gamma-Glutamyl transpeptidase activity in Ascaris suum

Using histochemical techniques γ-glutamyl transpeptidase activity has been localized mainly in the cuticle-hypodermis in Ascaris suum. The specific activity of γ-glutamyl transpeptidase was 3.87 ± 0.49 μmol h⁻¹ (g tissue)⁻¹ in cuticle-hypodermis as compared to gastrointestinal tract, where it was 0.07 ± 0.02 μmol h⁻¹ (g tissue)⁻¹, and muscle and reproductive tract where it was <0.001 μmol h⁻¹ (g tissue)⁻¹. When cuticle sections were incubated with labelled glutamine a large portion of the glutamine nitrogen was recovered as ammonia which indicated glutamine uptake and utilization by the cuticle-hypodermis. Collectively these histochemical and biochemical data support the fact that γ-glutamyl transpeptidase activity is found in the cuticle-hypodermis of A. suum and this may be an indication that amino acid absorption could occur through the cuticle via the γ-glutamyl cycle.     

原发性胆汁性肝硬化的临床及病理学特征

目的 分析原发性胆汁性肝硬化患者的临床及病理学特征,以有助于提高对该病的认识及诊断。方法对37例原发性胆汁性肝硬化患者临床资料及其中20例肝穿刺病理资料进行回顾性分析。结果 原发性胆汁性肝硬化患者中女性35例,确诊时平均年龄为（50.4±8.9）岁,常见临床表现多为黄疸（70.3％）、乏力（70.3％）、瘙痒（56.8％）。所有患者γ-谷氨酰转肽酶（GGT）与碱性磷酸酶均有显著升高（中位值分别为 467.50 U/L和424.00 U/L）。94.6％（35/37）患者血清总胆汁酸水平、86.5％（32/37）患者血清胆固醇、86.5％（32/37）患者血清IgM有明显升高。91.9％（34/37）患者血清线粒体抗体和（或）线粒体抗体M2亚型阳性。20例原发性胆汁性肝硬化患者肝穿刺病理主要表现为:纤维化85％（17/20）、小叶间胆管损伤65％（13/20）、单核细胞炎症65％（13/20）、碎屑样坏死50％（10/20）、胆色素聚集 45％（9/20）。应用非参数检验分析示 GGT升高与病理分期（Z= 3.099,P=0.002）及小叶间胆管损伤程度相关（Z=2.655,P=0.01）。结论 原发性胆汁性肝硬化中年女性多见,临床工作中需综合临床、生物化学、免疫学及病理情况及时准确诊断。而GGT可部分反映PBC的组织学改变的严重程度。     

The prevalence of nonalcoholic fatty liver disease in Chinese adults screened by vibration controlled transient elastography and its diagnostic discrepancy compared with ultrasound

BackgroundThe prevalence of non-alcoholic fatty liver disease (NAFLD) in China as assessed using vibration-controlled transient elastography (VCTE) and its consistency with ultrasound is still unknown. We aimed to conduct a head-to-head comparison of consecutive measurements of NAFLD with ultrasound or VCTE to evaluate the discrepancy in the prevalence and distribution of NAFLD screened by two non-invasive techniques.MethodsWe collected VCTE and ultrasound examination data from 4,388 participants who underwent health check-ups at the Health Promotion Center of Jiangsu Province Hospital between January 2017 and December 2019. The major outcome was the presence of hepatic steatosis, which was defined as a median controlled attenuation parameter (CAP) ≥ 248 dB/m by VCTE or the definition of steatosis by ultrasound.ResultsAmong the 4,388 participants, 2,214 were diagnosed with NAFLD by VCTE (CAP ≥ 248 dB/m, 50.46%). Participants with severe steatosis (CAP ≥ 280 dB/m) were commonly male (77.94% vs. 50.38%, P < 0.001), were obese (45.09% vs. 1.79%, P < 0.001), had a worse metabolic profile, had elevated liver enzyme levels, and had advanced fibrosis. The prevalence of ultrasound-diagnosed NAFLD was 56.42%. After consistency analysis, VCTE and ultrasound showed moderate agreement regarding the diagnosis of NAFLD (κ = 0.475). We then compared the characteristics and clinical features of the four groups classified by the diagnosis results of the two techniques. NAFLD participants diagnosed by VCTE only were older, more obese, and had worse metabolic and biochemical profiles than NAFLD participants diagnosed by ultrasound only; in particular, the former had a higher proportion of abnormal alanine aminotransferase and aspartate aminotransferase levels and a higher proportion of advanced fibrosis than the latter.ConclusionsMore than half of Chinese adults were affected by NAFLD according to VCTE. Screening based on VCTE is more likely to identify NAFLD patients with severe clinical features than ultrasound. Therefore, VCTE is a more practical non-invasive tool for the screening and follow-up of NAFLD in China.     

36例原发性胆汁性肝硬化的临床特征分析

目的探讨原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)患者的临床特征,以提高对PBC的诊断与治疗水平。方法对具有完整资料的36例PBC的一般资料、从出现症状或肝功改变到确诊的时间、临床表现、血清化学指标、免疫学、影像学、病理学改变及治疗转归等进行回顾性分析。结果本组36例PBC患者中女性33例(91.7%)。从出现症状或肝功改变至确诊的平均时间为18.95个月,最长82个月。临床表现主要为乏力(80.6%)、皮肤瘙痒(69.4%);最主要的体征为黄疸(61.1%)和脾大(61.1%);AMA/AMA-M2阳性率达91.67%;r-谷胺酰转肽酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)和血清白蛋白(ALB)在不同的临床分期中差异有统计学意义(P<0.05)。肝硬化前期组经熊去氧胆酸(UDCA)治疗前后肝功的对比差异有统计学意义(P<0.05),而肝硬化期组此项对比差异无统计学意义(P>0.05)。结论 PBC以中年女性多见,高滴度AMA及AMA-M2亚型是诊断PBC的主要指标。肝硬化期GGT、TBIL和DBIL的水平明显高于肝硬化前期,而ALB水平反而明显降低。该病病程较长,在早期主要表现为原发性胆汁性胆管炎,需较长时间才发展为原发性胆汁性肝硬化。以UDCA为主的综合治疗能够明显改善早期患者的症状和血清胆汁淤积指标。因此早期发现、早期治疗效果较好。     

全自动精浆γ-L-谷氨酰转肽酶检测方法的建立及评价

目的:建立精浆γ-L-谷氨酰转肽酶(GGT)全自动检测方法并对其准确性、重复性和线性范围等进行评价。方法:利用速率法检测精浆GGT活性,并在全自动生化分析仪上建立检测参数,并评估该方法的试剂空白吸光度、准确性、重复性和线性范围,同时与目前临床上常用的精浆GGT检测化学比色法试剂盒(南京欣迪)进行比较。结果:试剂空白吸光度平均为0.047 6,空白吸光度变化率(△A/min)平均为0.000 168。3份高、中、低GGT活性的精浆样本重复测定10次的变异系数值分别为0.26%、4.83%和1.60%。采用比对试验的方法来评价准确性,40份精浆标本每个浓度点的相对偏差范围为-13.38%¹1.05%,均低于15%的要求。精浆GGT活性在29911.05%,均低于15%的要求。精浆GGT活性在299¹ 833 U/L范围时,具有良好的线性关系(r>0.99)。以精浆GGT检测化学比色法试剂盒作为对照试剂,全自动检测法作为试验试剂,两者对115例精浆样本的检测结果呈显著正相关(r=0.981,P<0.01),Kappa值为0.776(P<0.05),符合率为90.43%。结论:本研究建立的精浆GGT全自动检测法有较低的试剂空白,重复性和准确性较好,且与目前临床上使用的化学比色法有很好的一致性。该法操作简单、快速,精浆样本无需稀释,适合临床上大批量样本的检测筛查,大大节省了人力和试剂成本。     

血清谷氨酰转肽酶、碱性磷酸酶、腺苷脱氨酶联合糖类抗原 CA19-9在黄疸鉴别中的意义

目的：探讨血清谷氨酰转肽酶（ GGT）、碱性磷酸酶（ ALP）、腺苷脱氨酶（ ADA）、糖类抗原CA19-9升高程度在黄疸类型鉴别中的价值。方法选取本院2011年1月-2013年10月收治的黄疸患者614例,根据黄疸类型将614位患者分为肝细胞性黄疸组和梗阻性黄疸组,后者又分为良性梗阻性黄疸和恶性梗阻性黄疸两组,分析 GGT、ALP、ADA、CA19-9水平在各组间分布差异。结果 GGT、ALP 值在梗阻性黄疸组中较肝细胞性黄疸组高,差异有统计学意义（P ＜0.05）;ADA 值在肝细胞性黄疸组较对照组与梗阻性黄疸组增高,差异有统计学意义（P＜0.05）;GGT、ALP、CA19-9值在恶性梗阻性黄疸组中较良性梗阻性黄疸组高,差异有统计学意义（ P ＜0.05）。结论 GGT、ALP 显著升高,而 ADA 无明显升高的黄疸考虑梗阻性黄疸;GGT、ALP 轻中度升高,而 ADA 显著升高的黄疸考虑肝细胞性性黄疸;GGT、ALP、CA19-9均显著升高者考虑恶性梗阻性黄疸。     

Measurement of circulating biliary glycoprotein (CD66a) in liver diseases

Purpose. Biliary glycoprotein (BGP), a member of the carcinoembryonic antigen (CEA) gene family, is produced by hepatocytes, and is suggested to function as a cell adhesion molecule, mouse hepatitis virus receptor, and tumor suppressor. Our aim was to establish an enzyme immunoassay for circulating BGP and to study its significance in liver diseases. Methods. For enzyme immunoassay, a monoclonal antibody (mAb), TS135, which recognizes BGP was used as a catcher, and biotin-labeled polyclonal anti-CEA antibodies were used as a tracer. Seventy-six serum specimens obtained from patients with various liver diseases were submitted to the assay. Results. The incidence of positivity for antigen TS135 in the serum samples of the 76 patients was 57.9%. The most significant correlation among conventional liver function tests was found between antigen TS135 and γ-glutamyl transpeptidase (γ-GTP). However, among the 56 patients whose serum antigen TS135 and γ-GTP levels could be measured simultaneously, 5 were antigen TS135-positive and γ-GTP-negative (8.9%) and 6 were antigen TS135-negative and γ-GTP-positive (10.7%). The increased serum level of antigen TS135 in 6 cholangiocellular carcinoma (CCC) patients led us to the immunohistochemical study of CCC, in which 8 of the 8 tissue specimens tested were positive for mAb TS135, indicating the production of the antigen from CCCs. Conclusions. This preliminary study suggests that the circulating antigen TS135 level correlates with γ-GTP in liver diseases, but that TS135 may also have a unique significance, different from that of γ-GTP, as a liver function test. Received: September 14, 2000 / Accepted: January 26, 2001     

Myeloperoxidase gene polymorphism predicts fibrosis severity in women with hepatitis C

Oxidative stress plays an important role on liver fibrosis progression in the course of hepatitis C virus (HCV) infection. Myeloperoxidase (MPO) is an enzyme released by neutrophils and macrophages, responsible for generating hypochlorous acid and reactive oxygen species (ROS) that may lead to liver injury in HCV infection. On the other hand, antioxidant enzymes such as manganese superoxide dismutase (SOD) controls ROS-mediated damage. The aim of the present study was to investigate the influence of MPO G-463A and SOD2 Ala16Val polymorphisms in the severity of liver fibrosis in individuals with chronic HCV infection. The present study included 270 patients with chronic HCV recruited from the Gastrohepatology Service of the Oswaldo Cruz University Hospital/Liver Institute of Pernambuco (Recife, Northeastern Brazil). All patients underwent liver biopsy, which was classified according METAVIR score. The SNPs were determined by real-time PCR. After multivariate analysis adjustment, the GG genotype of MPO and the presence of metabolic syndrome were independently associated with fibrosis severity in women (P = 0.025 OR 2.25 CI 1.10–4.59 and P = 0.032 OR 2.32 CI 1.07–5.01, respectively). The presence of the GG genotype seems to be a risk factor for fibrosis severity in women with HCV.     

青中年人群中血清谷氨酰转肽酶浓度与动脉硬化的关系

目的 探索社区青中年人群血清谷氨酰转肽酶浓度与动脉硬化的关系.方法 本研究是一个横断面研究,所有年龄18～65岁的参与者均于2014年1月至2016年12月来自广东社区,且均采集人口信息学及完善体格检查、血糖、血脂、肝酶和脉搏波传导速度检测,根据肱踝脉搏波传导速度将入选者分为动脉硬化(≥1400 cm/s)组和正常组(...     

Action mechanism of Yi Guan Jian Decoction on CCl4 induced cirrhosis in rats

Aim of study

To investigate action mechanism of Yi Guan Jian Decoction on cirrhosis induced by CCl₄ in rats.

Material and methods

CCl₄ (3 mL/kg) for the first time and then olive oil CCl₄ solution 50% (2 mL/kg) was administered hypodermically to rats twice each week for 12 weeks. At the end of 8th week, rats were randomly divided into CCl₄ control group (n = 10), Yi Guan Jian Decoction group (n = 9) and Xiao Chai Hu Decoction group (n = 9). Yi Guan Jian Decoction and Xiao Chai Hu Decoction were oral administrated per day respectively for 4 weeks, concomitantly continued CCl₄ administration. At 12th weekend, the rats were sacrificed for sampling and detection of liver function, histological changes of liver tissue, liver tissue hydroxyproline content and expression of α-SMA, CD68, MMP-13, TIMP-1, TIMP-2, Caspase-12, HGFα, MMP-2, MMP-9 and hepatocyte apoptotic index.

Results and conclusions

(1) Compared with that of normal rats, expression of α-SMA, CD68 and TIMP-1 in liver tissue of 8 week model group rats increases significantly (P < 0.01), moreover further increased in the 12 week of model group. However, MMP-13, HGFα, TIMP-2 content decreases gradually and the statistical difference is seen between each time point (P < 0.01). Activity of MMP-2, MMP-9, content of Caspase-12 and hepatocyte apoptotic index increased gradually at 4th, 8th, 12th week. (2) Compared to that of the same time point model group, activity of MMP-9 and contents of MMP-13, TIMP-2 and HGFα in Yi Guan Jian Decoction group improves significantly (P < 0.01), and activity of MMP-2 and contents of α-SMA, TIMP-1, Caspase-12 and hepatocyte apoptotic index decreases significantly (P < 0.01). This work suggests that Yi Guan Jian Decoction exerts significant therapeutic effect on CCl₄-induced cirrhosis in rats, through mechanism of inhibiting hepatocytes apoptosis and hepatic stellate cells activation, and regulating the function of Kupffer cell.

Ethnopharmacological relevance

This study investigates the mechanism of Yi Guan Jian against cirrhosis from aspect of heptocytes apoptosis and hepatic stellate cells activation. It suggest that although of unknown bioactive ingredients, mechanism of traditional Chinese medicine recipe against cirrhosis can be disclosed and of profound significance.