- Email: [email protected]
Systemic, splanchnic, and renal hemodynamic effects of dopaminergic dose of dopamine in patients with cirrhosis
13
14 SYSTEMIC,
SPLJNCHNIC. AND RENAL HEEIODYNAHIC EFFECTS OF DOPANINERCIC DOSE OF DOPAMINE LN PATIEIITS WITH CIRRHOSIS Y. Sacq, C. Csudi”. A. Hadenwe. D. Roulot, A. Brelllon, R. Moreau, D. Lebrec INSERN U-24, hapita Beaujo”, Clichy, France
TRANSFORMATION OF FAT STORING CELLS IS ASSOCIATED AND WITH AN ENHANCED SYhTHESlS OF PROTEOGLYCANS c’L7xx5s M. G. Bachem, -‘ D._/A Mcvcr R. E&Is R Mdcbior. K.-M. SeU. A. M. d Department of Cibdcal Chemistry sod Ceotral Labontary, PbilippsXJniversity, D-3550 Marburg fFRG).
is widely used Dopamlne in patients with failure. 1” circulatsry or renal cirrhotic patients supradopsminergic doses of dopamine increase portal pressure. Moreover, the effects of dopemine on renal function hew not yet bee” clearly elucidated. The aim of this study “-2 :c the systemic, splsnchnic and evaluate renal hemodynemic effects of low doses - dopaminergic in patients vieh cirrhosis. dose - of dopamine Nine cirrhotic patients vith ascites received Plasme 1.5 &kg.min of dopemine for 30 min. dopamlne kVelB rose from 35?20 to 31400?14900 pressure gradient and pRImI. h;patic biood flov were not affe-cted whereas ~zwos blood ilou cinrrlfi,antlv increased from O.Z*O.lj to 0.99tO.i8 l/min. Cardiac output blood Flow remained unchanSed. Renal (PAR clearance and extraction) sinnificantlv increased from O.Bzt0.13 t.3 1.07+O.I4 llmi”. ~Giomerular filtration rete (inuli” clearance) did no< change c92*12 and 98217 mllmi”). Thus, filrretio” fraction significantly decreased from 18~1 to 14+1x. It is concluded that dopaminergic dose of dopamine acts on renal hemodynamics and ha8 no deleterious effect on portal hypertension ir: patients with cirrhosis.
(:) and in human alcoh”lu. liir injury (2) a~ well a~ in culture on uncaated platic far storiog EcSls (FSC) ~raosform inI0 myofibroblast-like cells (MFEIIC). WC compared both alI typeswith ICgard to the synthesisof matrixelemccts(glyuK0njogate.a)and cytoldnlu a&g as fibrogenicmediators(self perpttuationof fibrogcnesis). Methods: Rat liver FSC were isolawl by single Nycodcnz gradient tier pronase/coUagenaseperfusion and cokwcd as mooolaycr. To get MFBIC (Is&Ld passage) FSC (6-7 drqs aftor seeding) .wen parsed Toot~protcc&cau (PG) synthesiswas measured by the mcorporation of [ S]rulfate sod specific PO were dctemked efrer urymatic and chcmicai degradation of lotal PG. Results: Transformationof FSC is associatedtilh ao enhanced glycoconjugate&x& (MFBIC produce 2.5.4foId more PG than FSC) md wirh a change in the syoIht&d PG-pattern (FSC: predomhmtiy dcrmatan-sulfate (@l-75%); MPBIC predominantly chondroitinlulfate (dO=lO%)). Compared to FSC MPBIC show a reduced need for.=+ genous growth facrors suggesting aulocrine sliolatio” mcch0u.w The production of siginifiieantamounts of adive EGFII%Falpha, IGFi and prcdominaody latent TGFDl was demonarrated by compuirive rsdiorcacmorbiidkw asa&. Conclnsi;“: A&& (t&formed) FSC (MFBIC) play a central role in liver fibroeenesk bv fij an enhanced oroduuio” of matrix COIII~~S (its) and (iij biibc synthesis of f&ogenic mediators (self pcrpetuafion oFGbrogenc.&).
In upcrimental
mpatic venous
_
1. Mak, K, MA. Leo, C.S. tieber. Gastiocnterology87: 188(1984). 2 McGee, JO’D., R.S. Patick. Lab. Iwest. 26: 429 (1972).
15 ANTI-h’EvpRopHIL ANTIBODIES CXUNGITIS (PSI?) Laura Baffoni, Daniela Fcsconi , M. Lenzi, G. >
IN FfUJ@RY
16 ASD CLISlCAL S166111SAWCi 01 Antt-C9EVATlTlS C SIVOS:SPACIflCITV
SCUXSING
190-3ASD PAPTIAL CSARACTESltATIOS OFAIITALIAS 7SOLATl
Zaul:l. F. Ballardini,
Cassani. M. F.B. Bianchi
kw!LL!Jllmi&6.~u.~L~E tAdAL§.‘3.WLl..Brillapti.kLiuettPL&V~L~ t U. Bnvlbtpp1 ud E Eprinelloliaette POSP.,a lost. of lot. Ned. Onia. of ToriaN IeA.Clia. Univ. of SoioAaa,ltalr and $ Cbirm Corp.. Ewrville, Califorair, DSA.
Antibodies directed against the nucleus of peripheral nsutrophils have been recently described in FSC. h’e have reevaluated the distribution of antineutrophil antibodies in patients with I?% inflammatory bowel disease (IBD), primary biliary cirrhosis (PeC), autoimmme chronic active hepati-
tis (A-CAH),alcoholic liver disease (AU), systemic lupus erithematosus(SLE) and blood donors Neutrophils wepe purified from (BD). lXWUk31 subjsztc., c:+xentrifuged and alcohol-fixed. Antibodies were detenned ‘“3 ir?direct iuanunofluorescence (IPL). The distribution oi IR, staining is, in our hands, confined to the perinuclear region of ‘-he cell in PSC cues. llw prevalence of the antibody is reported in the table. Cases NO No positive Prevalence x Fsc IBD PBC A-CAH .ALD
si
23 4
.
8
iZ
ci
74
BD 22 0 A perinucle~;i~ti-neutrop+il cytoplasmic antibody adentlcal to our PSC(pANc.1) associated pattern, has heen shown to he directed to myelo~roxidase and is comx~nly found vesculitis and blonwwlonephritis. Althowh su.% serologic marker is shared by clinically diverse entities, it provides evidence that they are possibly pathogenetically related.
I
reapectirelr,
aad 1 of
20 (5x1 haalP
carriers.
Tbe difiereal
prevalenceof aati-BCI in there groups was associated with dreg Anti-UC1 us also positive in 23 of 38 l%ll prtielts mirl bepatocellularcar&ma WC1and in 6 of 34 (16X)liver truspla~t patienta. 110 Eliaa positive sera wereretestedb! SIBArad the results are reported:MA-SC BIEI-ICI PoaiUre Se4atirt Positive SeSatirc 111 31 MUI 6116X) PCC 6(54X) 5l461) C’T6iRS ADlOAB 24 NBS) 11(32t)Sepatitis-SI($;) 1SlW) ALCOSOAlCS 9 [SOXI 111011 Aepa~iti~r 11~011 S(COl) PI-NW 13 l951) 1lW. Detectionof anti-C-700-3by ilis~ has IOacceptablespecificitr in patieats sitb PFRASB and 118 hepatitis aad in alcoholics. Anti-W is associatedritb oatoiag virus infection. NV-BWA lltb) frba 7 patients was sepueaced anda 5-15S beteromeitt wasobservedas cowred to the chiapdrrirtd stqutnee.
addiction.
‘4” tz
Anti-‘AC+ (anti-ClGO-3) saf detmiaed (Oitboilisa) in 1251 zera ire: patientsvitb chronicbepatiti,. Tbcantibody gas foundim213 of 235it611 pMtot6 ritb PFNASB1, in 171of 25416711aitbout Liston of transfasioa, ia 33 of SD1661)sitb anti-aicrosola autoaatibodicc (1111 md in ? vf 27 12btInitb otber aotoantibcdies. ICI-MAuas fouodbf PCRin the liver of 7 out of 10anti-W+ patients. but also in 2 anti-BCVaepatire PT-liAM1. 10 EBaAAcarriers it #aa detectedia 20 of 114 Wt) patieataritb BDV iatctioa. in 6 of 73 11111 and 4 of 41 (11) oitb cbroaic beprtitic B anti-IS+ aad SEeAS positive
seems
54
14 SYSTEMIC,
SPLJNCHNIC. AND RENAL HEEIODYNAHIC EFFECTS OF DOPANINERCIC DOSE OF DOPAMINE LN PATIEIITS WITH CIRRHOSIS Y. Sacq, C. Csudi”. A. Hadenwe. D. Roulot, A. Brelllon, R. Moreau, D. Lebrec INSERN U-24, hapita Beaujo”, Clichy, France
TRANSFORMATION OF FAT STORING CELLS IS ASSOCIATED AND WITH AN ENHANCED SYhTHESlS OF PROTEOGLYCANS c’L7xx5s M. G. Bachem, -‘ D._/A Mcvcr R. E&Is R Mdcbior. K.-M. SeU. A. M. d Department of Cibdcal Chemistry sod Ceotral Labontary, PbilippsXJniversity, D-3550 Marburg fFRG).
is widely used Dopamlne in patients with failure. 1” circulatsry or renal cirrhotic patients supradopsminergic doses of dopamine increase portal pressure. Moreover, the effects of dopemine on renal function hew not yet bee” clearly elucidated. The aim of this study “-2 :c the systemic, splsnchnic and evaluate renal hemodynemic effects of low doses - dopaminergic in patients vieh cirrhosis. dose - of dopamine Nine cirrhotic patients vith ascites received Plasme 1.5 &kg.min of dopemine for 30 min. dopamlne kVelB rose from 35?20 to 31400?14900 pressure gradient and pRImI. h;patic biood flov were not affe-cted whereas ~zwos blood ilou cinrrlfi,antlv increased from O.Z*O.lj to 0.99tO.i8 l/min. Cardiac output blood Flow remained unchanSed. Renal (PAR clearance and extraction) sinnificantlv increased from O.Bzt0.13 t.3 1.07+O.I4 llmi”. ~Giomerular filtration rete (inuli” clearance) did no< change c92*12 and 98217 mllmi”). Thus, filrretio” fraction significantly decreased from 18~1 to 14+1x. It is concluded that dopaminergic dose of dopamine acts on renal hemodynamics and ha8 no deleterious effect on portal hypertension ir: patients with cirrhosis.
(:) and in human alcoh”lu. liir injury (2) a~ well a~ in culture on uncaated platic far storiog EcSls (FSC) ~raosform inI0 myofibroblast-like cells (MFEIIC). WC compared both alI typeswith ICgard to the synthesisof matrixelemccts(glyuK0njogate.a)and cytoldnlu a&g as fibrogenicmediators(self perpttuationof fibrogcnesis). Methods: Rat liver FSC were isolawl by single Nycodcnz gradient tier pronase/coUagenaseperfusion and cokwcd as mooolaycr. To get MFBIC (Is&Ld passage) FSC (6-7 drqs aftor seeding) .wen parsed Toot~protcc&cau (PG) synthesiswas measured by the mcorporation of [ S]rulfate sod specific PO were dctemked efrer urymatic and chcmicai degradation of lotal PG. Results: Transformationof FSC is associatedtilh ao enhanced glycoconjugate&x& (MFBIC produce 2.5.4foId more PG than FSC) md wirh a change in the syoIht&d PG-pattern (FSC: predomhmtiy dcrmatan-sulfate (@l-75%); MPBIC predominantly chondroitinlulfate (dO=lO%)). Compared to FSC MPBIC show a reduced need for.=+ genous growth facrors suggesting aulocrine sliolatio” mcch0u.w The production of siginifiieantamounts of adive EGFII%Falpha, IGFi and prcdominaody latent TGFDl was demonarrated by compuirive rsdiorcacmorbiidkw asa&. Conclnsi;“: A&& (t&formed) FSC (MFBIC) play a central role in liver fibroeenesk bv fij an enhanced oroduuio” of matrix COIII~~S (its) and (iij biibc synthesis of f&ogenic mediators (self pcrpetuafion oFGbrogenc.&).
In upcrimental
mpatic venous
_
1. Mak, K, MA. Leo, C.S. tieber. Gastiocnterology87: 188(1984). 2 McGee, JO’D., R.S. Patick. Lab. Iwest. 26: 429 (1972).
15 ANTI-h’EvpRopHIL ANTIBODIES CXUNGITIS (PSI?) Laura Baffoni, Daniela Fcsconi , M. Lenzi, G. >
IN FfUJ@RY
16 ASD CLISlCAL S166111SAWCi 01 Antt-C9EVATlTlS C SIVOS:SPACIflCITV
SCUXSING
190-3ASD PAPTIAL CSARACTESltATIOS OFAIITALIAS 7SOLATl
Zaul:l. F. Ballardini,
Cassani. M. F.B. Bianchi
kw!LL!Jllmi&6.~u.~L~E tAdAL§.‘3.WLl..Brillapti.kLiuettPL&V~L~ t U. Bnvlbtpp1 ud E Eprinelloliaette POSP.,a lost. of lot. Ned. Onia. of ToriaN IeA.Clia. Univ. of SoioAaa,ltalr and $ Cbirm Corp.. Ewrville, Califorair, DSA.
Antibodies directed against the nucleus of peripheral nsutrophils have been recently described in FSC. h’e have reevaluated the distribution of antineutrophil antibodies in patients with I?% inflammatory bowel disease (IBD), primary biliary cirrhosis (PeC), autoimmme chronic active hepati-
tis (A-CAH),alcoholic liver disease (AU), systemic lupus erithematosus(SLE) and blood donors Neutrophils wepe purified from (BD). lXWUk31 subjsztc., c:+xentrifuged and alcohol-fixed. Antibodies were detenned ‘“3 ir?direct iuanunofluorescence (IPL). The distribution oi IR, staining is, in our hands, confined to the perinuclear region of ‘-he cell in PSC cues. llw prevalence of the antibody is reported in the table. Cases NO No positive Prevalence x Fsc IBD PBC A-CAH .ALD
si
23 4
.
8
iZ
ci
74
BD 22 0 A perinucle~;i~ti-neutrop+il cytoplasmic antibody adentlcal to our PSC(pANc.1) associated pattern, has heen shown to he directed to myelo~roxidase and is comx~nly found vesculitis and blonwwlonephritis. Althowh su.% serologic marker is shared by clinically diverse entities, it provides evidence that they are possibly pathogenetically related.
I
reapectirelr,
aad 1 of
20 (5x1 haalP
carriers.
Tbe difiereal
prevalenceof aati-BCI in there groups was associated with dreg Anti-UC1 us also positive in 23 of 38 l%ll prtielts mirl bepatocellularcar&ma WC1and in 6 of 34 (16X)liver truspla~t patienta. 110 Eliaa positive sera wereretestedb! SIBArad the results are reported:MA-SC BIEI-ICI PoaiUre Se4atirt Positive SeSatirc 111 31 MUI 6116X) PCC 6(54X) 5l461) C’T6iRS ADlOAB 24 NBS) 11(32t)Sepatitis-SI($;) 1SlW) ALCOSOAlCS 9 [SOXI 111011 Aepa~iti~r 11~011 S(COl) PI-NW 13 l951) 1lW. Detectionof anti-C-700-3by ilis~ has IOacceptablespecificitr in patieats sitb PFRASB and 118 hepatitis aad in alcoholics. Anti-W is associatedritb oatoiag virus infection. NV-BWA lltb) frba 7 patients was sepueaced anda 5-15S beteromeitt wasobservedas cowred to the chiapdrrirtd stqutnee.
addiction.
‘4” tz
Anti-‘AC+ (anti-ClGO-3) saf detmiaed (Oitboilisa) in 1251 zera ire: patientsvitb chronicbepatiti,. Tbcantibody gas foundim213 of 235it611 pMtot6 ritb PFNASB1, in 171of 25416711aitbout Liston of transfasioa, ia 33 of SD1661)sitb anti-aicrosola autoaatibodicc (1111 md in ? vf 27 12btInitb otber aotoantibcdies. ICI-MAuas fouodbf PCRin the liver of 7 out of 10anti-W+ patients. but also in 2 anti-BCVaepatire PT-liAM1. 10 EBaAAcarriers it #aa detectedia 20 of 114 Wt) patieataritb BDV iatctioa. in 6 of 73 11111 and 4 of 41 (11) oitb cbroaic beprtitic B anti-IS+ aad SEeAS positive
seems
54