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Antibodies to extractable cellular antigens specific of chronic liver disease (CLD)
ANTIBODIES TO EXTRACTABLE CELLULAR ANTIGENS SPECIFIC OF CHRONIC LIVER DISEASE (CLD). 63
F. Cassani, M. Fusconi, M. Lenzi, U. Volta, F.B. Bianchi,
E. Pisi.
Istituto di Patologia Medica I, Policlinico S. Orsola. Via Massarenti 9. 40138 BOLOGNA. Serum precipitating antibodies to a variety of soluble antigens are frequently identified by counterimmunoelectrophoresis (CIE) in connective tissue disease (CTD), using rabbit thymus extract and appropriate reference sera. Two new systems, XR and XR2, were recently reported in CLD. We tested sara from 175 CLD and 60 CTD patients, defined by established criteria. Autoimmune CAH(26) PBC(62) Cryptogenic CAH(21) HBsAg+ CAH(29) ALD(37) CTD(60) XR 8 (31%) ° 4 (7%) 0 3 (10%) 0 0 XR2
0
2 (3%)
0
0
0
0
0 I (2%) 0 0 0 3 (5%) Unidentified 0 2 (3%) 0 0 0 0 o Autoimmune CAH vs other CLD p ¢ 0.001, ~2. All XR+ sara were smooth muscle antibodies (SMA)+, while no correlation was found with anti nuclear antibodies (ANA), both detected by indirect immunofluorescence at 1:40 dilution. XR+ sara, compared with XR- SMA+ sera, displayed SMA at a higher titer ( p ¢ O . O l , Wilcoxon) and mainly with SMA-T or SMA-G patterns (14/15 versus 1/30; p <0.001, 9~. 2 Yates'). i. XR and XR 2 systems are specific of CLD; in particular, XR behaves like a marker of auto immunity. 2. Features of autoimmunity can be found in CLD subgroups other than classical auto immune CAH. 3. A cytoplasmic rather than nuclear localization of the XR antigen is suggested. 4. Preliminary results, obtained by immunoblotting, CIE and immunodiffusion, suggest that XR and anti-actin antibodies are immunologically distinct. SS-B
84
MEASURE OF PORTOCAVAL SHUNTING BY ORAL AND I.V. SORBITOL CIRRHOSIS. A. Cavanna, M. Ballar~, P. Avagnina, M. Torchio, G.P. Molino. Istituto di Medicina Interna,'Universit~ di Torino, Italy.
CLEARANCES
IN
The clearance of compounds which are completely extracted by the liver can be assumed as a measure of functional liver plasma flow (FLPF); moreover, provided that intestinal absorption is complete, the fractional portosystemic shunting may be also evaluated by comparing plasmatic curves obtained after oral and i.v. administrations (AUCos/AUCiv). These principles can be applied to D-sorbitol (S), a natural polyol with a very high intrinsic clearance. At doses not exceeding 2 g, S was proved to be completely absorbed after oral administration (H2-breath test) in both normal and cirrhotic subjects, and its liver extraction was found to be virtually complete. Ten normal subjects and 12 cirrhotic patients with documented esophageal varices were studied; in both, the same standard 2 g dose was orally and intravenously administered on successive days. In normals, the i.v. clearance (corresponding to FLPF) was 911 + 137 ml/min, and no S appeared in peripheric plasma after oral administration. In cirrhotics, i.v. clearance was 456 + 181 ml/min, and a plasmatic curve was observed after oral ingestion. These results agree with the hypothesis that in cirrhosis the functional liver plasma flow is reduced with respect to controls (p-~ O.OO1) because of the presence of portocaval shunting. This was quantified as ranging from 7 to 54% of portal plasmatic flow in the 12 examined cirrhotics. In conclusion, the evaluation of S kinetics can be considered a valuable tool for noninvasive studies of hepatic haemodynamics in liver diseases.
$210
F. Cassani, M. Fusconi, M. Lenzi, U. Volta, F.B. Bianchi,
E. Pisi.
Istituto di Patologia Medica I, Policlinico S. Orsola. Via Massarenti 9. 40138 BOLOGNA. Serum precipitating antibodies to a variety of soluble antigens are frequently identified by counterimmunoelectrophoresis (CIE) in connective tissue disease (CTD), using rabbit thymus extract and appropriate reference sera. Two new systems, XR and XR2, were recently reported in CLD. We tested sara from 175 CLD and 60 CTD patients, defined by established criteria. Autoimmune CAH(26) PBC(62) Cryptogenic CAH(21) HBsAg+ CAH(29) ALD(37) CTD(60) XR 8 (31%) ° 4 (7%) 0 3 (10%) 0 0 XR2
0
2 (3%)
0
0
0
0
0 I (2%) 0 0 0 3 (5%) Unidentified 0 2 (3%) 0 0 0 0 o Autoimmune CAH vs other CLD p ¢ 0.001, ~2. All XR+ sara were smooth muscle antibodies (SMA)+, while no correlation was found with anti nuclear antibodies (ANA), both detected by indirect immunofluorescence at 1:40 dilution. XR+ sara, compared with XR- SMA+ sera, displayed SMA at a higher titer ( p ¢ O . O l , Wilcoxon) and mainly with SMA-T or SMA-G patterns (14/15 versus 1/30; p <0.001, 9~. 2 Yates'). i. XR and XR 2 systems are specific of CLD; in particular, XR behaves like a marker of auto immunity. 2. Features of autoimmunity can be found in CLD subgroups other than classical auto immune CAH. 3. A cytoplasmic rather than nuclear localization of the XR antigen is suggested. 4. Preliminary results, obtained by immunoblotting, CIE and immunodiffusion, suggest that XR and anti-actin antibodies are immunologically distinct. SS-B
84
MEASURE OF PORTOCAVAL SHUNTING BY ORAL AND I.V. SORBITOL CIRRHOSIS. A. Cavanna, M. Ballar~, P. Avagnina, M. Torchio, G.P. Molino. Istituto di Medicina Interna,'Universit~ di Torino, Italy.
CLEARANCES
IN
The clearance of compounds which are completely extracted by the liver can be assumed as a measure of functional liver plasma flow (FLPF); moreover, provided that intestinal absorption is complete, the fractional portosystemic shunting may be also evaluated by comparing plasmatic curves obtained after oral and i.v. administrations (AUCos/AUCiv). These principles can be applied to D-sorbitol (S), a natural polyol with a very high intrinsic clearance. At doses not exceeding 2 g, S was proved to be completely absorbed after oral administration (H2-breath test) in both normal and cirrhotic subjects, and its liver extraction was found to be virtually complete. Ten normal subjects and 12 cirrhotic patients with documented esophageal varices were studied; in both, the same standard 2 g dose was orally and intravenously administered on successive days. In normals, the i.v. clearance (corresponding to FLPF) was 911 + 137 ml/min, and no S appeared in peripheric plasma after oral administration. In cirrhotics, i.v. clearance was 456 + 181 ml/min, and a plasmatic curve was observed after oral ingestion. These results agree with the hypothesis that in cirrhosis the functional liver plasma flow is reduced with respect to controls (p-~ O.OO1) because of the presence of portocaval shunting. This was quantified as ranging from 7 to 54% of portal plasmatic flow in the 12 examined cirrhotics. In conclusion, the evaluation of S kinetics can be considered a valuable tool for noninvasive studies of hepatic haemodynamics in liver diseases.
$210