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Anticentromere-antibodies in liver diseases
ANTICENTROMERE-ANTIBODIES IN L I V E R D I S E A S E S A. F r a n c o , G . V a l e s i n i , V . B a r n a b a , F . B a l s a n o Alessandra Franco,M.D., Istituto I Clinica Medica P o l i c l i n i c o U m b e r t o I, 0 0 1 6 1 Rome, Italy. The s e a r c h for A n t i c e n t r o m e r e A n t i b o d i e s (ACA) has b e e n c a r r i e d out u s i n g i n d i rect i m m u n o f l u o r e s c e n c e on H e p - 2 cells, in 84 sera of p a t i e n t s w i t h c h r o n i c liver d i s e a s e s (CLD) : IO a u t o i m m u n e c h r o n i c a c t i v e h e p a t i t i s (CAH) , 23 H B s A g p o s ~ tive CLD, 8 a n t i H B s / a n t i H B c p o s i t i v e CLD, 5 N A N B CAH, 3 c r y p t o g e n e t i c CAH, 27 a l c o h o l i c l i v e r d i s e a s e s (ALD) , 8 p r i m a r y b i l i a r y c i r r h o s i s (PBC) and 5 H B s A g h e a l t h y c a r r i e r s . S e r a from p a t i e n t s w i t h S y s t e m i c L u p u s E r y t h e m a t o s u s (SLE) , p r o g r e s s i v e s y s t e m i c s c l e r o s i s (PSS) and S J o g r e n ' s s y n d r o m e w e r e e x a m i n e d as controls. A C A w e r e p o s i t i v e in 42 o u t of 84 (50%) C L D sera. 2 o u t of 25 (8%) PSS s e r a w e r e a l s o p o s i t i v e , b o t h w e r e f r o m p a t i e n t s w i t h C R E S T s y n d r o m e . The higher p e r c e n t a g e of A C A p o s i t i v i t y was f o u n d in thm A L D sera (85%) . A C A w e r e also d e t e c t a b l e in the 20% of a u t o i m m u n e C A H sera, in the 43% of H B s A g + v e CLD sera, in n o n e of the N A N B CAH a n d of c r y p t o g e n e t i c CAH sera. A C A w e r e f o u n d in the 37% of PBC sera, all from p a t i e n t s w i t h o u t s i g n s of C R E S T and p o s i t i v e for a n t i - m i t h o c o n d r i a l a n t i b o d y (AMA) . A C A p o s i t i v i t y is r e l a t e d n e i t h e r to A N A pos i t i v i t y nor to a n y p a r t i c u l a r A N A p a t t e r n . The r e s u l t s of the p r e s e n t i n v e s t i g a t i o n s u g g e s t a l a r g e r d i s t r i b u t i o n of t h e s e a u t o a n t i b o d i e s in d i f f e r e n t subsets of l i v e r d i s e a s e s , even t h o u g h s u c h h e t e r o g e n e i t y is not a p p r e c i a b l e in other e x t r a h e p a t i c d i s e a s e s . 117
SHORT AND LONG-TERM EFFECTS OF NADOLOL ON HEPATIC AND RENAL HAEMODYNAMICS AND FUNCTION IN CIRRHOTIC PATIENTS WITH PORTAL HYPERTENSION 118
A. Gattap D. Sacerdoti t C. Merkel~ G. Battaqlia" t G.F. Finucci~ R. Zuin Departments of Clinical Medicine end Surgery c, University of Padua, Italy
Nadolol (N), in comparison with propranolol, shows: a)iong serum half life; b) absence of hepa tic metabolism; c) entering the central,nervous system to a lesser degree; d) maintainance of renal blood flow in patients with arterial hypertension. We studied 24 cirrhotics with oesophageal varices; 9 had had prior variceal bleeding (Bleeders); 15 had never bled from varices (Nonbleeders). Before and I and 6 months after N. treatment(40160 mg/day), cardiac output (CO) (Thermal dilution), porto-hepatic gradient (PHG) (occluded-free hepatic vein pressure), hepatic blood flow (HBF) (indocyanine green constant infusion),galacto se eliminating capacity (GEC) and renal blood flow (RBF) (PAH clearance) were determined. CO (From 7.61±0.40 to 6.15~ 0.28 to 6.02± 0.49 1/min) (mean±SE) and PHG ( from 25±1 to 19,1 to 18 • 2 cm H20) were significantly reduced both after 1 and 6 months. HBF (from 1174±145 to 956±150 to 865,141 ml/min) was reduced, significantly only after i month. GEC (from 290±24 to274~19 to 515±29 mg/min) and RBF (from 758±47 to 717±49 to 898±105 ml/min) were unchanged. Reduction in PHG was significantly greater in Nonbleeders than in Bleeders. Oesophageal varices degree ( a£ cording to Dagradi's classification) was reduced in 12/24 patients after 1 month, in 7/16 after 6 months, in 7/12 after 12 months. None of Nonbleeders bled during the period of study(18 mon~ hs); 2 of Bleeders rebled (1 after 6 months, I after 17 months). In conclusion N. reduced PHG in our patients; the effect was greater in Nonbleeders; in appro ximately 50: of patients also reduced the degree of varices; no patient had hepatic or renal side-effects.
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SHORT AND LONG-TERM EFFECTS OF NADOLOL ON HEPATIC AND RENAL HAEMODYNAMICS AND FUNCTION IN CIRRHOTIC PATIENTS WITH PORTAL HYPERTENSION 118
A. Gattap D. Sacerdoti t C. Merkel~ G. Battaqlia" t G.F. Finucci~ R. Zuin Departments of Clinical Medicine end Surgery c, University of Padua, Italy
Nadolol (N), in comparison with propranolol, shows: a)iong serum half life; b) absence of hepa tic metabolism; c) entering the central,nervous system to a lesser degree; d) maintainance of renal blood flow in patients with arterial hypertension. We studied 24 cirrhotics with oesophageal varices; 9 had had prior variceal bleeding (Bleeders); 15 had never bled from varices (Nonbleeders). Before and I and 6 months after N. treatment(40160 mg/day), cardiac output (CO) (Thermal dilution), porto-hepatic gradient (PHG) (occluded-free hepatic vein pressure), hepatic blood flow (HBF) (indocyanine green constant infusion),galacto se eliminating capacity (GEC) and renal blood flow (RBF) (PAH clearance) were determined. CO (From 7.61±0.40 to 6.15~ 0.28 to 6.02± 0.49 1/min) (mean±SE) and PHG ( from 25±1 to 19,1 to 18 • 2 cm H20) were significantly reduced both after 1 and 6 months. HBF (from 1174±145 to 956±150 to 865,141 ml/min) was reduced, significantly only after i month. GEC (from 290±24 to274~19 to 515±29 mg/min) and RBF (from 758±47 to 717±49 to 898±105 ml/min) were unchanged. Reduction in PHG was significantly greater in Nonbleeders than in Bleeders. Oesophageal varices degree ( a£ cording to Dagradi's classification) was reduced in 12/24 patients after 1 month, in 7/16 after 6 months, in 7/12 after 12 months. None of Nonbleeders bled during the period of study(18 mon~ hs); 2 of Bleeders rebled (1 after 6 months, I after 17 months). In conclusion N. reduced PHG in our patients; the effect was greater in Nonbleeders; in appro ximately 50: of patients also reduced the degree of varices; no patient had hepatic or renal side-effects.
$237