Sr. Maitra et al., Regulation of liver and kidney glucose-6-phosphatase gene expression in hemorrhage and resuscitation, ACAD EM MED, 7(7), 2000, pp. 731-738
The authors have recently demonstrated that increased gene expression of gl
ucose-6-phosphatase (Glu-6-Pase) in hemorrhagic hypotension (HH) and follow
ing lactated Ringer's resuscitation (LR) is associated with a decrease in i
nsulin and an increase in corticosterone concentrations. Objective: To eval
uate the in-vivo role of hormones the authors used insulin (IN), phentolami
ne and propranolol (PP) as an adrenergic blocker, and cyclic somatostatin (
CS) as a glucagon blocker to prevent the induction of Glu-6-Pase gene expre
ssion in liver and kidney following HH and LR. Methods: Hemorrhage was indu
ced in fasted anesthetized rats, and the reduction of blood pressure to 40
mm Hg for a duration of 30 minutes was accomplished by withdrawal or infusi
on of shed blood. The resuscitated group underwent hemorrhage followed by f
luid resuscitation with lactated Ringer's solution. Results: Neither PP nor
CS treatment could block the induction of Glu-6-Pase messenger ribonucleic
acid (mRNA) following either HH or LR. However, the administration of IN s
ignificantly prevented the increase of Glu-6-Pase mRNA level and activity i
n both liver and kidney following HH and LR. This was associated with a nor
malization of plasma glucose, corticosterone, and glucagon levels and gluco
se-6-phosphate concentrations in liver and kidney toward prehemorrhage leve
ls. Conclusions: These results indicate that in-vivo treatment with insulin
during hemorrhagic hypotension and resuscitation is capable of preventing
the increase in Glu-6-Pase gene expression in liver and kidney responsible
for the observed hyperglycemia.