To the Editor: We read with interest the report of Stacpoole et al. in the March 9 issue of the Journal concerning human trials with dichloroacetate. Some observations that we have made are of potential importance for further experimentation. Dichloroacetate stimulates fatty acid synthesis at 1 to 2 mM in isolated rat-liver cells, but this stimulation is lost at higher concentrations.1 Provided physiologic concentrations of bicarbonate, as well as a source of amino groups for the malate-asparate shuttle, are available, dichloroacetate does not inhibit gluconeogenesis at concentrations that fully activate pyruvate dehydrogenase.2 It is unfortunate that little work correlating blood.
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