[The anatomical and functional state of liver in chronic alcoholics].
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Biomedical subjects
Publications and source records attributed to J Bogdal.
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Serum immunoglobulin levels and alpha1-fetoprotein were measured in 49 male alcoholics entering an abstinence program. These parameters were evaluated in relation to liver histology. Of 49 studied alcoholics, 32 had elevated serum immunoglobulin levels, chiefly IgA, which occurred in 29 patients. IgA elevation was also observed in patients with normal histological picture of the liver. Of 17 alcoholics with normal immunoglobulin levels, in 9, i.e. 53%, liver histology was normal. In the group of 32 alcoholics with elevated immunoglobulin levles, normal liver histology was encountered only in 8 patients, i.e. 25%. Two-month abstinence in 18 alcoholics with previously elevated IgA levels caused their decrease in 12 patients, i.e. 66%. A decrease in IgA was noted even in patients with symptoms of histological worsening. Of 49 alcoholics, only 1 showed significantly elevated alpha1-fetoprotein.
It has been suggested that the low disulfide interchange activity in cells producing IgM causes the excretion of immunoglobulin molecules with deficient disulfide cross-linking. IgM material found in the serum formed aggregates which were stabilized largely by noncovalent bonds. Sedimentation coefficients of these aggregates ranged from 11 to 19 S and were similar to sedimentation coefficients calculated for molecules composed of 2, 3, 4 and 5 IgM subunits. A fraction corresponding to a single IgM subunit with a sedimentation coefficient 7.1 S was also present in the serum. The molecular weight of this fraction, determined in mild conditions by Sephadex gel filtration, appeared higher than that predicted for IgMs, reaching the value of 270 000-280 000. The evident increment of molecular weight, compared to a single IgM subunit, was attributed to glycopeptides of sedimentation coefficient 2 S, which form the complex with IgMs molecules. These glycopeptides were also present in aggregates consisting of more than one IgM subunit. The number of IgM subunits participating in aggregates and their molecular weights appeared to depend on the ratio of 2 S glycopeptides to IgM material. With the increase of this ratio the molecular weight of the aggregates lowered and vice versa. Electrical charge and some physico-chemical properties of the aggregates were also significantly affected by the presence of glycopeptides, 2 S glycopeptides were supposed to be the basement membrane related material. Suggestions concerning the interpretation of the phenomenon are presented and discussed.
Sodium thiosulfate was used to enhance in vivo the polymerization of myeloma IgM, deficient in disulfide cross-links. The therapy sharply decreased the amount of low molecular weight IgM fractions, while increasing the serum content of molecules of higher molecular weight. The degree of disulfide cross-linking in IgM increased under the influence of thiosulfate. The rate of secretion into the serum and urine of some membrane-related glycopeptides and species rich in sialic acid was reduced. Also, the discharge of L chains to the urine was lowered during the thiosulfate trial. All these changes were attributed to enhancement of disulfide-interchanging enzyme activity by thiosulfate.
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Porcine calcitonin given to guinea pigs in doses causing hypocalcaemia and hypophosphataemia decreased the bilirubin concentration and increased the activity of gamma glutamyl transpeptidase (GGTP) in the hepatic bile. Calcitonin had no effect on bile flow, its pH, electrolyte composition including calcium, or on the concentration of protein, glucose, cholesterol, nonprotein nitrogen (NPN), and bile acids. It also did not affect the activities of alanine aminotransferase (AIAT) and alkaline phosphatase (AP) in the hepatic bile. Calcitonin increased the calcium content in the liver.
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