. Much larger amounts of this substance appear in both blood and urine after exercise; the quantity is affected considerably by the degree of "oxygen debt." The liver undoubtedly removes a considerable part of this excess lactic acid from the circulation and stores it as glycogen. It has been shown (Schneider and Widmann) that the liver is capable of retaining considerable amounts of optically inactive lactic acid injected into the portal vein; the concentration of lactic acid of the hepatic venous blood is not increased, nor is its optical activity increased.From the foregoing, it is evident that the functional efficiency of the hepatic parenchyma must have a considerable effect on the value for lactic acid in the blood, and on the rate with which the accumulations of this substance are removed following exercise. As the recent experiments of Eggleton and Evans disclosed, the liver is not the only agent in removing lactic acid from the blood. The heart and brain take up this substance readily, and resting muscles absorb some of the lactic acid liberated by working muscles. Considerable amounts may also be lost in the perspiration.Muscular exercise is, of course, the factor most likely to produce an increase in lactic acid of the blood in the individual case. Other factors also elevate the value for lactic acid of the blood; among these may be mentioned cardiac decompensation with circulatory failure (Meakins and Long), anemia, anoxemia, prolonged vomiting, irradiation, ether narcosis (Ronzoni and coworkers), and administration of various sugars

Metabolic engineering of lactate dehydrogenase rescues mice from acidosis

“…We investigated if ABA could rescue mice from metformin induced lactic acidosis. Lactic acidosis was induced in mice by an intraperitoneal injection of 400 mg/kg of metformin, and blood lactate levels were monitored 13 14 . After the lactate levels reached 10 mM, these mice were injected with 100 mg/kg of ABA in PBS or PBS, and after 30 min the blood pH, NAD + /NADH ratio and lactate levels were analyzed.…”

The aminopyrine breath test predicts the outcome of hepatic transplantation in pigs

“…These include the galactose elimination capacity (161, t,he plasma clearance of indocyanine green dye (17), sulfohromophthalein (18), lactat,e (19) and, most recently, amino acids (5,20).…”

“…A number of tests of hepatic metabolic funct.ion have been proposed and have enjoyed variable clinical application. These include the galactose elimination capacity (161, t,he plasma clearance of indocyanine green dye (17), sulfohromophthalein (18), lactat,e (19) and, most recently, amino acids (5,20).…”

Symposium: Advances in Liver Pathology [Abridged]

“…Although he noted a normal blood lactate in 5 patients with hepatic disease, there have been several reports where the blood lactate has been raised (e.g. Adler & Lange 1927, Noah 1927, Hochrein & Meier 1928, Jervell 1928, Schumacher 1928, Mizuno 1931, Snell & Roth 1932, Mulhausen et al 1967). These instances include many examples of patients with fulminating liver disease with blood lactate levels above 10 mM who could be described as suffering from lactic acidosis.…”