ABSTRACT. To explore the possible association of hyperlipidemia with hyperammonemia and aspirin ingestion, the effects of NH4+, salicylate, and carnitine on the oxidation of [l-'4C]palmitic acid to acid-soluble products (ASP) and to C 0 2 were investigated in rat liver slices. DL-carnitine (5 mM) increased total oxidation (ASP + C02) more than oxidation to C02. KCN (1.5 mM) inhibited more than 90% of the oxidation. N&CI inhibited the oxidation that reached a maximum at about 40 mM, but the inhibition of oxidation to COz (63%) was larger than that of total oxidation (30%). Carnitine did not influence NH4+ inhibition, which is consistent with the results reported for isolated mitochondria. Salicylate effects depended on salicylate concentration as well as on the presence of carnitine. In the absence of carnitine, inhibition of total oxidation reached 90% at 3 mM salicylate but that of oxidation to C 0 2 reached 50%. Velocity calculated at saturating palmitic acid concentration for total oxidation was slightly increased by 0.75 mM salicylate, but the increase for oxidation to C 0 2 was larger. At 3 mM salicylate, velocity at saturating palmitic acid concentration for the oxidation was decreased, but the decrease for oxidation to COz was smaller than for total oxidation. Carnitine partially relieved the inhibition of total oxidation and further increased the formation of COz. The combination of 20 mM NKCI and 0.75 rnM salicylate inhibited total oxidation, which was more than additive of the individual effects, and carnitine partially relieved the inhibition. It is concluded that NH4+ exerted a stronger inhibition of oxidation to COZ than of oxidation to ASP, whereas salicylate strongly inhibited the oxidation to ASP but increased the oxidation to COz by uncoupling mitochondrial oxidative phosphorylation. Therefore, hyperammonemia and aspirin ingestion can inhibit fatty acid oxidation and mitochondrial metabolism that could lead to the pathophysiology seen in some childhood diseases such as Reye's syndrome. Carnitine therapy might offer some benefits. (Pediatr Res 25:119-123,1989 Abbreviations RS, Reye's syndrome ASP, acid soluble products V,, velocity calculated for saturating substrate (palmitic acid) concentration Elevation of serum-free fatty acids and fatty infiltration of liver are some of the common pathologic manifestations in children with enzyme defects of the urea cycle (1) and RS (2). Hyperammonemia is also an early laboratory finding in these disease states. It is suggested that the pathophysiology of RS is a metabolic response to an acute injury to mitochondria (3). Among many factors, salicylate, which is the predominant product circulating in blood after ingestion of aspirin, has been implicated in the etiology of RS (4). Salicylate may interfere with the synthesis of high energy phosphates and contribute to mitochondrial degeneration because salicylate uncouples mitochondrial respiration (5), inhibits the activation of fatty acids (6) and induces mitochondrial swelling (7). Similar damaging effec...