Selenium, alcohol and liver diseases

A possible pathogenetic role of selenium deficiency in alcoholic cirrhosis of the liver has previously been discussed. In the present study, serum concentrations of selenium, copper and zinc were analyzed in alcoholic cirrhosis as well as in chronic active hepatitis and primary biliary cirrhosis. The serum concentrations of selenium were consistently decreased in patients suffering from alcoholic cirrhosis. Zinc values were also low in these patients. Studies of a possible therapeutic effect of zinc and selenium supplementation are of interest. Other authors have reported increased hepatic lipoperoxidation and decreased hepatocellular glutathione levels in animals consuming ethanol. It is hypothesized that the low levels of Se and Zn, in combination with the reported glutathione depletion, makes the hepatocytes more vulnerable toward the toxicity of ethanol.     

Current problems in the diagnosis and treatment of small intestinal diseases

Based on the data obtained during clinical examination of 1,026 patients with small intestinal diseases the authors provide the portion of laboratory and instrumental methods employed in the diagnosis of different disease entities. The clinical picture of small intestinal diseases is mainly determined by the gravity of malabsorption. Histological examination of the small intestinal mucosa is a method of choice in the diagnosis of gluten enteropathy, Whipple's disease, primary lymphangiectasis and amyloidosis. Immunoassays play the key role in recognition of variable immunodeficiencies and disease of heavy alpha-chains. Meanwhile in differential diagnosis of Crohn's disease, small intestinal tumors, congenital abnormalities of rotation and in some others, the leading part is played by x-ray methods. The authors describe the treatment schedule based on the pathogenetic approach, that makes it possible to reach a stable clinical remission and recovery of the working capacity even in part of patients with stage III malabsorption.     

Reamberin for pathogenetic therapy of acute and chronic viral diseases of the liver

The study including 427 patients with acute and chronic viral hepatitis was designed to assess results of clinical and laboratory diagnostics of hepatic problems and the state of thiosulfide antioxidative system. It was shown that infusion of succinate-containing preparation reamberin (400 ml/day for 10 days) took less time to eliminate clinical manifestation of the disease (dispeptic and asthenovegetative syndromes) than conventional therapy. Simultaneously the levels of biochemical markers of hepatic cytolysis and cholestasis significantly decreased while serum antioxidative potential recovered. The normal size of the liver was achieved 3.4 times more frequently than in control. No side effects or adverse reactions other than listed in the instruction for use of reamberin occurred. The preparation had to be withdrawn only in one patient.     

Orcein-positive material in hepatocytes in viral hepatitis and other liver diseases

Summary Liver biopsy samples from 110 patients with various liver diseases were stained by orcein according to the method of Shikata et al. Orcein-positive hepatocellular material was observed in only the 31.7% of HBsAg seroposirive cases. A positive orcein reaction was frequently found in prottracted and chronic viral hepatitis and occasionally in other liver diseases, such as alcoholie and cholestatic hepatitis, as well as in cryptogenetic cirrhosis and in liver metastases. The results obtained suggest a more cautious evaluation of the diagnostic and prognostic significance of orcein positive hepatocellular material.     

Differential expression of matrix metalloproteinases in viral and non-viral chronic liver diseases

BACKGROUND: Fibrosis is a common consequence of chronic liver diseases irrespective of aetiology. Metalloproteinases play an important role in the fibrotic process participating in the balance between collagen synthesis and degradation. We examined whether matrix gelatinases and stromelysins are similarly involved in the development of viral (HCV, HBV) and non-viral (NASH) liver diseases. METHODS: Hepatic mRNA levels of matrix metalloproteinase MMP-2, MMP-9, MMP-10 and MMP-11 isolated from liver biopsies were measured by semi-quantitative RT-PCR. Seventy-three patients were examined in this study: non-diseased controls (10), patients with chronic hepatitis B (14), chronic hepatitis C (33) and non-alcoholic steatohepatitis (16). RESULTS: A significant increase of MMP-9 and MMP-10 expression was found in patients with non-viral (non-alcoholic steatohepatitis) liver disease. Patients with chronic hepatitis B and hepatitis C showed an increase in MMP-2 mRNA expression compared to controls. Moreover, chronic hepatitis B and hepatitis C patients had significantly different mRNA expression patterns. CONCLUSIONS: These findings indicate that matrix metalloproteinases are differentially involved in the fibrotic process of viral and non-viral chronic liver diseases. Differences exist between HBV and HCV chronic hepatitis. Differences between early and late fibrosis indicate that in future studies, careful staging of patients is mandatory for interpretation of results.