Early changes in the permeability of the blood-brain barrier produced by toxins associated with liver failure

H Juhling McClung, HR Sloan, P Powers… - Pediatric …, 1990 - nature.com
H Juhling McClung, HR Sloan, P Powers, A John Merola, R Murray, B Kerzner…
Pediatric research, 1990nature.com
Our study was designed to determine whether substances that appear in the serum during
the course of liver failure have a detrimental effect on the passive permeability of the blood-
brain [blood-cerebrospinal fluid (CSF)] barrier. Lactic acid, octanoic acid, and ammonia were
infused into rabbits for 4 h. The permeability changes of the blood-brain barrier were
quantified by infusing polyethylene glycol 400 (PEG 400) and measuring the quantity and
average mol wt of the PEG 400 that entered the CSF. The lipid solubility and effective …
Abstract
Our study was designed to determine whether substances that appear in the serum during the course of liver failure have a detrimental effect on the passive permeability of the blood-brain [blood-cerebrospinal fluid (CSF)] barrier. Lactic acid, octanoic acid, and ammonia were infused into rabbits for 4 h. The permeability changes of the blood-brain barrier were quantified by infusing polyethylene glycol 400 (PEG 400) and measuring the quantity and average mol wt of the PEG 400 that entered the CSF. The lipid solubility and effective diffusional radius of the PEG molecules were also quantified to provide greater precision for measurements using this probe. None of the animals receiving toxic infusions became seriously ill during the infusions. Low dose infusions of lactic acid, octanoic acid, and ammonia increased the effective pore diameter of the blood-brain barrier from 7.3 A to an average of 8.5 Å. The amount of PEG entering the CSF increased from 1.7 to 4.0 (p< 0.025), 4.7 (p< 0.025), and 6.7 (p< 0.001) mmol/L, respectively. Rabbits with galactosamine-induced liver failure had 10.1 mmol/L PEG 400 in the CSF (p> 0.001) before any evidence of cerebral edema. These changes occur soon after these toxins accumulate in the plasma and may alone or together with other toxins account for the permeability changes that allow seurotoxic substances to enter the brain during hepatic disease and encephalopathies such as Reye's syndrome.
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