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Untersuchungen über den Austausch von freien Aminosäuren und Harnstoff zwischen Blut und Zentralnervensystem

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Zusammenfassung

1. Bei 25 Patienten wurden erstmals im simultan entnommenen Blut aus Arteria femoralis und Bulbus sup. der Vena jugularis interna 19 freie Aminosäuren, Taurin und Harnstoff mit Hilfe der Elutionschromatographie an Ionenaustauschern quantitativ bestimmt. Außerdem wurden der cerebrale Sauerstoffverbrauch und die Größe der Hirndurchblutung gemessen und daraus die cerebrale Aminosäure-Utilisation je 100 g Hirngewebe und Minute errechnet.

2. Für sämtliche Substanzen wurden mehr oder weniger häufig signifikante positive und negative Bilanzen ermittelt. In keinem Falle wurden alle untersuchten Aminosäuren gleichzeitig aufgenommen oder abgegeben. Stets waren Aufnahmen bestimmter Aminosäuren mit Abgaben anderer Aminosäuren kombiniert. Es scheint sich also um einen in beiden Richtungen verlaufenden Austauschvorgang zu handeln, bei dem beträchtliche Mengen freier Aminosäuren umgesetzt werden können.

3. Durchschnittlich fiel der freie Gesamt-α-Aminostickstoff von der Arterie zur Vene um etwa 5% ab. Dabei bestanden jedoch sowohl bei den Einzelaminosäuren als auch beim Gesamt-Aminostickstoff erhebliche individuelle Schwankungen. Hohe Utilisationsraten beobachteten wir vor allem bei pathologischen Fällen mit stark herabgesetzter Glucose-Utilisation, so bei einem Fall von Morbus Wilson mit cerebraler Glucose-Verwertungsstörung und bei einer Patientin mit Inselzelladenom im Zustand der Hypoglykämie.

4. Bei einigen Aminosäuren nahm die zwischen Gehirn und Blutplasma pro Zeiteinheit ausgetauschte Menge in Parallelität zum Sauerstoffverbrauch mit steigender Hirndurchblutung zu. Bei anderen Aminosäuren konnte dies nicht nachgewiesen werden.

5. Durch den Nachweis negativer Harnstoffbilanzen werden neue Befunde bestätigt, die eine Harnstoffsynthese auch im Nervengewebe beweisen. Unsere Werte geben erstmals einen Eindruck von dem Ausmaß, in dem das Gehirn des Menschen davon Gebrauch macht.

Summary

1. In 25 patients blood was obtained simultaneously from the femoral artery and bulbus superior venae jugularis internae. Plasma levels of 19 free amino acids, taurine, and urea were quantitavely determined by elution chromatography with ion exchange resins. Cerebral oxygen consumption and blood flow were measured, and the utilisation of amino acids per 100 grams of brain tissue per minute was calculated.

2. For all the substances examined a certain number of significant positive and negative balances was found. In no case however were all the 19 amino acids simultaneously consumed or released. The consumption of certain amino acids was invariably combined with the release of others. There appears thus to be present an exchange mechanism going in both directions, whereby significant quantities of free amino acids can be metabolized.

3. There was on the average a 5% arterio-venous decrease of free total α-amino-acid nitrogen. However there existed important variations for both the total amino-acid nitrogen and the individual amino acids. We found high rates of utilisation of amino acids particularly in patients with a greatly reduced cerebral utilisation of glucose, i. e., in a case of Wilson's disease with a discorder of cerebral glucose utilisation and in a patient with an islet-cell adenoma during hypoglycemia.

4. The amount of certain amino acids exchanged per unit time between brain and plasma increased parallel with oxygen consumption as the cerebral blood flow increased. The remaining amino acids either showed no such increase or varied inconsistently.

5. The demonstration or negative urea balances confirms newer results that show urea synthesis to be present in nervous tissue. Our values are the first to show quantitativly to what extent the human brain may make use of this ability.

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  1. Aus der II. Medizinischen Klinik der Universität München, Germany

    H. G. Knauff, U. Gottstein & B. Miller

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Knauff, H.G., Gottstein, U. & Miller, B. Untersuchungen über den Austausch von freien Aminosäuren und Harnstoff zwischen Blut und Zentralnervensystem. Klin Wochenschr 42, 27–39 (1964). https://doi.org/10.1007/BF01485676

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