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HCV infection in LKMI autoimmune hepatitis (AH) is confirmed by recombinant immunoblotting assay (RIBA)
157 IN LKMlAUlOl?f+UNR HEPATITIS (AHI IS WV INFECIYON axFIRHErJ BY RE(X?lBINAW IPPWNCBUYlTINo ASSAY (RIW
150
PROTECTIVE EFFECT OF CICLGSFQRIN AGAINST CIRRHOTIC ALTERATION OF ‘IIE LIVER T-S-Lie. M. Bach, J. Vogel, G. Brunner. T. Krijger Sectlon of Transplantation, Departmentof Surgery, Institute of Pathology, University of Bonn, FRG Ciclosporin (CiS) is today the most effective immunosuppressive drug in organ transplantation. We observed nocd clinical results in the therapy of orimary biriary cirrhosis or other autoimmun~chro~ic heoatitis whenwe charmedthe dosage of CiS in c&respondence to the ievels of se;um transaminaseg inspite of its own hepatotoxicity. After several years of treatment, we found also histological improvementin cirrhotic alteration in the biopsy material of some patients. Therefore, we assumedthat CiS inhibits not only autoimnunephenomenabut also directly inhibits cirrhotic alteration in chronic liver disease. To clarify this hypothesis, we treated hepatotoxin (CC141 induced chronic liver damage 6 weeks with CiS (lmg/kg/Zd). We found 64% fibrosis and cirrhosis in the control group.but only 25% in the CiS treated group.50b of the CiS treated rats showedminimal fibrosis in contrast to 14% in the icontrol group.Furthermore,the CiS treated rats presented a very lower degree of fatty degeneration than the control group. Our results demonstrates, that CiS inhibit not only autoimmunephenomenaand inflamation in the chronic hepatitis,but also fibrosis and cirrhotic alteration. An adequate dosage. correspondent to the drug metabolization ability and hepatotoxity, might have a potential inhibitory effect on patients with chronic hepatitis.
Lenzi M. Baldi M, LevariniC, Miniero R, Caseani F, BallardiniG, Fusconi M, Bonino F, Bianchi FE.
Semeiotioa Medica 2 and Laboratorio Centralizsato s. Orsola, Bologna, Castroenterology Molinette, Turin, Italy.
The relation between anti HCV end lXM1 AH is under evaluation. 8 LKMl and anti HCV positive sera were titrated for anti HCV by dilution to end point ad the reciprocaldilution value used as titre. Titres (from 10 to 2560) were not correlated to serlm Igci (m0.143). RIR4 was positive in 5 of 8 ELISA Positive and 0 of 4 UMl positive, anti HCV F&ISA negative sera. The overall co"cordmce was 75%. A lower sensitivity of the RIBA is supportedby the fact that the 3 ELISA positive and RIBA negative sea had the lowest titres by ELISA (10, 20 and 40, respectivel?_)es RIBA is performed at l/50 serm dilution. 3 patients anti HCV (RIBA and l&ISA positive) had teen treated. and bed responded to steroids.Concltz+ms:l. the high prevalence of anti HCV in LIW AH is confirmed by RIBA; 2. both the lack of correlationbetween anti HCV titres and serum IgG and the high anti HCV titres male out the possibilitythat the F&ISA results arz merely due to aspecific IgCibinding to the solid phase; 3. biochemical response to steroid treatmentin autoimmunehepatitisdoes not exclude HCV infection.
159 REN;LG;;;kURE IN CIR?HDSIS ASCITES. J Llach., Jll Salmeron. A w CVT&& R Fernandez, J Gaya, TJinbnez. A J Rod&s. Liver Unit. Hospital Rinola. Clinic. Bircelona. DIPVRIDAZlLE IWCES
UITH
I
,
y,
The synthesis of ,qdenosine (Ade), an endogenous nucleoside with powerful renal vasoconstrictor effect, increases in conditions of ischemia. Therefore, it is possible that in cirrhotics with ascites, the renal svnthesis of Ade mav be increased as a consequ;?nce of the impaired -renai perfusion. contributing to the pathogenesis of hepatorenal syndrome. To investigate this %hesis. Dipyridanole (Dp) (a bolus of 0.4 mgjkg '. drug that increases the extracellular levels of .?.de, was given to 14 non-azotemic cirrhotics with ascites and to 6 patients with compensated cirrhosis. Dp induced a reversibls reduction in GFR in 8 patients with cirrhosis and ascites(90t7 to 50+5 ml/min) (Group I). GFR did not change in the remaining patients with ascites(l23221 to 122~20 ml/min) (Group II), nor in patients with compeansated cirrhosis. Patients from Group I differed fron those of Group II with respect to baseline ClH20 (3.120.8 vs 0.923.2 nllnin: p
We have invesligated 164 anti-HCV-positive donoa of the 309 identifiedamong27153donorsroutinelyscreenedsince J$y 1989(overallprevalence1.13%).Resultswerecompared wnh thoseof 16s sex and a c matchedseroncgative donon. A historyof blood tram7u~lon(21% vs 5%. parental historyof chronicliverdisease(18%vs 4KD.Ool'* ;p
. , a
44%. Ninely per cent of donon with elevated ALT as well as 20% of those with normal ALT had chronic hepatitis. Among those with normal ALT, ,therisk of chronic he atitis incrcasid with the opticaldcnwy obtained in the !&ISA. Samples from 74 positive donors were tested by a recombinant immunoblot assay (Chiron RIBA). Ovcrdl, 44 60%) were confirmed, 23 (31%) were indeterminate and 7 I9%) were negative.len of thirteen(77%) of indewrminax paucrns showmg a S.i.1band (+ or +/-) had liverdiseaseor had been implicnlcdin PTH \vhcrcas 9 of 10 (82%)or those rcaclivc onl IO C-100 had not transmitred PTH or had normal histo Yogy. In summary. 75% anti-HCV positivedonors have not been parcnwally csposcd 10 blood. 56% of them have chronic hcrwi~is. which presence corrclmcs with ALT lcvcl and IXISA rcading. 'I'hcIWh\ may bc a good confirmatory nssny,allhough a ncgsliw rcsul~may not esclude inicclivity.
s40
150
PROTECTIVE EFFECT OF CICLGSFQRIN AGAINST CIRRHOTIC ALTERATION OF ‘IIE LIVER T-S-Lie. M. Bach, J. Vogel, G. Brunner. T. Krijger Sectlon of Transplantation, Departmentof Surgery, Institute of Pathology, University of Bonn, FRG Ciclosporin (CiS) is today the most effective immunosuppressive drug in organ transplantation. We observed nocd clinical results in the therapy of orimary biriary cirrhosis or other autoimmun~chro~ic heoatitis whenwe charmedthe dosage of CiS in c&respondence to the ievels of se;um transaminaseg inspite of its own hepatotoxicity. After several years of treatment, we found also histological improvementin cirrhotic alteration in the biopsy material of some patients. Therefore, we assumedthat CiS inhibits not only autoimnunephenomenabut also directly inhibits cirrhotic alteration in chronic liver disease. To clarify this hypothesis, we treated hepatotoxin (CC141 induced chronic liver damage 6 weeks with CiS (lmg/kg/Zd). We found 64% fibrosis and cirrhosis in the control group.but only 25% in the CiS treated group.50b of the CiS treated rats showedminimal fibrosis in contrast to 14% in the icontrol group.Furthermore,the CiS treated rats presented a very lower degree of fatty degeneration than the control group. Our results demonstrates, that CiS inhibit not only autoimmunephenomenaand inflamation in the chronic hepatitis,but also fibrosis and cirrhotic alteration. An adequate dosage. correspondent to the drug metabolization ability and hepatotoxity, might have a potential inhibitory effect on patients with chronic hepatitis.
Lenzi M. Baldi M, LevariniC, Miniero R, Caseani F, BallardiniG, Fusconi M, Bonino F, Bianchi FE.
Semeiotioa Medica 2 and Laboratorio Centralizsato s. Orsola, Bologna, Castroenterology Molinette, Turin, Italy.
The relation between anti HCV end lXM1 AH is under evaluation. 8 LKMl and anti HCV positive sera were titrated for anti HCV by dilution to end point ad the reciprocaldilution value used as titre. Titres (from 10 to 2560) were not correlated to serlm Igci (m0.143). RIR4 was positive in 5 of 8 ELISA Positive and 0 of 4 UMl positive, anti HCV F&ISA negative sera. The overall co"cordmce was 75%. A lower sensitivity of the RIBA is supportedby the fact that the 3 ELISA positive and RIBA negative sea had the lowest titres by ELISA (10, 20 and 40, respectivel?_)es RIBA is performed at l/50 serm dilution. 3 patients anti HCV (RIBA and l&ISA positive) had teen treated. and bed responded to steroids.Concltz+ms:l. the high prevalence of anti HCV in LIW AH is confirmed by RIBA; 2. both the lack of correlationbetween anti HCV titres and serum IgG and the high anti HCV titres male out the possibilitythat the F&ISA results arz merely due to aspecific IgCibinding to the solid phase; 3. biochemical response to steroid treatmentin autoimmunehepatitisdoes not exclude HCV infection.
159 REN;LG;;;kURE IN CIR?HDSIS ASCITES. J Llach., Jll Salmeron. A w CVT&& R Fernandez, J Gaya, TJinbnez. A J Rod&s. Liver Unit. Hospital Rinola. Clinic. Bircelona. DIPVRIDAZlLE IWCES
UITH
I
,
y,
The synthesis of ,qdenosine (Ade), an endogenous nucleoside with powerful renal vasoconstrictor effect, increases in conditions of ischemia. Therefore, it is possible that in cirrhotics with ascites, the renal svnthesis of Ade mav be increased as a consequ;?nce of the impaired -renai perfusion. contributing to the pathogenesis of hepatorenal syndrome. To investigate this %hesis. Dipyridanole (Dp) (a bolus of 0.4 mgjkg '. drug that increases the extracellular levels of .?.de, was given to 14 non-azotemic cirrhotics with ascites and to 6 patients with compensated cirrhosis. Dp induced a reversibls reduction in GFR in 8 patients with cirrhosis and ascites(90t7 to 50+5 ml/min) (Group I). GFR did not change in the remaining patients with ascites(l23221 to 122~20 ml/min) (Group II), nor in patients with compeansated cirrhosis. Patients from Group I differed fron those of Group II with respect to baseline ClH20 (3.120.8 vs 0.923.2 nllnin: p
We have invesligated 164 anti-HCV-positive donoa of the 309 identifiedamong27153donorsroutinelyscreenedsince J$y 1989(overallprevalence1.13%).Resultswerecompared wnh thoseof 16s sex and a c matchedseroncgative donon. A historyof blood tram7u~lon(21% vs 5%. parental historyof chronicliverdisease(18%vs 4KD.Ool'* ;p
. , a
44%. Ninely per cent of donon with elevated ALT as well as 20% of those with normal ALT had chronic hepatitis. Among those with normal ALT, ,therisk of chronic he atitis incrcasid with the opticaldcnwy obtained in the !&ISA. Samples from 74 positive donors were tested by a recombinant immunoblot assay (Chiron RIBA). Ovcrdl, 44 60%) were confirmed, 23 (31%) were indeterminate and 7 I9%) were negative.len of thirteen(77%) of indewrminax paucrns showmg a S.i.1band (+ or +/-) had liverdiseaseor had been implicnlcdin PTH \vhcrcas 9 of 10 (82%)or those rcaclivc onl IO C-100 had not transmitred PTH or had normal histo Yogy. In summary. 75% anti-HCV positivedonors have not been parcnwally csposcd 10 blood. 56% of them have chronic hcrwi~is. which presence corrclmcs with ALT lcvcl and IXISA rcading. 'I'hcIWh\ may bc a good confirmatory nssny,allhough a ncgsliw rcsul~may not esclude inicclivity.
s40