In vivo correlation between liver and blood energy status as evidenced by chronic treatment of carbon tetrachloride and adenosine to rats

Several tissues, such as red blood cells, depend on the liver supply of the purine ring for adenine nucleotide synthesis. We explored whether progressive liver damage, induced by carbon tetrachloride (CCl4), is accompanied by alterations in liver and blood energy status. After 4 weeks of CCl4 treatment, liver ATP, ATP/ADP, and energy status were decreased. Blood ATP remained normal, whereas the blood energy status was also diminished. After 8 weeks the changes were more evident, and a significant decrease of total liver nucleotides was also found. In the blood, the changes paralleled those in the liver. Simultaneous administration of adenosine counteracted the CCl4 effects. A good correlation (r = 0.79, p < 0.01) between the liver and blood ATP changes and a very significant relationship between liver and blood ATP/ADP ratio (r = 0.92, p < 0.001) were observed. Therefore, the data suggest that liver function could influence the energy availability in other tissues, such as red blood cells, perhaps as a result of its capacity to provide purine rings for extrahepatic synthesis of adenine nucleotides.Key words: liver–blood ATP interrelationship, cirrhotic rats, carbon tetrachloride, energy parameters, adenosine.

Predictive markers of chronic liver disease in hemophilia

In an attempt to predict progressive liver damage in hemophiliac patients by noninvasive means, we conducted a retrospective analysis of clinical and laboratory data from 44 liver biopsies taken from 35 hemophiliac patients. This showed that serum IgG was normal in patients with chronic persistent hepatitis (CPH) but significantly elevated in those with chronic active hepatitis (CAH) or cirrhosis (CIR) (P less than .001). Relationships were less significant between liver histology and IgM (P less than .01), IgA (P less than .05), and globulin (P less than .05). This was unaffected by human immunodeficiency virus (HIV) antibody status in asymptomatic individuals. Although patients with progressive liver disease were also older than those with CPH (P less than .001), the immunoglobulin abnormalities were independent of this. Neither clinical examination nor liver biochemistry at the time of biopsy were of significant diagnostic value. Our results indicate that in the absence of AIDS an elevated IgG level is a reliable indicator of progressive hemophilic liver disease.

Predictive markers of chronic liver disease in hemophilia

In an attempt to predict progressive liver damage in hemophiliac patients by noninvasive means, we conducted a retrospective analysis of clinical and laboratory data from 44 liver biopsies taken from 35 hemophiliac patients. This showed that serum IgG was normal in patients with chronic persistent hepatitis (CPH) but significantly elevated in those with chronic active hepatitis (CAH) or cirrhosis (CIR) (P less than .001). Relationships were less significant between liver histology and IgM (P less than .01), IgA (P less than .05), and globulin (P less than .05). This was unaffected by human immunodeficiency virus (HIV) antibody status in asymptomatic individuals. Although patients with progressive liver disease were also older than those with CPH (P less than .001), the immunoglobulin abnormalities were independent of this. Neither clinical examination nor liver biochemistry at the time of biopsy were of significant diagnostic value. Our results indicate that in the absence of AIDS an elevated IgG level is a reliable indicator of progressive hemophilic liver disease.

BENIGN RECURRENT CHOLESTASIS IN A CHILD

A 17-month-old female patient developed signs of biliary obstruction, as evidenced by jaundice, pale stools, severe pruritus, bilirubinuria, and slightly elevated serum levels of cholesterol and alkaline phosphatase. These signs remitted spontaneously after 6 months. During the subsequent 5 years, the child suffered eight further such episodes, recurring at irregular intervals and lasting 1 to 6 months. During icteric episodes, BSP retention was increased and cholangiograms showed no biliary dye excretion. Laparotomy revealed no hepatic or biliary pathology. Between periods of jaundice, all signs of biliary obstruction disappeared, BSP retention became normal and normal cholangiograms were obtained. Four liver biopsies, performed over 6 years, demonstrated marked cholestasis, with no distortion of the lobular pattern and no evidence of progressive histological changes. The patient is believed to represent a further case of "benign recurrent cholestasis." In this condition, beginning in childhood or early adulthood, there is no evidence of progressive liver damage, despite numerous recurrences of biliary tract obstruction.