Inducibility of microsomal liver function may differentiate cirrhotic patients with maintained compared with severely compromised liver reserve.

Abstract

BACKGROUND AND AIM:

Quantitative tests of liver function (QTLF) can be modulated by enzyme-inducing agents. The objective of the study was to examine changes in QTLF after treatment with Phenobarbital, a potent cytochrome P450-inducing agent.

METHODS:

Forty-six consecutive patients with liver cirrhosis Child-Pugh score B and C (34 alcoholic, 12 hepatitis C) and a compromised aminopyrine breath test (ABT) were included. Thirty-six patients (group I) received phenobarbitone (150 mg) for 7 days. Ten patients (group II) received a placebo. The QTLF, which included ABT (microsomal liver function), galactose elimination capacity (GEC, cytosolic liver function), sorbitol clearance (SCl, liver plasma flow) and indocyanine green clearance (ICG, liver perfusion) was carried out before and after pharmacological induction.

RESULTS:

Group I showed a basal ABT of 0.18 +/- 0.11% dose.kg/mmol CO2 (normal >0.6%), which increased significantly after induction (172%, P < 0.05), whereas in group II the ABT values did not change. In group IB, a subgroup of group I which exceeded the basal threshold value of 0.30% after stimulation (n = 22), the ABT values increased significantly to 0.44 +/- 0.17% (244%, P < 0.01). The GEC, SCl and ICG remained unchanged before and after induction.

CONCLUSIONS:

After pharmacological induction, microsomal liver function increased significantly in a subgroup of patients with liver cirrhosis, whereas the GEC, SCl and ICG remained unchanged. Inducibility of the microsomal liver function could be used as a novel parameter of functional hepatic reserve and prognosis in cirrhosis.

• Authors: Chirstoph Herold, Marion Ganslmayer, Matthias Ocker, Steffen Zopf, Barbara Gailer, Eckhart G Hahn, Detlef Schuppan
• Journal: Journal of gastroenterology and hepatology (J Gastroenterol Hepatol) Vol. 18 Issue 4 Pg. 445-9 (Apr 2003) ISSN: 0815-9319 [Print] Australia
• PMID: 12653894 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Evaluation Study, Journal Article)
• Copyright: Copyright 2003 Blackwell Publishing Asia Pty Ltd

Chemical References

• Anticonvulsants
• Cytochrome P-450 Enzyme System
• Phenobarbital

Topics

• Adult
• Anticonvulsants (pharmacology)
• Cytochrome P-450 Enzyme System (drug effects, physiology)
• Diagnosis, Differential
• Enzyme Induction (drug effects, physiology)
• Female
• Hepatitis C (diagnosis, physiopathology)
• Humans
• Liver Cirrhosis, Alcoholic (diagnosis, physiopathology)
• Liver Function Tests
• Male
• Microsomes, Liver (drug effects, physiology)
• Middle Aged
• Phenobarbital (pharmacology)
• Predictive Value of Tests
• Prognosis
• Severity of Illness Index