Serum isoamylases in liver diseases

Total serum amylase and its pancreatic and salivary isoamylase activities were studied in serum from 30 normal volunteers and 30 patients with liver disease. Isoenzyme analysis was performed by inhibitor assay and electrophoretic techniques. Six out of 30 patients had total serum amylase activities which exceeded the mean +/- 2 SD value for normal volunteers. The prominent type of isoenzyme was the pancreatic, except for patients with alcoholic cirrhosis. There was no evidence of any other type of isoenzyme by the electrophoretic method, nor was there an age-dependent isoamylase distribution.     

Serum hyaluronate correlates with histological progression in alcoholic liver disease

OBJECTIVES: Chronic alcohol consumption may lead to the development of liver cirrhosis. Serum concentrations of hyaluronate were suggested as a predictor in chronic liver disease, but its power to distinguish between severity of fibrosis and inflammation had not been assessed. In order to evaluate hyaluronate as a marker to detect early stages of alcoholic liver disease and to establish a possible correlation with hepatic histology, serum concentrations were measured by radioimmunoassay in 87 patients with biopsy-proven fatty liver, fatty liver and mild fibrosis, fatty liver and inflammation, severe fibrosis and inflammation, and cirrhosis, and in 12 non-alcoholic control subjects. In addition, serum hyaluronate was determined in 40 non-cirrhotic alcoholic patients with either a normal serum aspartate aminotransferase (AST) or an AST elevated at least two-fold. RESULTS: Serum hyaluronate increased significantly with advanced stages of alcoholic liver disease, while levels in patients with fatty liver were elevated only slightly without reaching significance. Hyaluronate correlated well with histological stage and was highly sensitive for detecting fibrosis in general and perivenular fibrosis as an indicator of progression to cirrhosis. Hyaluronate levels were not influenced by AST levels. CONCLUSION: Serum hyaluronate is a good predictor of the presence of even moderate hepatic fibrosis in alcoholic liver disease, justifying its clinical use to assess morphological alterations of the liver in alcoholics.     

Serum hyaluronate as a marker of hepatic derangement in acute liver damage

Twenty patients with paracetamol(acetaminophen)-induced acute liver damage of varying severity were studied longitudinally with assessment of clinical state, standard liver function tests and radiometric hyaluronate (HYA) assay (Pharmacia). In patients (n = 6) who developed coma, HYA rose rapidly with clinical deterioration to reach a median value of 27,510 micrograms/l, 7 days post-ingestion, which was significantly higher (p less than 0.005) than in patients (n = 7) who exhibited only marked derangement of liver function tests without evidence of encephalopathy, HYA median value of 3240 micrograms/l. These peak values showed no correlation to the peak values of serum alanine aminotransferase (ALT). A third group of patients (n = 7) who were treated with N-acetyl cysteine, did not exhibit any evidence of liver failure and showed no significant rise in levels of HYA or ALT. The data demonstrate that HYA is a rapidly changing marker of liver derangement which appears to follow the clinical course of the patient. The increase to extremely high levels in patients with hepatic encephalopathy, suggests that there is a reversible defect in the hepatic endothelial cell HYA receptor, possibly due to endothelial cell damage or release of toxins from the necrotic liver.     

Serum dolichols in chronic cholestatic liver diseases

BACKGROUND/AIMS: Dolichols are long-chain polyisoprenoid alcohols. It has been suggested that they modify membrane fluidity, stability and permeability. Some lysosomal diseases are associated with elevated serum dolichol levels. Liver has been suggested to play an important role in the regulation of serum dolichol levels and biliary excretion of dolichols has been proposed to be the main elimination route for dolichols from the body. The possible effect of liver diseases on serum dolichol, however, is not known. METHODS: We therefore studied the effect of early or intermediate primary biliary cirrhosis, primary sclerosing cholangitis and alcoholic liver cirrhosis on serum dolichol concentration. Furthermore, serum dolichol content was measured in patients with end-stage primary biliary cirrhosis, primary sclerosing cholangitis and chronic active hepatitis, waiting to be transplanted. RESULTS: As compared to age-adjusted controls, serum dolichol was significantly increased in early and intermediate primary biliary cirrhosis (451+/-56 ng/ml vs. 225+/-13 ng/ml, p<0.0001) and primary sclerosing cholangitis (315+/-16 ng/ml vs. 224+/-7 ng/ml, p<0.0001). However, in alcoholic liver cirrhosis serum dolichol was unaffected. Serum dolichol content was also significantly elevated in patients with end-stage primary biliary cirrhosis (844+/-210 ng/ml vs. 225+/-13, p<0.001) and chronic active hepatitis (594+/-198 vs. 224+/-7 ng/ml, p<0.02). Furthermore, in patients with liver diseases serum dolichol concentration correlated positively with serum high density lipoprotein (HDL)-cholesterol (r = +0.50, p<0.0001). CONCLUSIONS: Serum dolichol levels are elevated in all stages of chronic cholestatic liver diseases but not in alcoholic liver cirrhosis. Impaired biliary excretion of dolichols appears to be the primary explanation for this finding.     

Serum cathepsin activity in chronic liver diseases

Serum cathepsin activity and serum level of glycoproteins were determined in patients with chronic liver disorders (cirrhosis, chronic persistent hepatitis, chronic active hepatitis, hepatoma. An increase of cathepsin activity was found in chronic persistent hepatitis and cirrhosis of the liver. Increased level of glycoproteins was observed, the most evident in patients with chronic active hepatitis. An increase of the ratio cathepsin activity/glycoprotein concentration was found in chronic persistent hepatitis, and a decrease of this ratio was observed in chronic active hepatitis.     

酒精性肝病血清乙醇脱氢酶活性的变化

我们通过检测酒精性肝病、大量饮酒无肝病者的血清乙醇脱氢酶（ａｌｃｏｈｏｌｄｅｈｙｄｒｏｇｅｎａｓｅ，ＡＤＨ）活性，探讨其在酒精性肝病中的变化，为临床提供一个诊断酒精性肝损害的参考指标。 一、资料与方法 １．研究对象：酒精性肝病住院患者、大量饮酒无肝病者及健康人各３０例，男女之比分别为：２１：９、２２：８、２０：１０，平均年龄分别为３９．５岁、４１岁、４０．５岁。酒精性肝病的诊断标准参考既往报道［１］，部分经病理确诊，所有入选对象肝炎病毒标志物均阴性。 ２．标本收集：受试者于清晨空腹时静脉采血２ｍｌ…     

Serum hepatocyte growth factor levels in liver diseases: Clinical implications

Although recent studies have shown that hepatocyte growth factor (HGF) is a potent mitogen in vivo, the significance of serum HGF in liver diseases remains unclear. To clarify clinical significance of serum HGF in liver diseases, serum HGF was measured in 127 patients with liver diseases and in 200 healthy individuals, using a highly sensitive immunoradiometric assay (IRMA). This assay is specific for HGF and is sensitive enough to detect 0.1 ng/mL of HGF. Mean values for serum HGF in acute hepatitis (AH), chronic hepatitis (CH), liver cirrhosis (LC), hepatocellular carcinoma (HCC), primary biliary cirrhosis (PBC), fulminant hepatic failure (FHF), and normal controls were 0.45, 0.40, 1.05,1.06, 0.44, 16.40, and 0.27 ng/mL, respectively. Serum HGF levels in these diseases were significantly increased compared with those in the controls (P < .001), and exhibited a positive correlation with total bilirubin, indocyanine green (ICG) test (R15), asparate aminotransferase (AST), and a negative correlation with albumin and prothrombin time (P < .001). Cirrhotic patients with modified Child class C had higher levels of serum HGF than those graded as modified Child class A or B (P < .001). In CH, serum HGF levels were significantly related to the histological activity index (HAI) score (P < .002). Seven patients with HCC who underwent transcatheter arterial embolization (TAE) exhibited a gradual increase in serum HGF levels up to day 4 after treatment; these higher levels were maintained until day 7, although AST reached a peak on day 2 and then decreased gradually. During clinical courses of patients with AH and CH, serum HGF was increased immediately after elevations of aminotransferases, and decreased as clinical symptoms improved. Serum HGF levels in survivors with FHF or AH were decreased during the illness (P = .0156), whereas serum HGF levels in nonsurvivors with FHF were increased. These findings suggest that serum HGF reflects the degree of liver dysfunction in chronic hepatic failure, and that serial measurement of serum HGF levels in acute hepatic injury serves as a prognostic factor.