The concentration of plasma
vitronectin was determined and compared with various parameters of liver function including the blood coagulation system in patients with
liver diseases. The severity of
cirrhosis was graded according to Child's criteria and compared with the plasma
vitronectin level. Furthermore, the distribution of
vitronectin in the liver of patients with
liver diseases was studied by light and electron microscopy using the indirect immunoperoxidase method. The plasma
vitronectin level was low in all
liver disease groups as compared with the healthy controls. The difference from the controls was significant in patients with
hepatocellular carcinoma and decompensated
cirrhosis. Moreover, the plasma
vitronectin level was positively correlated with the levels of serum
cholinesterase,
albumin, plasma
alpha 2 plasmin inhibitor-
plasmin complex and the prothrombin time and results of the hepatoplastin test. Plasma
vitronectin decreased with increasing severity of
cirrhosis according to Child's criteria. These results suggest that the plasma
vitronectin level is a useful parameter of hepatic synthetic function in patients with
liver diseases; it may also reflect the severity of
cirrhosis. Light microscopy revealed
vitronectin in the area of focal
necrosis and the portal tracts in the liver of patients with acute viral
hepatitis, in the area of piecemeal
necrosis in the liver of patients with
chronic hepatitis and along the area of fiber deposition in the liver of patients with
cirrhosis. Immunoelectron microscopy showed
vitronectin in the rough endoplasmic reticulum of hepatocytes. Moreover,
vitronectin was seen around inflammatory cells, endothelial cells, Ito cells and hepatocytes in the perisinusoidal area near focal
necrosis and piecemeal
necrosis and on
collagen fibers.(ABSTRACT TRUNCATED AT 250 WORDS)