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dc.contributor.authorJalloh, Ibrahim
dc.contributor.authorHelmy, Adel
dc.contributor.authorHowe, Duncan J
dc.contributor.authorShannon, Richard J
dc.contributor.authorGrice, Peter
dc.contributor.authorMason, Andrew
dc.contributor.authorGallagher, Clare N
dc.contributor.authorMurphy, Michael P
dc.contributor.authorPickard, John D
dc.contributor.authorMenon, David K
dc.contributor.authorCarpenter, T Adrian
dc.contributor.authorHutchinson, Peter J
dc.contributor.authorCarpenter, Keri LH
dc.date.accessioned2018-07-17T14:18:57Z
dc.date.available2018-07-17T14:18:57Z
dc.date.issued2018-09-01
dc.identifier.issn0897-7151
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/278188
dc.description.abstractMetabolic abnormalities occur after traumatic brain injury (TBI). Glucose is conventionally regarded as the major energy substrate, although lactate can also be an energy source. We compared 3-13C lactate metabolism in TBI with "normal" control brain and muscle, measuring 13C-glutamine enrichment to assess tricarboxylic acid (TCA) cycle metabolism. Microdialysis catheters in brains of nine patients with severe TBI, five non-TBI brain surgical patients, and five resting muscle (non-TBI) patients were perfused (24 h in brain, 8 h in muscle) with 8 mmol/L sodium 3-13C lactate. Microdialysate analysis employed ISCUS and nuclear magnetic resonance. In TBI, with 3-13C lactate perfusion, microdialysate glucose concentration increased nonsignificantly (mean +11.9%, p = 0.463), with significant increases (p = 0.028) for lactate (+174%), pyruvate (+35.8%), and lactate/pyruvate ratio (+101.8%). Microdialysate 13C-glutamine fractional enrichments (median, interquartile range) were: for C4 5.1 (0-11.1) % in TBI and 5.7 (4.6-6.8) % in control brain, for C3 0 (0-5.0) % in TBI and 0 (0-0) % in control brain, and for C2 2.9 (0-5.7) % in TBI and 1.8 (0-3.4) % in control brain. 13C-enrichments were not statistically different between TBI and control brain, showing both metabolize 3-13C lactate via TCA cycle, in contrast to muscle. Several patients with TBI exhibited 13C-glutamine enrichment above the non-TBI control range, suggesting lactate oxidative metabolism as a TBI "emergency option."
dc.description.sponsorshipMedical Research Council (Grant Nos. G0600986 ID79068 and G1002277 ID98489) and National Institute for Health Research Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme). Authors’ support: IJ – Medical Research Council (Grant no. G1002277 ID 98489) and National Institute for Health Research Biomedical Research Centre, Cambridge; KLHC – National Institute for Health Research Biomedical Research Centre, Cambridge (Neuroscience Theme; Brain Injury and Repair Theme); CG – the Canadian Institute of Health Research; AH – Medical Research Council/Royal College of Surgeons of England Clinical Research Training Fellowship (Grant no. G0802251) and Raymond and Beverly Sackler Fellowship; Royal College of Surgeons of England and the NIHR Cambridge Biomedical Research Centre; DKM and JDP – National Institute for Health Research Senior Investigator Awards; MPM - Medical Research Council UK (MC_U105663142) and a Wellcome Trust Investigator award (110159/Z/15/Z). PJH – National Institute for Health Research Professorship, Academy of Medical Sciences/Health Foundation Senior Surgical Scientist Fellowship and the National Institute for Health Research Biomedical Research Centre, Cambridge.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherMary Ann Liebert Inc
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectHumans
dc.subjectLactic Acid
dc.subjectGlutamine
dc.subjectDialysis
dc.subjectMagnetic Resonance Spectroscopy
dc.subjectBrain Chemistry
dc.subjectCitric Acid Cycle
dc.subjectOxidation-Reduction
dc.subjectAdolescent
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectBrain Injuries, Traumatic
dc.titleA Comparison of Oxidative Lactate Metabolism in Traumatically Injured Brain and Control Brain.
dc.typeArticle
prism.endingPage2035
prism.issueIdentifier17
prism.publicationDate2018
prism.publicationNameJ Neurotrauma
prism.startingPage2025
prism.volume35
dc.identifier.doi10.17863/CAM.25531
dcterms.dateAccepted2018-04-13
rioxxterms.versionofrecord10.1089/neu.2017.5459
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.licenseref.startdate2018-09
dc.contributor.orcidHelmy, Adel [0000-0002-0531-0556]
dc.contributor.orcidGrice, Peter [0000-0003-4658-4534]
dc.contributor.orcidMurphy, Mike [0000-0003-1115-9618]
dc.contributor.orcidPickard, John [0000-0002-5762-6667]
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.contributor.orcidCarpenter, Adrian [0000-0002-2939-8222]
dc.contributor.orcidHutchinson, Peter [0000-0002-2796-1835]
dc.contributor.orcidCarpenter, Keri [0000-0001-8236-7727]
dc.identifier.eissn1557-9042
rioxxterms.typeJournal Article/Review
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idRoyal College of Surgeons of England (2016/2017)
pubs.funder-project-idMedical Research Council (G0001237)
pubs.funder-project-idMedical Research Council (G9439390)
pubs.funder-project-idMedical Research Council (G0600986)
pubs.funder-project-idMedical Research Council (G1002277)
pubs.funder-project-idWellcome Trust (110159/Z/15/Z)
pubs.funder-project-idMedical Research Council (MC_UU_00015/3)
pubs.funder-project-idMedical Research Council (MC_U105663142)
pubs.funder-project-idMedical Research Council (G0802251)
pubs.funder-project-idNETSCC (None)
pubs.funder-project-idTCC (None)
cam.issuedOnline2018-05-18
cam.orpheus.successThu Jan 30 13:00:30 GMT 2020 - The item has an open VoR version.
rioxxterms.freetoread.startdate2100-01-01


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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International