Extraction of Uraemic Toxins with Activated Carbon Restores the Functional Properties of Albumin

High-Porosity Activated Carbon as a Possible Matrix For Native DNA and Dextran-Sulfate Immobilization

In this study, specific and nonspecific activity of calf thymus DNA and Dextran-Sulfate (DS)-containing synthetic carbonic adsorbents (0.7-7mg of each ligands per 1 cm3 of activated carbonic beads, 0.3-0.6mm diameter, bulk density gamma=0.1-0.2g/cm3) have been compared in stir-bath and micro-column in vitro tests. DS coating as well as DNA coating does not demonstrate deep influence on the unspecific adsorptive activity of carbonic matrix toward creatinine, vitamin B12, and unconjugated bilirubin. No essential difference has been found in the specific activity of DNA and DS containing adsorbents toward anti-ds- and anti-ss-DNA-antibodies, as well as antibodies against DNA-protein complexes (anti-DNP-antibodies): in both cases the percentage of decrease of appropriate antibody concentration varied between 35 and 51% for single-pass microcolumn experiments with moderate enhancement of extraction efficacy (up to 60-75%) due to additional recirculation (2 h) or preliminary plasma dilution in 2-5 times. In the micro-column experiments with the proinflammatory cytokines DNA or DS-coating did not diminish TNF-alpha, IL-1beta, and IL-6 adsorption from 3% BSA solution, but even improves to some extent its removal compared with uncoated matrix.

Albumin-binding function is reduced in patients with decompensated cirrhosis and correlates inversely with severity of liver disease assessed by model for end-stage liver disease

BACKGROUND

Human serum albumin has multiple functions, the most important being maintaining colloid osmotic pressure, ligand binding and transport. In liver failure, an impaired binding of endogenous substances and drugs can be observed. The aim of this study was to investigate the relationship between the severity of liver disease and an impaired albumin binding.

METHODS

In 44 patients with decompensated liver cirrhosis, Child-Turcotte-Pugh and model for end-stage liver disease scores were assessed and the site II-specific albumin-binding function (albumin-binding capacity) was characterized. Briefly, the unbound amount of diazepam site ligand Dansylsarcosine in a sample was determined and compared with the unbound amount in a reference albumin solution (=100%).

RESULTS

Thirty-two out of 44 of the patients presented with Child-Turcotte-Pugh class C, the median Child-Turcotte-Pugh score was 10 [6-13 (min-max)], median model for end-stage liver disease score was 21 (8-40) and the median albumin-binding capacity was 63 (24-91)% compared with healthy controls 98 (95-106)% (P<0.001). Albumin-binding capacity was found to be strongly correlated to model for end-stage liver disease (r=0.783; P<0.001).

CONCLUSIONS

An impaired albumin-binding function of a site II-specific marker in decompensated liver cirrhosis was found to be correlated to the severity of the liver disease.