Changes in fibrinolytic parameters in male patients with type 2 (non-insulin-dependent) diabetes mellitus

We examined changes in fibrinolytic parameters in male patients with diabetes mellitus (DM) and controls. DM patients were divided into three groups: patients without retinopathy, patients with simple retinopathy, and patients with proliferative retinopathy. Plasma levels of t-PA (tissue plasminogen activator) and t-PA-PAI-1 (plasminogen activator inhibitor-1) complex increased with increase in age, but those of PAI-1 (total and free) did not change in controls. On the other hand plasma levels of PAI-1 decreased with increase in age in DM patients. Plasma levels of t-PA, t-PA-PAI-1 complex, free and total PAI-1 increased with increase in body mass index in controls, but no significant changes were shown in these parameters in DM patients. When compared with controls, plasma levels of t-PA, t-PA-PAI-1 complex and PAI-1 were lower in DM patients. Plasma levels of UK (urokinase) and Lp(a) were higher in DM patients. ELT (euglobulin clot lysis time) was significantly shorter in DM patients than in controls. Patients without retinopathy showed increased fibrinolytic activities compared with those with retinopathy due to the increased levels of t-PA in plasma. These results seem to indicate that blood vessels release larger amounts of t-PA at the early stage of DM, then release being impaired at its advance stage. It is also suggested that the regulatory control mechanisms of fibrinolytic activity associated with mechanisms of fibrinolytic activity associated with change in age and body mass index are different between patients with DM and normal people.

The potential role of platelet PAl-1 in t-PA mediated clot lysis of platelet rich plasma

The potential role of platelets in platelet rich plasma clot lysis induced by tissue plasminogen activator (t-PA) was investigated. At the various concentrations of both single chain t-PA (sct-PA) and two chain t-PA (tct-PA) (1.5nM, 3nM, and 6nM), we compared the t-PA mediated lysis time of platelet rich plasma clot (PRP-clot) with that of platelet poor plasma clot (PPP-clot). At the concentrations ranged from 1.5 to 6 nM of both types of t-PA, the clot lysis time of PRP-clot was longer than that of PPP-clot. This elongation was more significant in the tct-PA induced clot lysis than that in the sct-PA induced clot lysis. At the concentration of 3nM of tct-PA, the lysis time of PRP-clot was longer by a factor of 30% in comparison with that of PPP-clot. When the release and the aggregation of platelets were blocked by prostaglandin E1 (PGE1) and theophylline in this experiment, the lysis time of PRP-clot was essentially the same as that of PPP-clot. We then measured the antigen levels of total PAI-1 and t-PA-PAI-1 complex in the lyzed solutions of PRP-clot and PPP-clot to analyse the possible effect of plasminogen activator inhibitor-1 (PAI-1) present in platelets. Most of PAI-1 in a PPP-clot lyzed sample existed as t-PA-PAI-1 complex. In the lyzed solution of PRP-clot, however, the antigen levels of both total PAI-1 and t-PA-PAI-1 complex were significantly higher than those in PPP-clot, and larger amounts of PAI-1 existed as free PAI-1 which possesses activity. These data suggest that at least certain amounts of PAI-1 in platelets exist as an active form and inhibits t-PA activity resulting in the prolongation of the clot lysis time. Activation of platelets, therefore, seems to play an important role in the platelet rich plasma clot lysis induced by t-PA.

Specific expression of a complex sialyl Lewis X antigen on high endothelial venules of human lymph nodes: possible candidate for L-selectin ligand

L-selectin is a cell adhesion molecule that mediates homing of lymphocytes to the peripheral lymph nodes and is speculated to bind to the carbohydrate determinant which is specifically expressed by the endothelial cells of high endothelial venules (HEVs) in the peripheral lymph nodes. One of the murine monoclonal antibodies (2H5, IgM, kappa), which was raised against sialyl LeX-active glycolipids which have long and complicated carbohydrate structures, was found to react strongly to the HEV endothelial cells of the human peripheral lymph nodes, while the typical anti-sialyl LeX antibodies SNH-3, FH-6 and CSLEX-1 failed to detect the antigen on HEV under the same condition. This new antibody was reactive to essentially all endothelial cells of HEV in the peripheral lymph nodes, and moderately to some endothelial cells in Payer's patches and appendices, but never reacted with the endothelial cells of post capillary venules in the spleen, thymus, or other organs. The 2H5 antibody detected three major glycoproteins of 90, 110 and 250 kDa, the most abundant molecular species being 110 kDa, in the stroma of human lymph nodes. In Stamper-Woodruff assays employing cryostat sections of human lymph nodes, the 2H5 antibody significantly inhibited the adhesion of peripheral lymphocytes to the endothelial cells of HEV. These results indicate that the carbohydrate antigens defined by the 2H5 antibody, most probably sialyl LeX determinants having complex carbohydrate structures, serve as the ligand for L-selectin on HEV endothelial cells.

Changes in type IV collagen content in livers of patients with alcoholic liver disease

An increase of serum type IV collagen levels in patients with liver disease has been reported; however, the mechanisms of this increase are not yet well known. We recently developed an assay system for type IV collagen content in liver biopsy specimens. In this study, type IV collagen content in the livers and sera of patients with alcoholic liver disease and nonalcoholic liver disease was determined. Serum and hepatic type IV collagen contents were measured with a one-step sandwich enzyme immunoassay system using monoclonal antibodies for human type IV collagen. Hepatic type IV collagen content increased significantly in liver disease. In alcoholic liver disease, type IV collagen content in patients with mild fibrosis was lower than that in advanced types of alcoholic liver disease. In nonalcoholic liver disease, hepatic type IV collagen content tended to increase with the progression of fibrosis. Type IV collagen content in alcoholic liver disease was significantly higher than that in the corresponding type of nonalcoholic liver disease. Hepatic total collagen content increased significantly in parallel with the progression of fibrosis in both alcoholic liver disease and nonalcoholic liver disease. The total collagen content in each type of alcoholic liver disease was significantly lower than that in the corresponding type of nonalcoholic liver disease. The ratio of type IV collagen to total collagen content was the highest in livers showing mild fibrosis, both in alcoholic liver disease and nonalcoholic liver disease, and decreased in parallel with the progression of fibrosis. The ratio in patients with alcoholic liver disease was significantly higher than that in those with the corresponding nonalcoholic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of MCI-9042 on serotonin-induced platelet aggregation in type 2 diabetes mellitus

MCI-9042, a potent inhibitor of 5HT2 receptor, was used to examine its effects on serotonin induced-aggregation of platelets obtained from patients with type 2 diabetes mellitus (DM). The extent of platelet aggregation induced by serotonin increased in DM patients without retinopathy, but the increase was further significant in DM patients with retinopathy. MCI-9042 as well as ketanserin, inhibited significantly serotonin induced-aggregation of platelets obtained from DM patients with retinopathy. MCI-9042 dose dependently inhibited platelet aggregation induced by serotonin and collagen. These results suggest that serotonin which may be released from platelets of DM patients may activate platelets together with collagen exposed on atherosclerotic endothelium and that MCI-9042 may be inhibitory to enhanced platelet aggregability under these conditions.

Conformational change of plasminogen: effects of N-terminal peptides of Glu-plasminogen

Seven peptides were synthesized to analyze the mechanism of the intramolecular binding of the N-terminal peptide of Glu-plasminogen (Glu-plg) to its kringles. They were Ala44-Lys50, Ala44-Glu51, Ala44-Ser49, Val17-Gly23, Lys19-Gly23, Lys19-Gln21 and Lys19-Lys20. Ala44-Lys50, Ala44-Glu51 and Lys19-Lys20.enhanced the activation of Glu-plg by tissue plasminogen activator (t-PA) or urinary plasminogen activator (u-PA). The activation of Lys-plg, however, was not influenced by these peptides. Therefore, it is suggested that these three peptides worked on Glu-plg in a similar manner as lysine analogue by making the conformation of Glu-plg looser. These peptides did not have any direct effects on u-PA and t-PA. Concerning the effect on fibrinolysis Ala44-Lys50 and Lys19-Lys20 prolonged euglobulin clot lysis time. These results indicate that Ala44-Glu51 may be a responsible binding site in the N-terminal portion of Glu-plg, and LBS of kringle 1 or 4 is the binding site of N-terminal portion of Glu-plg.

Impaired fibrinolytic activity induced by ingestion of butter: effect of increased plasma lipids on the fibrinolytic activity

To investigate the effects of the increased plasma lipid level on fibrinolysis, we measured the levels of fibrinolytic components in serially obtained plasma samples from healthy volunteers after the intake of different amounts of butter. Plasma triglyceride level increased significantly after butter intake compared to the control group. Eight hours after the intake of 100g of butter, plasminogen activator inhibitor 1 (PAI-1) level in plasma was significantly higher and euglobulin clot lysis time was significantly prolonged compared to those of the control group. There was no effect on plasma tissue plasminogen activator level. These results suggest that the temporary increase in plasma triglyceride level induced high PAI-1 level, resulting in impaired fibrinolytic activity. The effect of temporary hyperlipidemia on platelet function was also analyzed and revealed that the response of platelets to ADP and collagen was lower in the butter intake group compared to those of the control.

Effects of genotypes of hepatitis C virus on interferon treatment for chronic type C hepatitis

Interferon is commonly used for treatment of type C hepatitis, but the effects are variable and many factors may be responsible. Hepatitis C virus (HCV) can be classified into 4 types, PT, K1, K2a and K2b. Therefore, the responses to interferon treatment in patients with the different HCV genotypes were analyzed. Twenty-four patients with type C hepatitis were treated with 3 to 10 million units of various types of interferon for more than 8 weeks. HCV-RNA encoding the NS5 region (HCV-NS5) was positive in these 24 patients, 16 of which were classified with the K1 type and 8 with the K2 type of HCV. In all patients except for 2, HCV-NS5 became negative within 3 weeks of treatment without relation to the HCV genotypes. Serum alanine aminotransferase levels were normalized in 7 out of 8 patients in the K2 group and in 4 out of 16 patients in the K1 group at the end of 8 weeks. At the 24th week, ALT levels were normalized in 5 out of 6 patients in the K2 group, and in one out of 9 patients in the K1 group. The percentage of patients exhibiting a good response was significantly higher in the K2 group than in the K1 group at both observation periods. During the post-treatment periods, relapse following complete response was found in 3 patients in the K2 group and in one patient in the K1 group. The final effects of interferon were significantly better in the K2 group than in the K1 group.(ABSTRACT TRUNCATED AT 250 WORDS)

Dissociation of alpha 2-plasmin-inhibitor-plasmin complex and regeneration of plasmin activity by SDS treatment

In order to understand the mechanism for the complex between alpha 2-plasmin-inhibitor (alpha 2-PI) and plasmin to express its specific activity on fibrin autography after SDS-PAGE, we analyzed the effects of SDS on alpha 2-PI molecule and alpha 2-PI-plasmin complex. Treatment of alpha 2-PI by SDS at the concentrations of 0.01% and 0.1% abolished the activity of alpha 2-PI to form a stoichiometric complex with plasmin, whereas it did not interfere with plasmin's activity. More interestingly, in the case of 0.01% SDS, alpha 2-PI was further cleaved to a smaller molecule. Treatment of previously formed alpha 2-PI-plasmin complex by SDS at the concentrations of both 0.01% and 0.1% dissociated the complex and expressed specific amidolytic activity against tripeptide substrate (S-2251), which activity was totally quenched by aprotinin. When alpha 2-PI-plasmin complex was treated by higher concentration of SDS for 12 hours, dissociated free plasmin's band could be observed on SDS-PAGE analysis. It is likely, therefore, that the exposure of alpha 2-PI-plasmin complex to SDS during the procedure of SDS-PAGE dissociates the complex and expresses its specific proteolytic activity in fibrin autography. These features of alpha 2-PI and its complex with plasmin are similar to those of plasminogen activator inhibitor type 1 (PAI-1) and its complex with plasminogen activators (PAs), thus they may represent some common features of the SERPINS.

Serotonin as a factor involved in pathophysiology of thromboangiitis obliterans

Whole blood and plasma levels of serotonin (5-hydroxy-tryptamine, 5-HT) as well as its uptake and spontaneous release from blood platelets were studied in 20 patients suffering from thromboangiitis obliterans (TAO, Buerger's disease) and 20 healthy subjects matched in pairs for age. Results of patients suffering from thromboangiitis obliterans differed in several ways from those of controls. Whole blood 5-HT content was significantly lower in the group of patients compared to that of the control group. It was established that patients with Buerger's disease have significantly greater plasma concentrations of free serotonin. In Buerger's disease patients, maximal platelet serotonin uptake velocity (Vmax) was significantly decreased. It was associated with the enhanced spontaneous release of 5-HT from blood platelets. We conclude that impaired platelet serotonin uptake and increased local concentration of serotonin in the vicinity of platelets in Buerger's disease may lead to platelet activation via 5-HT2 receptors, and it could be involved in the pathogenesis of thromboembolic complications.

Differences in the hepatitis C virus genotypes in different countries

We recently classified the hepatitis C virus (HCV) into 4 types (HCV-PT, -K1, -K2a and -K2b) according to differences in nucleotide sequences. It was found that HCV-PT, the prototype reported from the U.S.A., was rare in Japan, suggesting that distribution of HCV genotypes may be different in various countries. The prevalence of HCV genotypes was therefore compared in different countries. Genotyping of HCV was performed by slot-blot hybridization analysis using cDNA probes specific to each type of HCV or by restriction fragment length polymorphism analysis. In 121 Japanese non-cancer patients, the prevalence of HCV genotypes was 77.7% for HCV-K1, 16.5% for HCV-K2a and 5.0% for HCV-K2b. HCV-PT was detected in only 1 patient (0.8%). The prevalence in 43 Japanese hepatocellular carcinoma (HCC) patients was 74.4% for HCV-K1, 18.6% for HCV-K2a and 4.7% for HCV-K2b. HCV-PT was found in only 1 sample. In 19 European non-cancer patients, HCV-PT was found in 42.1% and HCV-K1 was found in 52.6%. HCV-K2 was not found. All 7 samples from European HCC patients were HCV-K1, indicating a significantly higher prevalence than in non-cancer patients. In 13 Brazilian non-cancer patients, the distribution pattern was similar to that of the Europeans. In 10 samples from the U.S.A., HCV-PT was found in 70% and HCV-K2 was found in 1 sample. In 18 Chinese non-cancer patients, HCV-K1 was found in 44.4%, HCV-K2a in 50.0% and HCV-K2b in 5.6% HCV-PT was not found. Two samples from Chinese HCC patients were HCV-K1.(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristic features of alcoholic liver disease in Japan: a review

The characteristics of alcoholic liver disease (ALD) in Japanese patients were reviewed and compared with those in Western countries. From the study in Japanese cases, it became clear that alcoholic fibrosis and chronic hepatitis induced by alcohol were types of ALD other than the traditional 3 types. Liver injury in Japanese cases was clearly milder than that in American cases. In American cases, the injury may be fully developed, because of greater alcohol and fat intake. This may be one reason why the two above types of ALD have not been mentioned in the literature of Western countries. In Japanese patients, hepatitis C virus (HCV) infection is not related to alcoholic fibrosis and alcoholic hepatitis. On the other hand, the prevalence of HCV markers was high in chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) patients. Alcoholic hepatitis and chronic hepatitis are the high risk groups for the development of cirrhosis and the chronic hepatitis group is at high risk for the development of HCC. Although the risk is low in alcoholic fibrosis, some patients also develop cirrhosis. About half of the cases of cirrhosis may develop from alcoholic hepatitis and alcoholic fibrosis, and the remaining half cases may develop from chronic hepatitis. Over 80% of HCC cases may develop from chronic hepatitis in Japan. Chronic alcoholism enhanced the development of HCV-related HCC. Recent increase of HCC in alcoholic cirrhosis in Japan may be related to the increase of alcohol consumption, the increase of blood transfusions, and longer survival of cirrhosis patients.

Contribution of carbohydrate antigens sialyl Lewis A and sialyl Lewis X to adhesion of human cancer cells to vascular endothelium

The carbohydrate antigen, sialyl Lex, is known to be a ligand for the cell adhesion molecule called ELAM-1 (E-selectin, endothelial cell leukocyte adhesion molecule-1), which is present on cytokine-activated human endothelial cells. Recently, we reported that another carbohydrate antigen, sialyl Lea, can also serve as a ligand for ELAM-1 (A. Takada, K. Ohmori, N. Takahashi, K. Tsuyuoka, K. Yago, K. Zenita, A. Hasegawa, and R. Kannagi, Biochem. Biophys. Res. Commun., 179: 713-719, 1991). Both sialyl Lex and sialyl Lea are expressed in many human malignant cells. In order to assess the contribution of these carbohydrate antigens to the adhesion of human malignant cells to vascular endothelium, we selected a panel of 12 cultured human epithelial cancer cell lines and a panel of 12 human leukemia cell lines which express sialyl Lex and/or sialyl Lea antigens. All 12 epithelial cancer cell lines exhibited a clearly ELAM-1-dependent adhesion to cytokine-activated human umbilical vein endothelial cells, while only 3 of the 12 leukemia cell lines exhibited significant participation of ELAM-1 in the adhesion. With regard to epithelial cancer cells, the adhesion of 6 cancer cell lines, mostly of colon and pancreas origin, was dependent almost exclusively on sialyl Lea. A significant contribution of the sialyl Lex antigen was noted in the adhesion of the other 6 cell lines, including cancers of lung and liver origin. These results imply that the sialyl Lea/ELAM-1 adhesion system, as well as the sialyl Lex/ELAM-1 adhesion system, plays an important role in the adhesion of human cancer cells to human umbilical vein endothelial cells. With regard to leukemia cells, on the other hand, adhesion of the 3 leukemia cell lines that showed ELAM-1-dependent adhesion was mediated by the sialyl Lex antigen, and none of these leukemia cell lines expressed sialyl Lea or exhibited sialyl Lea-dependent adhesion.

Impaired fibrinolysis in hypertension and obesity due to high plasminogen activator inhibitor-1 level in plasma

In order to elucidate the influence of the risk factors of coronary heart disease on the fibrinolytic activity, relationships between blood pressure, body mass index (BMI), plasma lipoprotein (a) (Lp(a)) level and the plasma levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) were analyzed in the subjects with mild hypertension. Systolic blood pressure showed a positive correlation with total PAI-1 and free PAI-1. Diastolic blood pressure showed no correlation with these proteins involved in the fibrinolytic system. BMI had a positive correlation with total PAI-1, free PAI-1 and euglobulin clot lysis time (ECLT). Plasma Lp(a) level showed correlation with neither blood pressure nor fibrinolytic parameters, but it showed weak negative correlation with body mass index (BMI). These results suggest that high blood pressure and obesity tend to increase free PAI-1 which reduces fibrinolytic activity. Lp(a), however, seems not to influence directly the fibrinolytic system but may work to decrease fibrinolytic activity only in conjunction with other risk factors. The effects of daily drinking of alcohol and smoking on the fibrinolytic system were also investigated in the present study and we obtained the results that habitual drinking increased plasma levels of both tPA and PAI-1 whereas smoking did not affect fibrinolytic activity. These results suggest that risk factors for coronary heart disease such as hypertension and obesity are closely related to the impaired fibrinolysis.

The relationship between the development of alcoholic liver and pancreatic diseases and the induction of gamma glutamyl transferase

It is well known that the responses of serum gamma glutamyl transferase (GGT) to chronic alcohol drinking are different depending on the individual. In order to clarify the genetic backgrounds in the development of alcoholic liver and pancreatic diseases, the relationships between serum GGT response and alcoholic liver and pancreatic diseases in heavy drinkers were studied. The responses of GGT to alcohol drinking were classified into three groups: non-response, mild-response and hyperresponse. In alcoholic liver disease, non-responders were scarcely found and the response of GGT tended to increase in parallel with the progression of liver disease, when the hepatitis C virus (HCV) marker-positive patients were excluded. The differences in GGT levels between just after and at 4 weeks after abstinence in the HCV marker-negative patients were significantly higher than those in the HCV marker-positive patients. The rate of decrease in GGT activities during 4 weeks following abstinence was significantly higher in the HCV marker-negative patients than in the HCV marker-positive patients, indicating higher GGT induction in the HCV marker-positive patients. All patients with alcoholic pancreatitis, but without liver disease, were non-responders. All patients, except one, with severe pancreatitis were also non-responders. In alcoholic pancreatic disease, GGT induction correlated negatively with the development of pancreatitis. These results suggested that genetic polymorphism of GGT may link with the induction of GGT by alcohol drinking, and consequently link with the development of alcoholic liver and pancreatic diseases.

Correlation between serotonergic measures in cerebrospinal fluid and blood of subhuman primate

The relationship between the concentration of serotonin (5-hydroxytryptamine; 5-HT), its precursor; tryptophan (Trp) and the main metabolite 5-hydroxyindoleacetic acid (5-HIAA) in cerebrospinal fluid (CSF) and blood of monkey have been studied. 5-HT, Trp and 5-HIAA underwent circadian changes in both CSF and blood. Significant correlations were found between 5-HT, 5-HIAA and Trp in CSF and blood. The significance of these findings and their relationship to the use of peripheral serotonergic system as a functional model of the central nervous system are discussed.

Analysis of the characteristics of microheterogeneity of various serum glycoproteins in chronic alcoholics

It has been reported that microheterogeneity of serum glycoproteins including transferrin is found in alcoholic liver disease. In the present study, microheterogeneity of serum glycoproteins in alcoholic liver disease patients was analysed using the Western blotting technique after isoelectric focusing. Microheterogeneity was found for serum alpha 1-antitrypsin, alpha 2-macroglobulin, caeruloplasmin, alpha 1-acid glycoprotein and hemopexin as well as transferrin. Microheterogeneity disappeared following treatment with sialidase in some but not all glycoproteins. In hemopexin, microheterogeneity was recognized only after treatment with sialidase. These results suggest that mechanisms of microheterogeneity of serum glycoproteins in alcoholic liver disease may vary. One mechanism may be the interference of glycosylation of glycoproteins in the Golgi apparatus, and another may be the decrease of asialo-protein receptors in hepatocytes.

Studies on capillarization of the hepatic sinusoids in alcoholic liver disease

It has been reported that basement membranes were found around the sinusoidal walls in cirrhotic livers, indicating the development of capillarization of the sinusoids. It has been also emphasized that capillarization of the sinusoids is more prominent in alcoholic liver disease (ALD). In the present study, factor VIII related antigen (VIII-Ag) and UEA-1 were identified immunohistochemically in order to analyze capillarization of the sinusoids in chronic liver diseases. Electron microscopic studies on the endothelial cells and sinusoids were also performed. Electron microscopic studies revealed that the number of fenestra in the endothelial cells decreased and basement membranes were clearly observed in the space of Disse from an early stage of ALD. However, these changes were not observed in the early stage of non-ALD. VIII-Ag or UEA-1 was not stainable in the sinusoidal cells of normal livers or at an early stage of non-ALD. However, in ALD, both VIII-Ag and UEA-1 were clearly demonstrated in the sinusoidal cells from the early stage of fibrosis. These results suggest that the sinusoidal endothelial cells may transform to vascular endothelial cells from an early stage of ALD. The alterations in the sinusoidal endothelium and the basement membrane formation in the Disse space indicate that capillarization of the sinusoid may occur. Capillarization of the sinusoid may cause a disturbance in exchanges of many bioactive substances between the sinusoidal blood and hepatocytes across the Disse space and may thereby contribute to the pathogenesis of ALD.

Effects of alcohol on the replication of hepatitis C virus

We have reported that hepatitis C virus (HCV) RNA encoding the NS5 region (HCV-NS5) became negative following abstinence in some patients with alcoholic liver disease (ALD). In order to clarify the relationship between alcohol misuse (abuse) and the replication of HCV, serial changes of HCV-NS5 and the titer of HCV (HCV-titer) in blood after abstinence were studied in 11 male patients with ALD. Disappearance of HCV-NS5 after abstinence was found in five out of 11 patients (45%) and HCV-titer in blood decreased in all of these cases. In one patient, HCV-NS5 became positive and HCV-titers increased again following resumption of alcohol misuse. The etiology of liver disease in heavy drinkers was subdivided into three categories: alcohol alone, alcohol and HCV, and HCV alone, according to the diagnostic criteria of the Japanese research group for ALD. The etiology in four patients was a combination of alcohol and HCV, and was HCV alone in the remaining seven patients. In all four patients of the alcohol and HCV group, and one out of seven patients in the HCV alone group, HCV-NS5 became negative and HCV-titer decreased after abstinence. The decrease in HCV-titer was not related to the HCV genotypes. These results suggest that alcohol misuse may enhance the replication of HCV.

Relationship between alcoholic liver disease and HCV infection

The high prevalence of hepatitis C virus (HCV) markers in alcoholic liver cirrhosis (AL-LC) and hepatocellular carcinoma (HCC) suggests a close aetiopathogenic relationship between alcoholic liver disease (ALD) and HCV infection. In the present study, HCV markers in ALD were measured by the highly sensitive methods, and the changes of sequential HCV markers after abstinence in ALD patients were analysed in order to elucidate the effect of alcohol on HCV. Antibodies to HCV-related antigen were determined using the first or second generation test kit. HCV-RNA genomes encoding the NS-5 region were detected using the RT-PCR method. In the HCV-NS5 negative serum, HCV genomes of the 5'-noncoding region were detected using the two-stage PCR method. Titres of HCV-RNA were measured by multiple cyclic PCR and cDNA dot blotting. Typing of HCV genomes was carried out on the PCR product from the NS-5 region by slot blot hybridization using type-specific cDNA probes, or by restriction fragment length polymorphisms analysis. In alcoholic fibrosis and alcoholic hepatitis, the prevalence of HCV markers was low, suggesting that the main aetiological factor is alcohol but not HCV in these types of ALD. HCV markers were positive in the half of the patients with AL-LC, and in more than 80% of patients with AL-CH and AL-HCC, indicating that HCV infection closely relates to these types of ALD. The ratio of the K1 type to the K2 type of HCV genomes was 4:1 in all types of NANB liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Type IV collagen and laminin contents of livers from patients with alcoholic liver disease

Characteristic histological features of alcoholic liver disease (ALD) are pericellular and perivenular fibrosis. It has been emphasized from immunohistochemical studies that pericellular and perivenular fibrosis may be caused by the increase of type IV collagen (IV-C) and/or laminin (LM). However, quantitative changes of hepatic IV-C and LM contents in ALD are not well known. Recently, we have developed assay systems for IV-C and LM contents in liver biopsy specimens. In the present study, hepatic IV-C and LM contents in ALD and non-ALD patients were measured. Liver biopsy specimens were obtained from 36 patients with ALD, 24 patients with non-ALD and five patients without liver disease. IV-C and LM contents in liver biopsy specimens were measured using the one-step sandwich enzyme immunoassay system for human serum IV-C and LM levels. Total collagen (T-C) content was also measured by the method of Leon and Rojkind. Hepatic IV-C, LM and T-C contents were significantly higher in all types of liver disease than in controls, and tended to increase with the progression of fibrosis. Especially in ALD, both IV-C and LM contents increased from the early stage, and the values in each type of ALD were significantly higher than those in the corresponding type of non-ALD. The ratio of IV-C or LM to T-C was also significantly higher in ALD than in the corresponding non-ALD. The prominent increases of IV-C and LM at the early stage of fibrosis may be one of the characteristics of collagen metabolism in ALD.(ABSTRACT TRUNCATED AT 250 WORDS)

The alcohol-altered liver membrane antibody and hepatitis C virus infection in the progression of alcoholic liver disease

Progression of alcoholic liver disease is closely related to drinking habits. However, prognosis of alcoholic liver disease is not determined just by drinking habits, but also by other factors. In this study, the roles of alcohol-altered liver membrane antibody and hepatitis C virus infection were analyzed in alcoholic patients who were followed up for various lengths of time. Serial changes of liver histological appearance were analyzed in 39 patients with alcoholic liver disease who were followed for long periods (49.7 +/- 34.3 mo) and who underwent liver biopsy at least two times. Prognoses of 35 patients with alcoholic cirrhosis who were followed for more than 1 yr were also evaluated. Development of cirrhosis in alcoholic liver disease was significantly higher in the alcohol-altered liver membrane antibody-positive patients than in the patients negative for this antibody. On the other hand, hepatitis C virus markers were not related to development of cirrhosis. However, hepatocellular carcinoma developed more frequently in the hepatitis C virus marker-positive patients. In patients with cirrhosis, the cumulative rates of hepatocellular carcinoma development were significantly higher in the hepatitis C virus marker-positive patients than in the marker-negative patients. Cumulative survival rates in the hepatitis C virus marker-positive patients were significantly lower than rates in the hepatitis C virus marker-negative patients, even in noncancer patients. However, such differences were not observed in the alcohol-altered liver membrane antibody-positive and alcohol-altered liver membrane antibody-negative cirrhotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)