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Revista Española de Enfermedades Digestivas
versión impresa ISSN 1130-0108
Resumen
GIL-GOMEZ, Antonio et al. Metformin modifies glutamine metabolism in an in vitro and in vivo model of hepatic encephalopathy. Rev. esp. enferm. dig. [online]. 2018, vol.110, n.7, pp.427-433. ISSN 1130-0108. https://dx.doi.org/10.17235/reed.2018.5004/2017.
Aim: to analyze the effect of metformin on ammonia production derived from glutamine metabolism in vitro and in vivo.
Methods:
twenty male Wistar rats were studied for 28 days after a porto-caval anastomosis (n = 16) or a sham operation (n = 4). Porto-caval shunted animals were randomized into two groups (n = 8) and either received 30 mg/kg/day of metformin for two weeks or were control animals. Plasma ammonia concentration, Gls gene expression and K-type glutaminase activity were measured in the small intestine, muscle and kidney. Furthermore, Caco2 were grown in different culture media containing glucose/glutamine as the main carbon source and exposed to different concentrations of the drug. The expression of genes implicated in glutamine metabolism were analyzed.
Results:
metformin was associated with a significant inhibition of glutaminase activity levels in the small intestine of porto-caval shunted rats (0.277 ± 0.07 IU/mg vs 0.142 ± 0.04 IU/mg) and a significant decrease in plasma ammonia (204.3 ± 24.4 µg/dl vs 129.6 ± 16.1 µg/dl). Glucose withdrawal induced the expression of the glutamine transporter SLC1A5 (2.54 ± 0.33 fold change; p < 0.05). Metformin use reduced MYC levels in Caco2 and consequently, SLC1A5 and GLS expression, with a greater effect in cells dependent on glutaminolytic metabolism.
Conclusion:
metformin regulates ammonia homeostasis by modulating glutamine metabolism in the enterocyte, exerting an indirect control of both the uptake and degradation of glutamine. This entails a reduction in the production of metabolites and energy through this pathway and indirectly causes a decrease in ammonia production that could be related to a decreased risk of HE development.
Palabras clave : Hepatic encephalopathy; Metformin; Ammonia; Glutaminase; Glutamine; Cirrhosis; ASCT2; mTOR; Porto-caval anastomosis.