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Liver membrane antibodies (LMA) as another marker of delta overinfection
INFLUENCE OF COOLING AND NORMOTHERMIC NONFLOW ANOXIA ON AEROBIC AND ANAEROBIC GLYCOLYSIS: IMPLICATIONS FOR LIVER PRESERVATION.
83
G.N. de Ruijter, R.A.F. Krom, J.R. Huizenga*, I. Pieters*, C.H. Gips*. Departments of Surgery and Medicine*, University Hospital Groningen (Holland).
The e f f e c t o f c o o l i n g and normothermic (37oc) n o n f l o w a n o x i a on t h e p r o d u c t i o n o f p y r u v a t e and l a c t a t e by t h e l i v e r , as markers f o r a e r o b i c and a n a e r o b i c g l y c o l y s i s r e s p e c t i v e l y ~ was s t u d i e d i n r a t . I t can be assumed t h a t n o r m a l l y t h e p r o d u c t i o n o f p y r u v a t e and l a c t a t e i s i n e q u i l i b r i u m . The L/P p r o d u c t i o n r a t i o remains below 10. S i x t y f o u r i s o l a t e d r a t l i v e r s , h a l f o f which p r e t r e a t e d by one hour normothermic nonflow a n o x i a i m m e d i a t e l y b e f o r e t h e experiment~ were s i n g l e p a s s p e r f u s e d w i t h E a g l e ' s medium f o r t h r e e hours i n normothermia and h y p o t h e r m i a (30, 20 and IO°C; n=8 f o r each g r o u p ) . To d e t e r mine w h e t h e r c o o l i n g d e p r e s s e s g l y c o l y s i s o n l y o r c a u s e s more s e v e r e damage, t h e l i v e r s were rewarmed and p e r f u s e d n o r m o t h e r m i c a l l y d u r i n g a f o u r t h o u r . P y r u v a t e and l a c t a t e p r o d u c t i o n were d e t e r m i n e d e v e r y h o u r . O x y g e n a t i o n , a c i d b a s e b a l a n c e , and t e m p e r a t u r e were m o n i t o r e d frequently. P02 was kept high (70 kPa at 37oC). In the unpretreated livers, pyruvate and lactate production in the 20 ° and I0 ° groups were lower than in the 37 ° and 30 ° groups (Wilcoxon: P <.01 and P < . 0 0 2 resp.) during the first three hours of perfusion. There were no differences between 37 ° and 30 ° groups, nor between the 20 ° and I0 ° groups. After rewarming all differences disappeared. In all experiments the median L/P ratio was about 6. In the pretreated livers, pyruvate production was lower in the first three hours of perfusion and after rewarming (P <.002). They also showed a lower lactate production after rewarming in all groups (P <.05). The median L/P ratio was about 6. Conclusions: I. Cooling causes a reversible depression of aerobic and anaerobic glycolysis in livers that were not pretreated with normothermic nonflow anoxia. 2. Cooled perfusion is needed to prevent damage to the aerobic glycolytic pathway in livers, pretreated by normothermic nonflow anoxia.
LIVER MEMBRANE ANTIBODIES OVERINFECTION 84
(LMA) AS ANOTHER MARKER OF DELTA
M.de Torres,A.Martinez,C.Bas,I.Mora,J.C.Porres,J.Gutiez, C.Hernandez Guio and V.Carrefio. Department of Gastroenterolog~.Fundaci6n Jim4nez Dfaz.Madrid.SPAIN.
The aim of the study was to determine the possible relationship between the presence of LMA and delta overinfection in patients with chronic hepatitis (CH). Twenty healthy controls (normal LFT,HBV markers -),20 HBsAg asymptomatic carriers (normal LFT) and 137 CH (22 Ci,99 CAH,16 CPH) were tested for the presence of LMA (rat liver perfusion and indirect immunofluorescence),HBV markers,antidelta (RIA) and HBV-DNAp (ultracentrifugation and 3H-dTTP incorporation). The results are summarized in the table: Antidelta
CHRONIC
Antidelta
+
-
i
HEPATITIS
VBH-DNAp +
VBH-DNAp -
VBH-DNAp +I
VBH-DNAp -
TOTAL
11
24
37
65
20 (83%) 1 (3%) 22 (34%) LMA +(%) 9 (82%) LMA were not detected in controls and HBsAg asymptomatic carriers. LMA positivity was higher in antidelta positive CH (29/35: 83%) than in antidelta negative ones (23/I02:22%;p(0.001). Among patients with antidelta positive CH, presence of LMA was independent of HBV-DNAp activity. However, among antidelta -ve CH patients, the presence of LMA was almost restricted to HBV-DNAp -ve cases (34% LMA +). In contrast, only I out of 37 patients was positive in both HBV-DNAp and LMA tests (3%; p < 0.001). In conclusion: Autoimmunity may be involved in the pathogenesis of antideita positive CH, since a very high percentage of LMA was detected in this group of patients, independently of the level of HBV replication.
S220
83
G.N. de Ruijter, R.A.F. Krom, J.R. Huizenga*, I. Pieters*, C.H. Gips*. Departments of Surgery and Medicine*, University Hospital Groningen (Holland).
The e f f e c t o f c o o l i n g and normothermic (37oc) n o n f l o w a n o x i a on t h e p r o d u c t i o n o f p y r u v a t e and l a c t a t e by t h e l i v e r , as markers f o r a e r o b i c and a n a e r o b i c g l y c o l y s i s r e s p e c t i v e l y ~ was s t u d i e d i n r a t . I t can be assumed t h a t n o r m a l l y t h e p r o d u c t i o n o f p y r u v a t e and l a c t a t e i s i n e q u i l i b r i u m . The L/P p r o d u c t i o n r a t i o remains below 10. S i x t y f o u r i s o l a t e d r a t l i v e r s , h a l f o f which p r e t r e a t e d by one hour normothermic nonflow a n o x i a i m m e d i a t e l y b e f o r e t h e experiment~ were s i n g l e p a s s p e r f u s e d w i t h E a g l e ' s medium f o r t h r e e hours i n normothermia and h y p o t h e r m i a (30, 20 and IO°C; n=8 f o r each g r o u p ) . To d e t e r mine w h e t h e r c o o l i n g d e p r e s s e s g l y c o l y s i s o n l y o r c a u s e s more s e v e r e damage, t h e l i v e r s were rewarmed and p e r f u s e d n o r m o t h e r m i c a l l y d u r i n g a f o u r t h o u r . P y r u v a t e and l a c t a t e p r o d u c t i o n were d e t e r m i n e d e v e r y h o u r . O x y g e n a t i o n , a c i d b a s e b a l a n c e , and t e m p e r a t u r e were m o n i t o r e d frequently. P02 was kept high (70 kPa at 37oC). In the unpretreated livers, pyruvate and lactate production in the 20 ° and I0 ° groups were lower than in the 37 ° and 30 ° groups (Wilcoxon: P <.01 and P < . 0 0 2 resp.) during the first three hours of perfusion. There were no differences between 37 ° and 30 ° groups, nor between the 20 ° and I0 ° groups. After rewarming all differences disappeared. In all experiments the median L/P ratio was about 6. In the pretreated livers, pyruvate production was lower in the first three hours of perfusion and after rewarming (P <.002). They also showed a lower lactate production after rewarming in all groups (P <.05). The median L/P ratio was about 6. Conclusions: I. Cooling causes a reversible depression of aerobic and anaerobic glycolysis in livers that were not pretreated with normothermic nonflow anoxia. 2. Cooled perfusion is needed to prevent damage to the aerobic glycolytic pathway in livers, pretreated by normothermic nonflow anoxia.
LIVER MEMBRANE ANTIBODIES OVERINFECTION 84
(LMA) AS ANOTHER MARKER OF DELTA
M.de Torres,A.Martinez,C.Bas,I.Mora,J.C.Porres,J.Gutiez, C.Hernandez Guio and V.Carrefio. Department of Gastroenterolog~.Fundaci6n Jim4nez Dfaz.Madrid.SPAIN.
The aim of the study was to determine the possible relationship between the presence of LMA and delta overinfection in patients with chronic hepatitis (CH). Twenty healthy controls (normal LFT,HBV markers -),20 HBsAg asymptomatic carriers (normal LFT) and 137 CH (22 Ci,99 CAH,16 CPH) were tested for the presence of LMA (rat liver perfusion and indirect immunofluorescence),HBV markers,antidelta (RIA) and HBV-DNAp (ultracentrifugation and 3H-dTTP incorporation). The results are summarized in the table: Antidelta
CHRONIC
Antidelta
+
-
i
HEPATITIS
VBH-DNAp +
VBH-DNAp -
VBH-DNAp +I
VBH-DNAp -
TOTAL
11
24
37
65
20 (83%) 1 (3%) 22 (34%) LMA +(%) 9 (82%) LMA were not detected in controls and HBsAg asymptomatic carriers. LMA positivity was higher in antidelta positive CH (29/35: 83%) than in antidelta negative ones (23/I02:22%;p(0.001). Among patients with antidelta positive CH, presence of LMA was independent of HBV-DNAp activity. However, among antidelta -ve CH patients, the presence of LMA was almost restricted to HBV-DNAp -ve cases (34% LMA +). In contrast, only I out of 37 patients was positive in both HBV-DNAp and LMA tests (3%; p < 0.001). In conclusion: Autoimmunity may be involved in the pathogenesis of antideita positive CH, since a very high percentage of LMA was detected in this group of patients, independently of the level of HBV replication.
S220