cholecystokinin and Liver-Cirrhosis--Alcoholic

The liver influences the metabolism of several peptide hormones. The metabolic effect may, however, change considerably by diseases in the liver. This study examined whether hepatic cirrhosis influences the occurrence and concentrations of procholecystokinin (proCCK) and its products in plasma.. The sum of proCCK and its products (both processing intermediates and bioactive fragments) in plasma were measured by a recently developed "processing-independent analysis". Bioactive forms of CCK in plasma were measured using a highly specific radioimmunoassay directed against the C-terminal epitope of CCK.. In plasma from patients with primary biliary cirrhosis the basal concentration of the total proCCK product was increased. Moreover, a mixed meal increased plasma concentrations of both bioactive CCK (i.e. carboxyamidated an 0-sulfated CCK peptides) and the total proCCK product in primary biliary cirrhosis. In contrast, plasma concentrations of bioactive CCK and the total proCCK product were normal in patients with alcoholic liver cirrhosis-both pre- or postprandially. The fraction of bioactive CCK in plasma from patients with both biliary and alcoholic cirrhosis was also normal. Hence, in primary biliary cirrhosis, alcoholic cirrhosis and in controls, respectively, bioactive CCK constituted 15%, 15% and 17% of the total proCCK product in the basal state; 70%, 58% and 53% 30 min after and 48%, 56% and 51% 90 min after the meal. As shown by gel chromatography, plasma from patients with primary biliary cirrhosis and controls sampled 30 min after a meal contained CCK-33, -22 and -8-like peptides. In addition, plasma contained non-amidated (approximately non-bioactive) proCCK products corresponding in size to CCK-83, -58 and -33. Ninety minutes after a meal, CCK-8 predominated in plasma from patients with primary biliary cirrhosis, whereas plasma from controls displayed a CCK profile similar to that obtained 30 min post-prandially.. The results show that CCK-8 is metabolized at a slower rate in patients with primary biliary cirrhosis.

Topics: Adult; Amides; Animals; Cholecystokinin; Chromatography, Gel; Epitopes; Female; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Cirrhosis, Biliary; Male; Middle Aged; Protein Precursors; Radioimmunoassay; Reference Values

This investigation was undertaken to examine the alterations in serum bile acid concentration after intravenous administration of cholecystokinin and a standard meal in 13 patients with alcoholic cirrhosis. Total 3 alpha-hydroxy bile acids in serum (SBA) were monitored for 2 h after injection of cholecystokinin and for 3 h after the standard meal. The median fasting value of SBA was 39.9 mumol/l (range, 3.2-148 mumol/l). The increase in SBA after cholecystokinin started earlier and lasted shorter than after standard meal stimulation (median, 30 min and 120 min, respectively). The appropriate relative peak levels of SBA were 173% and 212% of the fasting value. The increments were significant (P less than 0.01) within groups but insignificant between groups. Day-to-day variation of postprandial SBA was more pronounced than after cholecystokinin stimulation. The difference, however, was insignificant. An inverse correlation was detected between both fasting and stimulated peak levels of SBA and P-coagulation factors 2, 7, and 10.

Topics: Adult; Aged; Bile Acids and Salts; Blood Coagulation Factors; Cholecystokinin; Female; Food; Humans; Injections, Intravenous; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Serum Albumin

In 12 patients with Laennec's cirrhosis conjugated cholic acid was measured by radioimmunoassay simultaneously in the portal vein, the aorta, and the hepatic vein. Furthermore, the concentration was measured for 90 minutes after i. v. injection of cholecystokinin. In the fasting patient the porto-venous extraction ratio was 0.45 (SD 0.23) and the arterio-venous extraction ratio was 0.24 (SD 0,21). 15-30 minutes after cholecystokinin the bile acid concentration significantly increased. In this time the porto-venous extraction ratio rose to 0.71 while the aorto-venous extraction ratio was different. These results agree with the hemodynamics found in cirrhosis. After cholecystokinin the increase in the extraction ratio account for the blood loss by porto venous shunts which corresponds to an increase of the portal compartment.

Topics: Adult; Aged; Aorta, Abdominal; Bile Acids and Salts; Cholecystokinin; Cholic Acids; Esophageal and Gastric Varices; Female; Hepatic Artery; Hepatic Veins; Humans; Hypertension, Portal; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Portal Vein

We have studied the volume, protein concentration, total protein, and chymotrypsin and trypsin outputs in pure pancreatic juice (PPJ) following endoscopic cannulation of the pancreatic duct in 11 male and 2 female patients with advanced alcoholic cirrhosis (AC). Results were compared to those obtained from 21 nonalcoholic volunteers (NAV) and 26 chronic alcoholic (CA) patients without cirrhosis. Intravenous stimulation with secretin followed 10 min later by intravenous cholecystokinin-pancreozymin (CCK-PZ) resulted in highly significant increases in volumes during both phases of pancreatic stimulation in AC compared to NAV and CA. Protein concentration and total output during secretin stimulation was not different among the three groups. During CCK-PZ stimulation, CA exhibited a significant elevation in protein concentration and total output compared to NAV and AC. Although total chymotrypsin output was lower in secretin-stimulated CA than other groups, no other differences between the groups were observed in either of the hormone-stimulation phases. Marked elevations in trypsin output were observed in secretin-stimulated AC and in CCK-PZ-stimulated AC and CA. The high PPJ volume and the relatively low protein concentration observed in AC may effect a washout phenomenon resulting in a decreased tendency for ductal protein precipitation in these patients.

Topics: Adult; Aged; Alcoholism; Cholecystokinin; Chymotrypsin; Female; Humans; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pancreas; Pancreatic Juice; Proteins; Secretin; Trypsin

The exocrine function of the pancreas was studied with the aid of the pancreozymin-secretin-test in 30 patients with ethanolic and 10 patients with nonalcoholic cirrhosis of the liver as well as 30 healthy subjects. It was established that the changes of the pancreatic secretion in cirrhosis of the liver are characterized by elevated output of water and bicarbonate, diminished bicarbonate concentration without substantial changes in enzyme secretion. In alcoholic cirrhosis, these changes are more frequent, but they do not differ from those observed in cirrhosis of other etiology.

Topics: Amylases; Bicarbonates; Cholecystokinin; Female; Humans; Lipase; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pancreas; Secretin

Topics: Acute Disease; Adult; Cholecystitis; Cholecystokinin; Chronic Disease; Cystic Duct; Humans; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Radionuclide Imaging

Topics: Cholecystokinin; Female; Humans; Liver Cirrhosis, Alcoholic; Male; Middle Aged; Pancreatic Juice; Pancreatin; Pancreatitis; Secretin