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Gamma-glutamyl transpeptidase activity alters the T cell response to oxidative stress and Fas-induced apoptosis.

The ectoenzyme gamma-glutamyl transpeptidase (GGT) is absent on resting naive peripheral blood T cells, highly expressed upon stimulation and intermediate on resting memory T cells. In other tissues, GGT is essential for the recapture of the antioxidant glutathione (GSH). T cells with different levels of GGT activity were examined for their ability to withstand oxidative stress. To create a model system that reflected the level of GGT seen on naive and memory T cells, Jurkat T cells were cloned by limiting dilution and their GGT expression analyzed. Jurkat expressing GGT at levels comparable to resting memory T cells have levels of intracellular reactive oxygen species (ROS) that are only 65% that seen in Jurkat that have low levels of GGT (similar to naive T cells). Treatment of the cells with H(2)O(2) increases ROS in both cells, although the level seen in the GGT(high) Jurkat is less than half that in the GGT(low) variant. Despite protection from oxidative stress, the GGT(high) Jurkat were found to be 2- to 3-fold more sensitive to Fas-induced apoptosis. The redox-regulated NF-kappaB pathway is activated in GGT(low) cells, resulting in higher levels of cIAP-1/2 proteins that limit caspase activity. The GGT(low) cells were found to have higher levels of NF-kappaB in the nucleus as well as lower levels of IkappaB-alpha. The GGT(low) cells also express higher levels of the caspase inhibitors cIAP-1/2 and have lower levels of caspase activity. These findings suggest that GGT expression regulates ROS in T lymphocytes and modulates Fas-induced killing by altering NF-kappaB activity.

Apoptosis↗

Ethanol challenge in non-alcoholic patients with schistosomiasis.

AIMS: To evaluate serum gamma glutamyltransferase (GGT) activity in a group of non-alcoholic patients with the hepatointestinal form of schistosomiasis; and the response of both GGT and alkaline phosphatase to an ethanol challenge in two subgroups of patients with different baseline serum concentrations of GGT. METHODS: Seventy six non-alcoholic, non-smoking hepatitis B virus (HBV) negative men with normal body mass index, who denied blood product transfusion or use of medication, were studied (30 healthy volunteers (control group) and 46 patients with the hepatointestinal form of schistosomiasis). GGT activities were determined in all subjects and the ethanol test (measurement of GGT and alkaline phosphatase (ALP) before and 24 hours after the ingestion of 1 g/kg of ethanol) was performed in 14 patients (7 with GGT below 25 IU/l and seven with GGT above 25 IU/l). The ethanol serum concentrations were determined in the samples collected one hour after ingestion of the solution in four patients with schistosomiasis. RESULTS: The mean serum ethanol concentration one hour after the ingestion was 0.7 g/l and all patients were clinically intoxicated. GGT was below 25 IU/l in all 30 volunteers and in 33 of the patients with schistosomiasis. In 13 patients the GGT varied from 28 to 140 IU/l. The two enzymes GGT and ALP determined in the 14 patients submitted to the test were positively correlated in the baseline samples (r = 0.8130) as well as in the samples obtained 24 hours after stimulation (r = 0.7921). Neither the plasma activity of GGT nor the GGT:ALP ratio was affected by the ethanol challenge. CONCLUSIONS: These results suggest that the mechanisms for the increase of GGT serum activity in schistosomiasis and in alcoholism differ. In the latter, microsomal induction increases GGT serum activity, while alterations in the biliary tree may be responsible for the increase observed in patients with schistosomiasis.

Adult↗

Relationship between serum gamma-glutamyl transferase and pulse pressure in apparently healthy middle-aged subjects.

UNLABELLED: Higher values of pulse pressure (PP)--the difference between systolic blood pressure (SBP) and diastolic blood pressure (DBP)--are associated with an increased cardiovascular risk; SBP and DBP values are correlated with serum levels of gamma-glutamyl transferase (GGT), both in drinkers and non-drinkers subjects. Moreover, some studies showed that high levels of serum GGT might be related with an increased cardiovascular risk. However, few studies analyzed the relationship between GGT and PP. In 72 subjects (18 male; 54 women), middle-aged (mean age: 36.63 yrs; limits: 24-54 yrs), apparently healthy, we performed the measurements of: weight, height (from which we calculated the body mass index [BMI]), SBP, DBP, PP, standard biochemical workup, including GGT (UI/l). RESULTS: PP values are correlated with SBP (r=0.74, p<0.001), but not with DBP (r=0.15, p=NS) values. GGT is significantly correlated with SBP (r=0.28, p=0.01), DBP (r=0.29, p=0.01), and BMI (r=0.41, p<0.001). Mean values of PP are significantly higher in those with a GGT>20 than those with GGT<20 (48.69 vs. 43.85 mmHg, p<0.05); similarly, mean values of SBP (131.66 vs. 116.81 mmHg, p=0.0004) and DBP (82.59 vs. 73.52 mmHg, p=0.0008) are higher in the group with GGT>20. We observed an ascending trend of the mean value of GGT in the different groups of PP; therefore, mean value of GGT was 19.21, 22.65, 23.18 in the PP<40, PP=40-60, respectively PP>60 groups. However, the correlation between PP and GGT was not significant, both in univariate analysis (r=0.14, p=NS) and after adjusting for SBP, DBP, BMI (r=0.12, p=NS). When we analyzed subgroups, the relationship between GGT and PP was more evident in women and in subjects with increased values of BMI. CONCLUSIONS: GGT values are significantly correlated with SBP and DBP, but not with PP, in middle-aged, apparently healthy subjects; even though the highest values of GGT are associated with an increased PP value, further studies would be necessary in order to explain this link.

Adult↗

Gamma-glutamyltranspeptidase activity in human ovarian carcinoma.

Gamma-glutamyltranspeptidase (GGT) is a cell membrane enzyme involved in the hydrolysis and uptake of extracellular glutathione. Histochemically detectable GGT has been shown in several human neoplasms. However, few studies have addressed the quantitative biochemical assessment of GGT activity in human tumors, and the importance of GGT activity in human tumor biology remains to be elucidated. The aim of the present study was to assess biochemically GGT enzyme activity in human ovarian surgical biopsies. GGT activity was assayed in homogenates of surgical samples of ovarian tumors and compared with the clinical data of the patients in order to establish: a) the level of tumor GGT activity, b) its correlation with other clinical parameters of the neoplasms, c) the possibility of the induction in vivo of GGT after anticancer platinum-based therapy, since some of the patients were pretreated. The results indicated that ovarian tumor expresses biochemically relevant GGT activity. The sensitive method used in this study allowed the quantitative evaluation of enzyme activity in all samples examined, showing that GGT activity values in ovarian carcinoma samples were extremely variable among the different subjects, both in untreated neoplasms (6.2 +/- 5.4 mU/mg protein) and in second-look laparotomy biopsies following platinum-based therapy (4.7 +/- 3.8 mU/mg protein). The mean GGT activity in benign ovarian tumors was lower than that in malignant tumors. No significant correlation was found between GGT activity and patient characteristics (tumor stage, age of patients, serum CA125, TAG-72, and GGT levels). However, the biological and pharmacological relevance of GGT expression remain to be elucidated in a large series of tumors.

Adult↗

gamma-Glutamyl transpeptidase of spermatozoa may decrease oocyte glutathione content at fertilization in pigs.

The presence of gamma-glutamyl transpeptidase (GGT) in boar spermatozoa and the potential role of the GGT at sperm penetration were examined using in vitro matured porcine oocytes. In the first experiment, GGT of boar spermatozoa was examined using a histochemical stain. GGT was detected in the midpiece and the acrosome regions of boar spermatozoa. In the second experiment, porcine oocytes matured in vitro were injected with approximately 40 pl of 10 mM HEPES solution alone or HEPES containing 0.5 U/ml GGT or 1 mM guanosine-5'-O-(3'-thiotriphosphate) (GTP-gamma-S; G-protein activator). When GGT was injected into oocytes, the incidence of oocytes activated (23.7 +/- 1.4%) was not different (P > 0.05) from HEPES-injected controls (24.9 +/- 1.3%) at 6 h after injection. Injected GTP-gamma-S, however, activated 76.0 +/- 5.3% of oocytes at 6 h after injection, but extrusion of the second polar body was very low (2.8 +/- 4.8%). Total content of glutathione (GSH) and glutathione disulfide (GSSG) did not differ (P > 0.05) between GTP-gamma-S injected oocytes (4.2 +/- 0.7 pmol/oocyte) and noninjected oocytes (4.0 +/- 0.1 pmol/oocyte) at 6 h after injection. However, the total content of GSH and GSSG was lower (P < 0.01) in GGT-injected oocytes (2.1 +/- 0.2 pmol/oocyte) than HEPES-injected oocytes (3.4 +/- 0.2 pmol/oocyte) at 6 h after injection. In the third experiment, in vitro matured porcine oocytes were injected with about 40 pl of 10 mM HEPES solution alone or HEPES containing 0.5 U/ml GGT and then inseminated. At 12 h after insemination, the incidence of male pronuclear formation was significantly lower in oocytes injected with GGT as compared with injected control oocytes. These results demonstrated that (1) GGT was present on the surface of spermatozoa, (2) total oocyte content of GSH and GSSG was decreased by microinjection of GGT but not by that of GTP-gamma-S, and (3) male pronuclear formation was inhibited in GGT-injected oocytes. These results suggest that sperm GGT may be a limiting factor for male pronuclear formation in polyspermic oocytes.

Animals↗

Electrophoretic behavior and partial characterization of disease-associated serum forms of gamma-glutamyltransferase.

We have recently devised an improved procedure for the rapid electrophoretic separation of multiple forms of serum gamma-glutamyltransferase (GGT). This procedure is based on the separation on cellulose acetate strips, usually employed for lipoprotein electrophoresis, followed by visualization with a fluorescent reagent. The method is highly sensitive and the fractions are more clearly resolved than with other procedures. Reference intervals have been evaluated in the sera from 142 healthy subjects and the patterns (two GGT forms comigrating with alpha 1 and alpha 2-globulin) are reproducible. In 150 sera from patients with various hepatobiliary diseases (including neoplasias), acute pancreatitis and non liver-involving neoplasias, we observed some disease-specific GGT forms: an albumin comigrating enzyme (Alb-GGT) specific of liver neoplasia; a gamma-globulin comigrating GGT (gamma-GGT) and a nonmigrating isoform (dep-GGT) both specifically associated to extrahepatic jaundice. Multiple lipoprotein fraction precipitation showed that beta-, gamma- and dep-GGT are complexes between GGT and low density lipoprotein and very low density lipoproteins (LDL + VLDL), and that some of the alpha 1-GGT from cirrhotic patients is a complex between GGT and high density lipoprotein (HDL). GGT fractions from normal subjects and Alb-GGT from patients with liver neoplasia do not appear to be complexed with lipoproteins.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomarkers, Tumor↗

Gamma-glutamyltransferase induction by glucocorticoids in rat liver: age-dependence, time-dependence, dose-dependence, and intralobular distribution.

Postnatal responsiveness of rat-liver gamma-glutamyltransferase (GGT) to glucocorticoids (GC) has been defined by investigating: age-dependence, time-dependence, hormonal dose-dependence, and lag-time of the enzyme re-expression; half-life of the induced enzyme activity; dynamics of the enzyme reappearance in the liver tissue. Hydrocortisone-acetate (HC) or dexamethasone (DEX) were administered to the animals starting 1, 2, 3, 4, or 5 d before killing, at the doses of 25 micrograms or 1 microgram/(g b. w. x d), respectively. In 14 d old rats, after a lag-time of about 20 h (DEX) or 30 h (HC), GGT activity progressively increased up to 38 and 31 times the control value, respectively, at 5th d; the enzyme re-expression was linearly hormone dose-dependent; half-life of the induced enzyme activity was about 36 h. In 21 d old rats, GGT re-induction behaved as in 14 d old animals, except that the induced activity was about half that of each correspondent treatment. In 28 d old rats, a very low but significant GGT activity was re-expressed only after hormonal treatments longer than 48 h. In 35 and 77 d old rats, significant GGT activity was never re-induced. GGT was re-expressed in liver parenchyma, with a defined space-course. In 14 d old rats, GGT reappeared first in periportal areas, then in acinar zone 1, finally in acinar zone 2. While the animals were ageing, GGT re-expression occurred to lesser and lesser extents in liver tissues, because of a progressive space-restriction from acinar zones 1 and 2 to zone 1 and finally, in 35 d old rats, to periportal areas. In adults, GGT was re-expressed only by rare hepatocytes in periportal spaces. Acinar zone-3 hepatocytes did never re-express GGT, irrespectively of the animal age. Thus, 2 rat hepatocyte populations could be distinguished (1 responsive, the other unresponsive to GC for GGT re-expression), the relative proportion of which changes in favour of the unresponsive one while the animal ages. Hepatic GGT re-induction by GC, occurring after a long lag-time, does not follow the typical model of hormonal induction. Previous permissive cell changes seem to be required. Hepatocyte-GGT re-expression by GC appears to be inversely correlated with the differentiation level and the cytochrome P-450 amount (activity) of the cell as limiting factors for the triggering of the enzyme induction.

Aging↗

Gamma-glutamyl transpeptidase immunoreactivity in benign and malignant breast tissue.

GGT 129, a polyclonal antibody directed against gamma-glutamyl transpeptidase (GGT), was used to study GGT expression in formalin-fixed paraffin-embedded tissues from normal breast, 24 benign lesions, 27 in situ carcinomas or atypical hyperplasias, and 79 infiltrating mammary carcinomas. Epithelium of the ducts and ductules in normal breast tissue showed immunoreactivity along the apical surface. There was a strong correlation (P < 0.01) between the histologic classification of the tissue and GGT expression. All of the benign breast lesions stained positive for GGT. Among in situ carcinomas and atypical hyperplasias, 5/27 (19%) were negative for GGT while 22/27 were immunopositive. Infiltrating carcinomas showed the greatest deviation from normal tissue with 23/79 (29%) negative for GGT. GGT expression in benign and malignant breast tissue was not correlated with the age of the patient, suggesting that menopausal status does not influence expression of GGT. Correlation of GGT immunoreactivity with tubule formation, nuclear pleomorphism, mitoses, grade, size of tumor, lymph node status, and ER/PR status was performed for 69 cases of infiltrating ductal adenocarcinoma. There were no statistically significant relationships between the level of GGT immunoreactivity and any of the parameters. The loss of GGT in some of the cases is evidence that this enzyme is not required for mammary tumor development or maintenance. However, as GGT is a component of the pathways that metabolize glutathione and glutathione-conjugates, the difference in levels of the enzyme in invasive breast cancers may be one explanation for the variation in chemotherapy response that has been observed in patients treated for advanced mammary cancer.

Breast↗

Gamma-glutamyl transpeptidase activity mediates NF-kappaB activation through lipid peroxidation in human leukemia U937 cells.

Gamma-glutamyl transpeptidase (GGT) is a key enzyme in the catabolism of glutathione (GSH). Recently, it has been reported that the extracellular cleavage of GSH by GGT induced the production of reactive oxygen species (ROS), suggesting that GGT plays a pro-oxidant role. In the present study, we investigated the nature of the oxidative stress generate by glutathione and GGT and the possibility that this stress affects the activity of NF-kappaB a prototypical oxidant-stress-responsive transcription factor. We found that, in the presence of iron, a natural substrate of GGT, glutathione induces lipid peroxidation in U937 cells. This induction depends on GGT activity as it is prevented by the Serine/Borate complex, a GGT inhibitor. We found that y-glutamyl transpeptidase activity induces NF-kappaB DNA binding activity, an effect which is significantly reduced by the addition of GGT inhibitors (Serine/Borate complex and Acivicin). Moreover, we show that lipid peroxidation is involved in GGT-dependent NF-kappaB activation since vitamin E, which completely inhibits GGT-induced generation of lipid peroxides, prevents the GGT-dependent NF-kappaB activation. Finally, inhibition of GGT by either the Serine/Borate complex or by Acivicin resulted in cell apoptosis. This finding suggests that GGT-mediated NF-kappaB activation plays a role in the control of apoptosis in U937 cells.

Apoptosis↗

Human germ cell tumours: expression of gamma-glutamyl transpeptidase and sensitivity to cisplatin.

Previous studies have shown that the enzyme-glutamyl transpeptidase (GGT) is essential for the nephrotoxicity of cisplatin. This study was designed to determine whether GGT activity is necessary for the therapeutic effect of the drug. The relationship between GGT expression and clinical response to platinum-based chemotherapy was examined in 41 human germ cell tumours. Sections of formalin-fixed, paraffin-embedded tumours were immunohistochemically stained with an antibody directed against human GGT. There was no expression of GGT in any of the 17 seminomas or four dysgerminomas; whereas, 12/12 ovarian yolk sac tumours and 4/4 embryonal carcinomas of the testis were GGT-positive. In stage I tumours fewer tumour cells expressed GGT than in later stage tumours. In four germ cell tumours of mixed histology, the seminomatous and dysgerminoma areas were GGT-negative while the areas of the tumour with yolk sac or embryonal histology contained GGT-positive tumour cells. The patients with seminomas or dysgerminomas who were treated with cisplatin-based chemotherapy, all had a complete response despite the absence of GGT expression in these tumours. Fifteen of the 16 patients with yolk sac or embryonal carcinomas received cisplatin-based chemotherapy following surgery. Twelve had a complete response, while three failed to respond to platinum-based therapy. There was no correlation between the level of GGT-expression and response to therapy in this group. Three of the four patients with tumours of mixed histology were treated with cisplatin-based therapy, and had a complete response. Therefore, expression of GGT is not necessary for the therapeutic effect of cisplatin in germ cell tumours. The results from this study suggest that systemic inhibition of GGT would inhibit the nephrotoxic side-effect of cisplatin without interfering with its activity towards germ cell tumours.

Adolescent↗

Gamma-glutamyl transpeptidase activity in superficial exfoliated cells during hamster buccal pouch carcinogenesis.

The study of gamma-glutamyl transpeptidase (GGT) activity in transformed tissues has conventionally involved the killing of an animal or excision of the lesion, preventing longitudinal study. Oral exfoliative cytology allows longitudinal examination; however, it has been shown to be an unreliable criterion of malignancy. GGT activity has been demonstrated histochemically to involve the full thickness of the epithelium, including the keratin layer during carcinogenesis of hamster buccal pouch epithelium. This study correlates the GGT-stained foci in tissue sections and the proportion of GGT-positive cells in a superficial smear during a 13-week regime of tri-weekly topical application of 7,12-dimethylbenz[a]-anthracene (DMBA) in mineral oil. GGT-positive cells were detected in smears 3 weeks after application of the carcinogen, coincident with GGT-positive foci in tissue sections involving the keratin layer. The proportion of GGT-positive cells in each experimental period increased during the first 7 weeks of the experiment and plateaued thereafter. The number of GGT-positive foci in tissue sections in each experimental period also increased during the experiment. GGT activity was not detected in either smears or tissue sections of untreated or mineral oil treated mucosa. The correlation between the proportion of GGT-positive cells in smears and GGT-positive foci in tissue sections suggest the possibility of studying the GGT activity in an experimentally induced lesion without its elimination. Furthermore, oral exfoliative cytology using GGT staining may be useful in detecting precancerous lesions clinically.

9,10-Dimethyl-1,2-benzanthracene↗

Differential induction of gamma-glutamyl transpeptidase in primary cultures of rat and mouse hepatocytes parallels induction during hepatocarcinogenesis.

In carcinogen-treated rats, gamma-glutamyl transpeptidase (GGT) is induced in preneoplastic liver lesions and liver tumors. However, in mice, GGT is rarely detected during hepatocarcinogenesis. Data in this study reveal that GGT is not induced in mouse hepatocytes when they are maintained in vitro under the same conditions that induce GGT activity in primary cultures of rat hepatocytes. GGT activity in rat hepatocytes increased 20-fold during the first 7 days in culture, but there was no induction of GGT in primary cultures of mouse hepatocytes. Comparison of intracellular glutathione levels in rat and mouse liver cells showed that the glutathione level was higher in the mouse liver cells than the rat. Blocking glutathione synthesis with buthionine sulfoximine reduced the intracellular glutathione concentration in mouse liver cells but did not trigger an induction of GGT. Analysis of the GGT mRNA in primary cultures of rat hepatocytes showed that only GGT mRNA(III) is induced. This is the same GGT mRNA species present in preneoplastic hepatic lesions and liver tumors in the rat (1-3). Therefore activation of promoter III in the GGT gene is responsible for induction of GGT in both hepatocytes in vitro and liver tumors in vivo. These data show that primary cultures of rat and mouse hepatocytes provide a model system with which to study interspecies differences in the regulation of this enzyme and to better understand the role of GGT in normal and neoplastic processes.

Animals↗

Gamma-glutamyl transferase deficiency results in lung oxidant stress in normoxia.

gamma-Glutamyl transferase (GGT) is critical to glutathione homeostasis by providing substrates for glutathione synthesis. We hypothesized that loss of GGT would cause oxidant stress in the lung. We compared the lungs of GGT(enu1) mice, a genetic model of GGT deficiency, with normal mice in normoxia to study this hypothesis. We found GGT promoter 3 (P3) alone expressed in normal lung but GGT P3 plus P1, an oxidant-inducible GGT promoter, in GGT(enu1) lung. Glutathione content was barely decreased in GGT(enu1) lung homogenate and elevated nearly twofold in epithelial lining fluid, but the fraction of oxidized glutathione was increased three- and fourfold, respectively. Glutathione content in GGT(enu1) alveolar macrophages was decreased nearly sixfold, and the oxidized glutathione fraction was increased sevenfold. Immunohistochemical studies showed glutathione deficiency together with an intense signal for 3-nitrotyrosine in nonciliated bronchiolar epithelial (Clara) cells and expression of heme oxygenase-1 in the vasculature only in GGT(enu1) lung. When GGT(enu1) mice were exposed to hyperoxia, survival was decreased by 25% from control because of accelerated formation of vascular pulmonary edema, widespread oxidant stress in the epithelium, diffuse depletion of glutathione, and severe bronchiolar cellular injury. These data indicate a critical role for GGT in lung glutathione homeostasis and antioxidant defense in normoxia and hyperoxia.

Animals↗

Membrane gamma-glutamyl transpeptidase activity of melanoma cells: effects on cellular H(2)O(2) production, cell surface protein thiol oxidation and NF-kappa B activation status.

The metabolism of glutathione by membrane-bound &ggr;-glutamyl transpeptidase (GGT) has been recently recognized as a basal source of hydrogen peroxide in the extracellular space. Significant levels of GGT activity are expressed by malignant tumours, and in melanoma cell lines they were found to correlate with the malignant behaviour. As hydrogen peroxide and other oxidants can affect signal transduction pathways at several levels, the present study was aimed to verify: (i) the occurrence of GGT-dependent production of hydrogen peroxide in melanoma cells; (ii) the effects of GGT-dependent prooxidant reactions on known redox-sensitive cellular targets, i.e. protein thiols, the nuclear transcription factor NF-kappa B and p53. Two melanoma Me665/2 cell clones, exhibiting traces of (clone 2/21) or high (clone 2/60) GGT activity, were studied. The occurrence of GGT-dependent production of hydrogen peroxide was apparent in 2/60 cells, in which it was accompanied by lower levels of cell surface protein thiols. In 2/60 cells, GGT expression was also associated with higher levels of NF-kappa B activation, as compared to GGT-poor 2/21 cell clone. Indeed, stimulation or inhibition of GGT activity in 2/60 cells resulted in progressive activation or inactivation of NF-kappa B, respectively. An analysis of the p53 gene product indicated lack of protein expression in 2/60 cells, whereas a mutant protein was highly expressed in 2/21 cells. Taken together, these results indicate that the expression of GGT activity can provide melanoma cells with an additional source of hydrogen peroxide, and that such prooxidant reactions are capable to modify protein thiols at the cell surface level. In addition, GGT expression results in an up-regulation of the transcription factor NF-kappa B, which could explain the higher metastatic behaviour reported for GGT-rich melanoma cells as compared to their GGT-poor counterparts.

Blotting, Western↗

Diagnostic value of serum gamma-glutamyl transferase isoenzyme for hepatocellular carcinoma: a 10-year study.

Serum gamma-glutamyl transferase (GGT) was separated into nine to 11 isoenzyme bands (designated as GGT I-XI) by vertical slab electrophoresis on polyacrylamide gradient gel. The diagnostic value of GGT isoenzyme II (GGT II) for hepatocellular carcinoma (HCC) was studied, and the results were as follows: 1) GGT II was positive in 90% of 90 cases of HCC, and negative in most patients with acute and chronic viral hepatitis, extrahepatic tumors, in pregnant women, and in healthy controls; 2) the positive rate of GGT II assay was higher than that of alkaline phosphatase isoenzyme I (ALP I), alpha-fetoprotein (AFP), and alpha 1-antitrypsin (AAT) in 101 cases of HCC. In cases in which the AFP was greater than 50 ng/ml or less than 50 ng/ml, the positive rates of GGT II were 70.8% and 75-100%, respectively; 3) of 14 cases of small-size HCC, the positive rate of GGT II was 78.6%, which was higher than that of AFP (50%), AAT (28.6%), and ALP I (0%); 4) of 62 cases that were false-positive for GGT II assay, 24.2% developed into HCC during a follow-up of 2.1-20 months. In subjects with persistent and recurrent positivity of GGT II, 86.7% and 22.2%, respectively, developed HCC. No patient with temporal positivity of GGT II developed HCC. The results show that GGT II can be applied as an additional marker for HCC, and is valuable not only for the diagnosis of clinical HCC, but for the detection of small or subclinical HCC. Periodic follow-up with assay of GGT II in patients at high risk for HCC may predict the development of hepatoma.

Biomarkers, Tumor↗

[The activity of gamma glutamyltransferase in the urine of sheep].

The activity of gamma glutamyltransferase (GGT) was measured in sheep urine using a method developed for the routine assay of serum. Despite variation in urine pH and specific gravity, this method gave reproducible results. Serial dilutions of urine samples to which bovine GGT extract was added, showed a linear relationship for GGT values between 48 U l-1 and 373 U l-1. When a saline solution of GGT was added to urine and serum to compare the behaviour of GGT in the two fluid mediums, no difference could be demonstrated. The presence of non-specific enzyme inhibitors for GGT in sheep urine could not be established, eliminating the need for urine dialysis before the assessment of GGT activity. GGT activity remained the same in urine samples that were stored at 4, 25 and -20 degrees C for 12 and 24 hours. Serial urine samples from 16 sheep were collected for 24 hours and the activity of GGT and the creatinine concentration were measured. Although there was significant variation in the measured GGT and creatinine values, the ratio of GGT:creatinine remained constant. The mean urine GGT:creatinine ratio was found to be 29.1 with a standard deviation of 7.0. A population reference value for urine GGT: urine creatinine ratio in clinically normal sheep was calculated to be 43.1.

Animals↗

Alcohol, smoking and body build: obesity as a result of the toxic effect of 'social' alcohol consumption.

Previous work showed that obesity in the average human male is not due to increased caloric intake. To test the hypothesis that 'social' ethanol consumption causes obesity by a hepatotoxic mechanism, the relationships between alcohol intake, cigarette smoking, serum gamma-glutamyl transpeptidase (GGT) and body build were investigated in 816 adult patients, 491 males and 325 females. A large part of the Broca index variance could be explained by hepatic damage as reflected by the GGT level. The higher the GGT, the more overweight were the subjects. Hyperinsulinemia may be the pathogenetic link; insulin is the strongest known blocker of lipolysis. Almost the total variation of obesity with GGT, however, occurred in the range of GGT up to 25 U/l, which is usually, but nevertheless erroneously, considered to be the normal range. This effect was independent of sex and age. Normal GGT is below 10 U/l, which is found on average in females aged less than 20 years. Females tolerate less alcohol than males. Although GGT is as high in females as in males around age 30, males drink about three times as much ethanol. For the same GGT the Broca index is significantly higher in females than in males. GGT generally increases with age; maximum GGT is reached in females in the age group 21-40 years (due to the change in drinking habits around 1968), declining thereafter; in males at age 50. Obesity per se is not correlated with a high GGT. In the females there are hormonal factors influencing obesity. Although in the females GGT decreases on average after age 40, obesity increases (due to the decrease in estrogens). After age 50 ethanol tolerance in males decreases: they reduce their alcohol consumption, and yet the GGT remains high. -Cigarette smoking is a factor which independently influences obesity. Although people who smoke tend also to drink more alcohol, smokers are significantly leaner than nonsmokers. On average males smoke about twice as heavily as females; this contributes to the fact that on average males are leaner than females despite their higher alcohol consumption. Due to lower consumption the influence of ethanol and smoking on body build is smaller in females than in males.

Adolescent↗

Altered expression of gamma-glutamyl transpeptidase in human tumors.

Elevated levels of gamma-glutamyl transpeptidase (GGT) activity and intracellular glutathione in tumor cells have been correlated with resistance to several classes of chemotherapeutic drugs. In this study, the first comprehensive analysis of GGT expression in human malignant neoplasms, 451 tumors were immunostained with an antibody directed against a c-terminus peptide of the human GGT protein. Analysis of the immunostaining revealed that GGT was expressed in 22 of 44 lung carcinomas and 16 of 22 ovarian surface epithelial carcinomas, although normal pulmonary and ovarian epithelium are GGT-negative. The tumor samples were obtained from patients before the start of therapy; therefore, GGT was not induced by radiation or chemotherapy. There was no GGT expression in mesotheliomas, Hodgkin's disease, non-Hodgkin's lymphomas, melanomas, basal cell carcinomas, and most soft tissue sarcomas, all of which are derived from GGT-negative cells. Carcinomas arising from some GGT-positive epithelium retained their GGT-positive phenotype. These included renal cell carcinomas, hepatocellular and cholangiocarcinomas, and carcinomas of the prostate and thyroid whereas both pancreatic adenocarcinomas and infiltrating carcinomas of the breast showed a wide range of GGT expression. Further studies are underway to determine whether expression of GGT plays a role in the inherent resistance of some tumors to alkylating agents and other classes of chemotherapeutic drugs.

Female↗