Hepatic collagenolytic cathepsin in patients with chronic liver disease

Human hepatic collagenolytic cathepsin consisted of a major component having a molecular weight of 25 000 and a minor one of 35 000; the former is indistinguishable for cathepsin B in its enzymatic properties. Hepatic collagenolytic cathepsin increased in chronic active liver disease in proportion to hepatic hydroxyproline content. The ratio of collagenolytic cathepsin to hepatic hydroxyproline content remained within the normal range in chronic hepatitis, but decreased significantly in cirrhosis. These results suggest that collagenolytic cathepsin participates, at least partly, in the progress of hepatic fibrosis.

Clinical evaluation of serum levels of tryptophan in hepatobiliary disease

Fasting serum levels of total and free tryptophan, and free fatty acids and albumin, were measured and compared by blood biochemical analysis in patients with hepatobiliary disease and neuropsychiatric symptoms. The serum total tryptophan level tended to be elevated in patients with chronic active hepatitis, hepatic coma and obstructive jaundice, but not significantly. The serum free tryptophan level was significantly elevated in patients with chronic active hepatitis, liver cirrhosis, primary hepatocellular carcinoma and obstructive jaundice. The free tryptophan level was related to the decreased serum albumin level and elevated serum free fatty acid levels, which seems to indicate a connection with liver parenchymal function. The level, however, seemed not to correlate with neuropsychiatric symptoms.

Antibodies to denatured bovine collagens in sera of patients with liver disease

Sera from 101 patients with liver disease were studied for the presence of antibodies to three types of denatured bovine collagens by passive haemagglutination assay. A high incidence and titres were found especially in chronic active hepatitis, liver cirrhosis and primary hepatoma. The incidence and titres of antibodies to Type I and Type III collagens were significantly higher than those of antibodies to Type II collagen. Analysis by gel filtration on Sephadex G-200 or absorption with anti-IgG and IgM antisera revealed that the antibodies belonged to both IgG and IgM classes. They correlated with serum gamma-globulin levels, but not with rheumatoid factor.

Effect of chronic ethanol administration on serum high density lipoprotein cholesterol in rat

In rats chronic ethanol administration was found in fasting state not to induce hypertriglyceridemia but moderate hypercholesterolemia through an increased level of high density lipoprotein cholesterol. In the liver, cholesterol contents slightly and triglyceride centents significantly increased. The result suggests that cholesterol accumulation in the liver leads to an increased level of high density lipoprotein cholesterol.

[Radioimmunoassay of cholylglycine in serum (author's transl)]

Serum levels of cholylglycines (CG) were determined by radioimmunoassay and that of total bile acids (TBA) by enzymatic method. In normal subjects, serum levels of CG, TBA and CG/TBA ratio were 0.6 +/- 0.4 micronM, 7 +/- 2 micronM and 0.08 +/- 0.06, respectively. They were increased markedly in acute hepatitis and moderately in chronic hepatitis and cirrhosis. Thus, measurement of serum CG as compared with serum TBA appears to be a sensitive liver test.

Dye clearance studies in Rotor's syndrome

Plasma clearances of sulfobromophthalein sodium (BSP), indocyanine green (ICG) and unconjugated bilirubin were studied in six patients with Rotor's syndrome. A marked retention of these three substances in the plasma was observed. At 60 minutes after injection, serum BSP consisted almost entirely of the unconjugated form. In three patients, BSP Tm and BSP S were significantly reduced. Clearance of unconjugated bilirubin was markedly impaired. This, together with the conjugated hyperbilirubinemia may be interpreted to reflect reduced storage. These results indicate that Rotor's syndrome is marked by reduced hepatic storage capacity and excretory function of BSP, ICG and bilirubin.

Unconjugated bilirubin kinetics in Dubin-Johnson syndrome

Plasma unconjugated bilirubin kinetics were studied by a two-compartment analysis in 10 patients with Dubin-Johnson syndrome (DJS) and 7 normal controls. The clearance of unconjugated bilirubin from plasma was significantly reduced in the patients with DJS as compared to the controls (p less than 0.01). Kinetic analysis of plasma disappearance data showed an increase in reflux and decrease in conjugation. These results indicate that defects in both conjugated and unconjugated bilirubin metabolism exist in DJS.

Serum cholesterol and squalene in hepatocellular carcinoma

In 15 patients with hepatocellular carcinoma, the serum squalene level is raised significantly in parallel with the serum cholesterol level, though significantly decreased in patients with cholestatic hepatobiliary disease. Serum levels of cholesterol and/or squalene, therefore, could be regarded as a laboratory index reflecting a peculiar sterol metabolism in hepatocellular carcinoma.

Serum squalene levels in hepatobiliary diseases

Serum squalene levels did not change in patients with acute hepatitis, chronic active hepatitis and liver cirrhosis, but were significantly reduced in patients with intra- and extrahepatic cholestasis. The ratio of cholesterol to squalene remained normal in patients with acute hepatitis as well as chronic active hepatitis, while being slightly decreased in patients with liver cirrhosis. On the other hand, in patients with cholestasis the ratio was markedly raised. From these observations we confirmed abnormal sterol metabolism in hepatobiliary diseases, and clinical usefulness of the ratio of cholesterol to squalene to distinguish hepatocellular injury and cholestasis.

Value of B-scan ultrasonography in the diagnosis of liver cancer. Accuracy compared to scintigraphy and angiography

Seventy-one patients with liver cancer were examined by B-scan ultrasonography. The presence of liver cancer was assumed through the irregularity and increased intensity of echos. The accuracy of ultrasonography in the diagnosis of liver cancer was 72%, while the diagnostic accuracy of scintigraphy was 85% and angiography 93%. No obvious correlation could be demonstrated between the ultrasonographic patterns and serum alpha-fetoprotein (AFP) levels. Ultrasonography is a useful method of detecting liver cancer.

Effect of corticosteroid treatment on bilirubin metabolism in chronic aggressive hepatitis

The metabolism of unconjugated bilirubin from the plasma was studied in 17 patients with chronic hepatitis and 7 normal subjects following a single injection of bilirubin of 2 mg per kg body weight. From the plasma disappearance curves of unconjugated bilirubin, hepatic uptake, reflux from the liver to the plasma and hepatic conjugation were calculated by 2 compartmental analysis. The clearance remained within normal range in 5 patients with chronic persistent hepatitis but was significantly impaired in 12 patients with chronic aggressive hepatitis, in which corticosteroid treatment improved the clearance significantly (p less than 0.01). Since urinary excretion of d-glucaric acid remained unchanged by corticosteroid treatment, the improved clearance may be attributable to increased hepatic parenchymal function.

Diagnostic significance of fasting serum bile acid in liver disease

Serum bile acid was extracted with Amberlite XAD-2 followed by determination with an enzymatic and fluorimetric technique. Normal value for fasting serum bile acid was found to be 3 +/- 2 muM. Serum bile acid level was raised markedly early in the course of acute viral hepatitis, subsequently fell rapidly before resolution of biochemical tests, and was elevated again in relapse. In chronic liver disease serum bile acid was elevated moderately and correlated roughly with disease severity. In comparison with routine biochemical tests, serum bile acid correlated significantly with serum bilirubin, BSP retention and other hepatic tests, except serum cholesterol. Thus fasting serum bile acid level is a reliable screening test for a variety of liver disease to assess functional and morphological impairment of the liver.

Serum cholesterol and bile acid in primary hepatoma

The close relationship between serum levels of cholesterol and bile acid has been confirmed in 46 patients with primary hepatoma. Serum levels of cholesterol and bile acid are roughly correlated with serum alpha-fetoprotein concentration. Because the relationship between serum cholesterol and bile acid did not exist in common hepatocellular diseases, the results suggest a peculiar sterol metabolism occurring in human hepatoma.

Serum haptoglobin type and liver cirrhosis

Haptoglobin phenotypes were studied by a polyacrylamide gel electrophoresis on 200 blood donors and 105 patients with liver cirrhosis, of which 79% belonged to non-alcoholic etiology. Though no difference of haptoglobin types could be found between blood donors with positive and negative hepatitis B antigen, the cirrhois patients had an excess haptoglobin gene 1. The patients with haptoglobin gene 1 were associated with severe liver dysfunction. Since the family pedigrees of the patients with type 1--1 excluded individuals with type 2--2, the phenotypes seemed to be stable in the cirrhotic process. The possibility that the haptoglobin 2 gene offered resistence to the non-alcoholic cirrhosis was discussed.

Studies on the relationship of hepatic anion-binding proteins and sulfobromophthalein-glutathione conjugation in normal and phenobarbital-treated rats

The enzyme activity which conjugates sulfobromophthalein with glutathione was separated from rat liver supernate by Sephadex G-75 gel filtration, and assayed by two different methods; paper electrophoresis and spectrophotometry. The enzyme activity was found mainly in the second protein fraction, and less than 5% of the activity in the first or third protein fractions. In vitro mixtures of sulfobromophthalein, [3-H]glutathione and rat liver supernate showed that the major part of [3-H]glutathione was detected in the first and second protein fractions, and the remainder in the third protein fraction. Phenobarbital treatment caused an increase of the enzyme activity, sulfobromophthalein and [3-H]glutathione, in the second protein fraction.

Quantitative and metabolic changes of hepatic collagens in rats after carbon tetrachloride poisoning

1. The collagen hydroxyproline in rat liver was composed of 3.5% neutral-soluble collagen, 4.9% acid-soluble collagen and 91.6% insoluble collagen. In labelling studies with [(14)C]proline in vitro, the specific radioactivities of neutral-soluble, acid-soluble and insoluble collagens in rat liver were found to be 233000, 69000 and 830d.p.m./mumol of hydroxyproline respectively after 1h. 2. During subacute carbon tetrachloride poisoning the hepatic content of insoluble collagen markedly increased, whereas those of soluble collagens did not change. During recovery from subacute poisoning hepatic contents of soluble collagens were markedly decreased. 3. After 8 weeks of carbon tetrachloride poisoning the specific radioactivities of hepatic soluble collagens increased, while that of insoluble collagen decreased. During recovery from subacute poisoning, the specific radioactivities of soluble collagens decreased to the normal range and that of insoluble collagen further decreased. 4. Hepatic collagenolytic activity solubilizing insoluble collagen, which differs from mammalian collagenase, decreased under the conditions of the subacute poisoning and also during recovery from subacute poisoning.

Hepatic collagenolytic activity in rats after carbon tetrachloride poisoning

1. Collagenolytic activity towards acid-soluble collagen labelled with [(14)C]-proline was assayed in rat liver with and without carbon tetrachloride poisoning. The products of enzymic digestion were found to be free amino acids and peptides. 2. The hepatic collagenolytic activity increased under conditions of single-dose and subacute carbon tetrachloride poisoning, and correlated with hydroxyproline content. The highest activity was found during recovery from subacute poisoning. 3. Under the same experimental conditions, hepatic acid-proteinase activity changed independently of the collagenolytic activity and also of hepatic hydroxyproline content. 4. The increased collagenolytic activity during carbon tetrachloride poisoning was found mainly in the supernatant fraction. 5. The ratio of the collagenolytic activity to hepatic hydroxyproline content increased during recovery from single-dose and subacute poisoning, and decreased during subacute poisoning.