Depletion of endogenous inorganic sulfate in the mammalian central nervous system by acetaminophen

The clinical chemistry of inorganic sulfate

Although inorganic sulfate is an essential and ubiquitous anion in human biology, it is infrequently assayed in clinical chemistry today. Serum sulfate is difficult to measure accurately without resorting to physicochemical methods, such as ion chromatography, although many other techniques have been described. It is strongly influenced by a variety of physiological factors, including age, diet, pregnancy, and drug ingestion. Urinary excretion is the principal mechanism of disposal for the excess sulfate produced by sulfur amino acid oxidation, and the kidney is the primary site of regulation. In renal failure, sulfoesters accumulate and hypersulfatemia contributes directly to the unmeasured anion gap characteristic of the condition. In contrast, sulfate in urine is readily assayed by a number of means, particularly nephelometry after precipitation as a barium salt. Sulfate is most commonly assayed today as part of the clinical workup for nephrolithiasis, because sulfate is a major contributor to the ionic strength of urine and alters the equilibrium constants governing saturation and precipitation of calcium salts. Total sulfate deficiency has hitherto not been described, although genetic defects in sulfate transporters have been associated recently with congenital osteochondrodystrophies that may be lethal. New insights into sulfate transport and its hormonal regulation may lead to new clinical applications of sulfate analysis in the future.

Molecular mechanisms of renal sulfate regulation

Inorganic sulfate is an important physiological anion that is a required cofactor for sulfate conjugation reactions of both endogenous and exogenous compounds. It is necessary for the detoxification of xenobiotics and endogenous compounds (catecholamines, steroids, bile acids), for the synthesis of structural components of membranes and tissues (sulfated glycosaminoglycans), and for the biologic activity of endogenous compounds (heparin and cholecystokinin). Inorganic sulfate homeostasis is largely maintained by reabsorption in the renal proximal tubule. Sodium-dependent sulfate cotransport in the brush border membrane is of primary importance in the regulation of plasma inorganic sulfate concentrations. Altered renal reabsorption of sulfate has been observed under different physiological (age, pregnancy, low dietary intake), pathological (hypothyroidism, trace metal excess), and pharmacological conditions (treatment with nonsteroidal antiinflammatory agents). The recent identification of the sulfate transporter genes has allowed the investigation of the molecular mechanisms of altered sulfate transport. Although the regulation of sulfate homeostasis is not fully understood, recent investigations have explored the cellular mechanisms of some of these alterations. In this review, the physiological importance of inorganic sulfate, the availability of this anion, and the regulation of sulfate homeostasis are discussed.

Age-related changes in homeostasis of inorganic sulfate in male F-344 rats

Advanced age is associated with a decline in renal function including decreased glomerular filtration rate, renal blood flow and renal tubular secretion. Endogenous inorganic sulfate homeostasis is maintained by concentration-dependent active renal reabsorption in the proximal tubule. The purpose of this study was to determine the effects of advanced age on: (1) the renal mechanisms for conserving endogenous inorganic sulfate and (2) the turnover of inorganic sulfate. Awake, male Fischer 344 rats age 4-5 months and 22-23 months received i.v. acetaminophen, 300 mg/kg, followed 2 h later by i.v. sodium sulfate, 2 mmol/kg, to lower and raise, respectively, plasma inorganic sulfate in order to measure the renal clearance of this anion from plasma at sub- and supraphysiologic concentration ranges. Another group of old and young male F-344 rats received a tracer injection of [35S]sodium sulfate to determine the effect of aging on the turnover of the endogenous inorganic sulfate pool. There was no statistically significant effect of advanced age on baseline plasma sulfate concentration or on the renal clearance of inorganic sulfate from plasma. The baseline excretion rate of inorganic sulfate in the senescent animals (0.38 +/- 0.25 mumol/min/kg, mean +/- S.D., n = 7) was significantly (P < 0.05) lower than that observed in the young animals (0.64 +/- 0.19 mumol/min/kg, n = 8). There was no difference in the turnover rate constant, as measured by the change in specific activity of urinary [35S]sodium sulfate, for the endogenous sulfate pool in old and young animals. Following acetaminophen administration, plasma sulfate concentrations declined similarly in young and old animals. Under the conditions of relative inorganic sulfate depletion, the renal excretion rate of inorganic sulfate decreased to zero in 7 of 8 young rats, whereas the old animals continued to excrete sulfate anion at an average rate of 23% of the baseline value. Aged animals have a defect in active tubular renal reabsorption of sulfate under conditions of sulfate depletion. Age-related changes in the total sulfate excretion rate may reflect changes in the metabolic fate of endogenous sulfate rather than changes in the endogenous production rate of this anion.

Assay of inorganic sulfate in biologic fluids by nonsuppressed (single-column) ion chromatography

An assay using nonsuppressed (single-column) anion chromatography was developed to determine the concentration of inorganic sulfate in biologic fluids. A conventional HPLC system with an anion-exchange column and conductimetric detector interfaced with an automatic injector and integrator was used. The mobile phase for the chromatography of urine and serum samples is 4 mM potassium hydrogen phthalate, pH 4.5, and potassium iodide is used as the internal standard. For cerebrospinal fluid samples, the mobile phase is modified by addition of 10% of a 4 mM phthalic acid solution. Results of the HPLC assay were found to correlate well (r = 0.991 and 0.999) with those of two commonly used spectrophotometric methods for urine and serum inorganic sulfate determinations. However, the concentrations determined by ion chromatography were 2.5 to 10% lower, possibly due to less assay interference by other substances following chromatographic separation of sulfate. Anion chromatography using a single-column system is a convenient and relatively inexpensive method with sufficient sensitivity for the determination of inorganic sulfate concentrations in urine, serum, and cerebrospinal fluid.