vitamin-k-semiquinone-radical and Liver-Diseases--Alcoholic

Topics: Alcoholism; alpha-Tocopherol; Animals; Calcifediol; Factor VII; Humans; Hydroxycholecalciferols; Intestinal Absorption; Liver Diseases, Alcoholic; Prothrombin Time; Tocopherols; Vitamin D; Vitamin D Deficiency; Vitamin E; Vitamin E Deficiency; Vitamin K; Vitamin K 1; Vitamin K Deficiency

Patients with acute-on-chronic liver failure show an aggravated hyperdynamic circulation. We evaluated, in a controlled manner, potential changes in systemic haemodynamics induced by the molecular adsorbent recirculating system (MARS) and the Prometheus system liver detoxification devices in a group of patients with acute-on-chronic liver failure.. Eighteen patients (51.2 +/- 2.3 years old; Child-Pugh score, 12.5 +/- 0.2; Maddrey score, 63.1 +/- 5.0; hepatic venous pressure gradient, 17.6 +/- 0.9 mmHg) with biopsy-proven alcoholic cirrhosis and superimposed alcoholic hepatitis were either treated with standard medical therapy (SMT) combined with MARS (n = 6) or Prometheus (n = 6) or were treated with SMT alone (n = 6) on three consecutive days (6 hours/session). Liver tests, systemic haemodynamics and vasoactive substances were determined before and after each session.. Groups were comparable for baseline haemodynamics and levels of vasoactive substances. Both MARS and Prometheus decreased serum bilirubin levels (P < 0.005 versus SMT), the Prometheus device being more effective than MARS (P = 0.002). Only MARS showed significant improvement in the mean arterial pressure (Deltachange, +9 +/- 2.4 mmHg versus -0.3 +/- 2.4 mmHg with Prometheus and -5.2 +/- 2.1 mmHg with SMT, P < 0.05) and in the systemic vascular resistance index (Deltachange, +131.5 +/- 46.2 dyne x s/cm5/m2 versus -92.8 +/- 85.2 dyne x s/cm5/m2 with Prometheus and -30.7 +/- 32.5 dyne x s/cm5/m2 with SMT; P < 0.05), while the cardiac index and central filling remained constant. This circulatory improvement in the MARS group was paralleled by a decrease in plasma renin activity (P < 0.05), aldosterone (P < 0.03), norepinephrine (P < 0.05), vasopressin (P = 0.005) and nitrate/nitrite levels (P < 0.02).. The MARS device, and not the Prometheus device, significantly attenuates the hyperdynamic circulation in acute-on-chronic liver failure, presumably by a difference in removal rate of certain vasoactive substances. These findings suggest conspicuous conceptual differences among the albumin dialysis devices.

Topics: Adult; Female; Hemodynamics; Humans; Liver Diseases, Alcoholic; Liver Failure, Acute; Male; Middle Aged; Renal Dialysis; Vitamin K

The aim of the study was to assess the efficacy and tolerance of the use of reduced GSH in patients suffering from alcoholic diseases of the liver. Eighty patients were randomly divided into two matched groups and treated for 30 days with 300 mg of reduced GSH or 10 mg of vitamin K. Clinical symptoms and the main indices of hepatic function were assessed before and after treatment. At the end of the study all patients had improved, but the group treated with reduced GSH showed a greater improvement of hepatic function indices (SAT, ALT, gamma-GT) which was statistically significant in comparison to that found in the vitamin K treatment group.

Topics: Adult; Female; Glutathione; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Vitamin K

Topics: Adult; Aged; Ascorbic Acid; Clinical Trials as Topic; Drug Combinations; Folic Acid; Humans; Liver Diseases, Alcoholic; Male; Middle Aged; Phosphatidylcholines; Time Factors; Vitamin B Complex; Vitamin K

The purpose of this study is to determine serum des-gamma-carboxy prothrombin (DCP) levels in benign liver diseases by a new sensitive method, and to demonstrate the elevation of serum DCP in alcoholic liver disease (ALD) without hepatocellular carcinoma (HCC). Median values of serum DCP were 16.2 mAU/ml (range: 3.2 to 1570 mAU/ml) in ALD and 16.7 mAU/ml (1.2 to 75.4 mAU/ml) in viral liver disease (VLD). Using the cut-off value of 40 mAU/ml as a tumor marker for HCC, 21% (11/52) was positive in ALD and 2% (1/57) was positive in VLD (p = 0.0014, Fisher's exact probability test), and 27% (9/33) was positive in alcoholic liver cirrhosis and 3% (1/39) was positive in viral liver cirrhosis (p = 0.0042, Fisher's exact probability test). The positive rate of DCP was significantly (p < 0.001, Spearman's rank correlation test) correlated with the severity of liver disease in ALD. Serum vitamin K level was not decreased in cases with ALD. In a demonstrable case, serum DCP was decreased after abstinence and was increased again after the beginning of ethanol intake, suggesting the involvement of ethanol to the elevation of serum DCP in ALD. In conclusion, serum DCP was significantly elevated in ALD, compared with VLD, although the mechanism of the elevation of DCP was not clarified. Ethanol intake may act, in part, on the increase of serum DCP in ALD.

Topics: Aged; Biomarkers; Biomarkers, Tumor; Carcinoma, Hepatocellular; Ethanol; Female; Hepatitis, Viral, Human; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Liver Diseases, Alcoholic; Liver Neoplasms; Male; Middle Aged; Protein Precursors; Prothrombin; Reference Values; Vitamin K