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At least 397 records · Page 22Linked to original sources
PubMed2002

Plasma amino acids in cirrhosis and after liver transplantation: influence of liver function, hepatic hemodynamics and circulating hormones.

Liver cirrhosis is characterized by substantial changes in amino acid (AA) metabolism, resulting in a deranged plasma AA profile. To investigate the effect of liver transplantation (OLT), we studied arterial AA profiles in 52 patients with advanced cirrhosis, 16 stable patients over 6 months after OLT and 48 controls. Changes in AA levels were correlated with portal pressure (hepatic venous pressure gradient), functional hepatic blood flow (indocyanine green extraction) and circulating hormone levels (catecholamines, insulin, C-peptide). Fourteen of 18 measured AA were significantly altered in cirrhosis and 11 of 18 remained abnormal after OLT compared with controls. Aromatic AA (AAA) and methionine were elevated in cirrhosis (p < 0.001 each), increasing with disease stage, and normalized after OLT. Branched chain AA (BCAA) levels were decreased in cirrhosis (p < 0.001) and were unrelated to disease stage. After OLT, BCAA levels remained subnormal (p < 0.01), although higher than in cirrhosis (p < 0.001). AAA levels increased with decreasing functional hepatic blood flow (r = -0.67; p < 0.001) and increasing portal pressure (r = 0.59; p < 0.001). BCAA levels decreased with increasing catecholamine (r = - 0.54, p < 0.001) and insulin levels (r = - 0.40, p = 0.001). We conclude that despite normal liver function, AA metabolism is only partially normalized after OLT. AAA levels mainly determined by hepatic metabolic function and functional liver blood flow return to normal, while BCAA levels remain subnormal, indicating persistent changes in muscular AA metabolism after OLT.

Adult↗
PubMed1983

Dual role of the liver in regulating circulating polymeric IgA in man: studies on patients with liver disease.

The human liver probably removes circulating polymeric IgA by two routes: (1) secretory component-mediated endocytic transport of polymeric IgA from portal tract blood vessels into bile across biliary epithelial cells and (2) uptake with possible catabolism by hepatocytes and/or sinusoidal phagocytic cells by uncharacterized receptor(s). Failure of either clearance mechanism due to liver disease results in elevated serum polymeric IgA levels. In patients with cholestasis, the raised serum polymeric IgA concentration is due to reflux of biliary secretory immunoglobulin into the blood.

Alkaline Phosphatase↗
PubMed1985

The effect of acute liver damage on circulating ferritin levels in vivo and in the isolated perfused rat liver.

The effects of minimal acute liver injury on circulating ferritin levels have been examined in the rat both in vivo and in the isolated perfused liver. Liver damage produced by 6 mmol/kg of D-galactosamine (GalN) in vivo resulted in a marked rise in plasma ferritin levels 4 h after administration, 2 h before any significant increase in plasma aspartate transaminase. In the isolated perfused liver, damage produced by 5mM GalN introduced into the perfusate also produced an early increase in circulating ferritin before any evidence of release of intracellular enzymes, or alteration in liver histology as assessed by light microscopy was apparent. It is concluded that minimal acute liver damage results in a pronounced increase in circulating ferritin levels before other evidence of liver dysfunction. This is unlikely to be due solely to increased release from damaged cells but may rather result from an alteration in the mechanism responsible for ferritin homeostasis.

Animals↗
PubMed1976

Disturbances in hepatic blood flow during anesthesia and surgery.

A study of 88 patients showed a reduction in the estimated hepatic blood flow (EHBF), as measured by a colloidal gold technique, to 88% and 84% of its initial value during ether and halothane anesthesia, respectively. During the operative procedure itself, there was a further fall in the EHBF. In patients undergoing herniorrhaphy or excision of a breast tumor, the EHBF decreased to 82% and 76%, while in patients undergoing partial gastrectomy or cholecystectomy, the EHBF fell to 48% and 42% of its initial value during operations under ether and halothane anesthesia, respectively. The surgical trauma itself would appear to be the main determinant of the alteration in the liver circulation during the operation.

Anesthesia, Inhalation↗
PubMed2001

Hepatocellular damage in porcine endotoxemia: beneficial effects of selective versus non-selective nitric oxide synthase inhibition?

UNLABELLED: While nitric oxide (NO) is implicated as an important mediator of hypotension in sepsis and endotoxemia, its role as a mediator of tissue injury in shock is controversial. During porcine endotoxemia (lipopolysaccharide (LPS) 1.7 microg kg(-1) x h(-1) i.v. for 6 h), we compared circulatory and morphological changes in the liver induced by two different NO synthase inhibitors (N(G)-nitro-L-arginine methyl ester, L-NAME, 25 mg x kg(-1) i.v. and aminoethyl-isothiourea, AE-ITU, 10 mg x kg(-1) i.v.), both given after 3 h. LPS induced time-dependent tissue reactions with edema, sinusoidal dilation, packing of red cells and leukocyte infiltration, progressing to endothelial cell and hepatocyte damage, formation of thrombi, and at 6 h widespread necrosis. These changes were similar in all pigs receiving LPS, regardless of treatment with NOS inhibitors. LPS caused significant increases in aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alpha glutathione S-transferase (alpha-GST), L-NAME caused further increases in AST, ALP and alpha-GST, while AE-ITU prevented the late increase in ALP and alpha-GST observed in the other LPS groups. LPS reduced liver blood flow by approximately 40%. L-NAME further reduced flow by approximately 50%, while AE-ITU restored liver blood flow to baseline values. CONCLUSION: L-NAME in endotoxemia had detrimental effects on liver circulation, while AE-ITU improved liver blood flow and attenuated the late increase in liver enzymes. Liver morphology was unaffected within the 3-h observation time after NOS inhibition.

Animals↗
PubMed1995

Hepatomesenteric release and removal of norepinephrine in swine.

Release and removal of norepinephrine (NE) by hepatomesenteric organs in anesthetized swine were examined using measurements of NE in arterial, portal, and hepatic venous plasma. NE spillover from the liver and mesenteric organs increased during splanchnic nerve stimulation, validating these measurements as indexes of sympathetic outflow. Administration of the neuronal uptake-blocking drug desipramine reduced mesenteric NE extraction more than hepatic extraction, suggesting that neuronal uptake was more important for NE removal in mesenteric organs than in the liver. Circulating NE was removed by the liver more efficiently than by mesenteric organs, whereas mesenteric NE spillover (2.46 nmol/min) exceeded liver NE spillover (0.74 nmol/min). Hepatomesenteric NE spillover represented 53% of total body spillover; NE clearance was 42% of total body clearance. Because of efficient hepatic extraction of NE released by mesenteric organs, the sum of mesenteric and hepatic NE spillovers (3.20 pmol/min) exceeded net hepatomesenteric spillover estimated using arterial and hepatic venous measurements alone (1.96 pmol/min). Thus valid assessment of the substantial amounts of NE released by hepatomesenteric organs requires separate examination of mesenteric and hepatic spillovers.

Animals↗
PubMed1991

Central nervous control of hepatic circulation.

This study was undertaken to assess the role of the hypothalamus and medulla oblongata in regulation of liver circulation in anesthetized dogs. Blood pressure, flow in hepatic artery and portal vein, and shifts of blood volume in the liver were recorded. Stimulation of the anterior hypothalamus produced changes in arterial pressure which were followed by passive changes in hepatic arterial blood flow; changes in hepatic artery resistance were rather small. Stimulation of the medial and posterior hypothalamus increased hepatic arterial resistance by 65-170%. Liver portal blood flow during stimulation of most of the hypothalamic sites decreased, hepatic portal pressure rose and vascular portal venous resistance increased 2.5-3 times. Three areas only (sympatho-inhibitory area, paraventricular and lateral hypothalamic nuclei) when stimulated produced dilatation of hepatic portal and splanchnic vascular beds, thus increasing portal blood flow. All cases of stimulation led to the decrease of blood volume in the liver by 10-36%. Stimulation of medullary structures (n. tractus solitarii, reticular nn.) caused similar changes in hepatic circulation, however the amplitude of reaction was 1.5-6 times smaller than upon hypothalamic stimulation. Central impulses to the hepatic vessels are transmitted by sympathetic adrenergic nerve fibers through vascular alpha-adrenoreceptors. It is concluded that the hypothalamic level of the central nervous system, unlike the bulbar one, exerts considerable, differentiated, well coordinated and to some extent specific influences on hepatic circulation.

Animals↗
PubMed1985

[A case of surgical correction of the inferior vena cava obstruction with Budd-Chiari syndrome].

A 37-year-old man is presented with Budd-Chiari syndrome associated with a membranous obstruction of the inferior vena cava. Clinical symptoms were ascites, leg edema and dilatation of the superficial abdominal veins. Aggressive surgery was carried out for this case. Midsternal incision and right subcostal oblique incision were made, and hepatic segment of the inferior vena cava was reconstructed using pericardial patch after endovenectomy and partial cardiopulmonary bypass was used without temporary interruption of liver circulation. Blood flow from the right hepatic vein was restored. Postoperative course was not eventful and this patient remains free of any evidence of ascites and liver dysfunction after operation. This procedure may be useful particularly for protecting the liver function which is damaged by hemostasis.

Adult↗
PubMed1994

Allopurinol dose is important for attenuation of liver dysfunction after normothermic ischemia: correlation between bile flow and liver enzymes in circulation.

We have investigated the effect of two doses of allopurinol (ALL) (100 and 50 mg/kg) administered i.v. on liver function after 1 h of normothermic ischemia. ALL given in a concentration of 100 mg/kg significantly improved bile output after 1 and 24 h of reperfusion. Hepatocyte injury reflected by alanine aminotransferase (ALT) and lactic dehydrogenase (LDH) in plasma was also significantly reduced at 24 h, but not at 1 h of reperfusion compared with controls. ALL administered at a concentration of 50 mg/kg had some protective effect. Significant correlation between circulating liver enzymes and bile output at 24 h after reperfusion indicates an important pathophysiologic link between hepatocyte function and injury in this time window.

Alanine Transaminase↗
PubMed1975

Protective effect of steroids on liver ischemia.

Occlusion of the afferent liver circulation for variable periods of time would be advantageous to temporarily control bleeding from profound lacerations or during extensive resections. Because of its low tolerance to ischemia we attempted to protect the liver with steroids during inflow occlusion. Total hepatic ischemia was produced in rabbits by ligating the portal triad and gastrohepatic ligament for 30 minutes. A 10 per cent survival was obtained in untreated controls whereas pre-treatment with methylprednisolone improved survival to 100 per cent. Methylprednisolone injection after occlusion improved survival only to 57 per cent. There were profound pathohistologic and electron microscopic changes in untreated controls. In animals treated with methylprednisolone either before or after occlusion changes were minimal or absent. This treatment was used in four trauma patients in whom occlusion of the liver inflow was carried out for various periods of time. Even though no significant statement can be made from such small group, the early postoperative course was remarkably smooth and stable. Methylprednisoline protects the liver during warm ischemia, especially if given before occlusion, and decreases the mortality from this maneuver in experimental animals.

Adolescent↗
PubMed1996

Hydrolysis of membrane-bound liver alkaline phosphatase by GPI-PLD requires bile salts.

Circulating liver plasma membrane fragments (LPMF) were purified from human serum by means of a monoclonal antileucine aminopeptidase antibody, AD-1. This was done by immunoaffinity chromatography or by incubating the sera with AD-1-coated nitrocellulose disks. Alkaline phosphatase (ALP, EC 3.1.3.1) is bound to these LPMF through a glycosylphosphatidylinositol (GPI) anchor and is referred to as membrane-bound liver ALP (Mem-LiALP). Low concentrations of Triton X-100 or high bile salt concentrations released GPI anchor-bearing LiALP (Anch-LiALP) from purified LPMF; once released, Anch-LiALP was slowly and progressively converted to hydrophilic dimeric LiALP [soluble LiALP (Sol-LiALP)], free from its GPI anchor. Low levels of GPI-specific phospholipase D (GPI-PLD) activity were measured in the pure LPMF. Apparently, this membrane-associated GPI-PLD was released by the action of detergents and contributed to the spontaneous conversion of Anch-LiALP to Sol-LiALP. In the absence of detergents, GPI-PLD had little effect on Mem-LiALP, both in purified form as well as in serum. In vitro, isolated Anch-LiALP was converted to Sol-LiALP by both GPI-specific phospholipase C and GPI-PLD. Sol-LiALP in serum, however, appeared to be the product of GPI-PLD activity only. Five- to tenfold higher concentrations of Triton X-100 were needed to release Anch-LiALP from LPMF in serum, compared with those required in a solution of purified LPMF. In serum, as well as in purified conditions, only a small range of detergent of bile salt concentrations permitted the conversion of Mem-LiALP to Sol-LiALP. A model is proposed for the release in the circulation of Mem-LiALP, Anch-LiALP, and Sol-LiALP, involving both LPMF-associated GPI-PLD and liver sinusoid bile salts.

Alkaline Phosphatase↗