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Progastrin and its Products from Patients with Chronic Viral Hepatitis and Liver Cirrhosis
Authors:Konturek S J  Gonciarz M  Gonciarz Z  Bielanski W  Mazur W  Mularczyk A
Institution:1. Dept. of Physiology Medical College Jagiellonian University Kraków Poland;2. Dept. of Internal Medicine Silesian University Medical School Katowice Poland;3. Dept. of Clinical Biochemistry Rigshospitalet University of Copenhagen Copenhagen Denmark
Abstract:Background: Gastrin and its precursor, progastrin, are synthesized in the stomach, particularly when infected with Helicobacter pylori , and they are metabolized, at least in part, in the liver. However, little is known about their levels in various hepatic diseases. Methods: This study was carried out on 147 patients including chronic hepatitis B ( n &#114 = &#114 35), hepatitis C ( n &#114 = &#114 52) and liver cirrhosis ( n &#114 = &#114 60) of class A ( n &#114 = &#114 38), class B ( n &#114 = &#114 15) and class C ( n &#114 = &#114 7) (Child-Pugh classification) and age- and sex-matched healthy controls ( n &#114 = &#114 65). The diagnosis of chronic hepatitis was confirmed by liver biopsy in all patients, whereas the diagnosis of liver cirrhosis was based on clinical and laboratory findings. Liver biopsy was done in 38 out of 60 patients. Blood samples were collected under basal conditions and separated plasma samples were kept frozen at &#109 70°C until radioimmunoassay of progastrin and its products, including bioactive amidated gastrins. Results: Median (range) plasma concentrations of total progastrin product and amidated gastrin in control subjects were 147.5 (73-345) pM and 33 (15-65), respectively. These concentrations in hepatitis B and C were not significantly different from those in controls. In cirrhosis (classes A, B and C), the concentrations of the progastrin and of gastrin were significantly ( P &#114 < &#114 0.05) higher than in controls reaching, respectively, 253.5 (135-683 &#114 pM) and 47.5 (17-385) pM. Both progastrin and gastrin levels were significantly higher in H. pylori -positive than in negative cirrhotic patients. Antibodies against H. pylori were present in about 50% of controls, 68% of hepatitis B, 57% of hepatitis C and in 83% in cirrhosis patients. The difference in H. pylori prevalence between cirrhosis and controls was statistically significant. Conclusions: Plasma levels of progastrin and gastrin are significantly increased in cirrhotic patients and this could be attributed to reduced metabolism of these peptides in liver cirrhosis and to their increased release due to H. pylori infection rate in this disease.
Keywords:Gastrin  H  Pylori  Hepatitis  Liver Cirrhosis  Progastrin
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