Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: EC:2.6.1.2 (alanine aminotransferase)
26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The recognition of replicating hepatitis B virus (HBV) may be important to both define the cause of and know how to manage chronic liver disease in multitransfused hemophilic patients. Replicating HBV can be detected at the molecular level by methods for HBV-specific DNA (HBV-DNA), which are much more sensitive than the immunologic methods for detecting hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg). Unselected hemophilic patients (260; 6% with HBsAg, 4% with isolated anti-hepatitis B core (anti-HBc), 52% with anti-HBs and anti-HBc, 26% with isolated anti-HBs, and 12% with no HBV marker) were investigated retrospectively with a dot spot hybridization technique that detects serum HBV-DNA down to 0.5 pg and by Southern blot analysis, which tests the specificity of the HBV-DNA reactions. Eighteen patients (7%; five with serum HBsAg and 13 HBsAg seronegative with antibodies to HBV) had serum HBV-DNA. Serum HBV-DNA was detected more frequently in HBsAg carriers than in seronegative patients (33% versus 6%, P less than .01), and had no relationship to serum alanine aminotransferase. Serum HBV-DNA was more sensitive than the radioimmunoassay for HBeAg was for detecting replicating HBV (7% versus 1.1%, P less than .01). These findings demonstrate that there is cryptic HBV infection in a number of hemophiliacs and that serum HBV-DNA may coexist with markers thought to reflect immunity against HBV.
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PMID:Serum hepatitis B virus DNA detects cryptic hepatitis B virus infections in multitransfused hemophilic patients. 232 16

In my opinion, independent, carefully conducted scientific studies indicate that an accurate, rapid, relatively sensitive, and inexpensive laboratory test substantially reduces the major long-term risk of blood transfusion in the United States; donor ALT has emerged as one of the most effective laboratory determinants for reducing the incidence of NANB PTH. Despite its nonspecificity and limited predictive value, ALT screening may prevent up to 30 percent of cases, one-half of which would progress to chronic liver disease and then possibly to cirrhosis and hepatocellular carcinoma. Blood donors appear to understand and accept the testing rationale as a reasonable precaution. Admittedly, ALT screening is not a perfect solution. It has not been validated by prospective studies and probably never will be. Determination of the proper cutoff value remains controversial. However, the risk of PTH progresses with increasing ALT levels, so that the real issue is not whether to test, but how best to configure the test to exclude the fewest false-positive donors while detecting the most true-positive donors. It is undesirable and expensive to discard safe units of blood, but the primary responsibility of blood collectors is to ensure an adequate supply of safe components. Some still consider the ALT assay technically too demanding for routine use. However, technical concerns regarding performance and interpretation are not insurmountable, and both quality control and proficiency testing are being addressed at the national level. The assay is capable of great precision, and a system employing a national standard and single cutoff has already been described and tested with excellent results. Circumstances have changed since donor screening with ALT was widely implemented in 1986. More thorough screening and testing have eliminated many high-risk donors. Public expectations have changed as well. While it is neither reasonable nor responsible to promise the public blood transfusions without risk, neither is it prudent to propose any major change in management of the blood supply without compelling evidence that such a change will not impair transfusion safety. It is hard to defend discontinuing the ALT screen at this time, especially when the costs of retaining it are minimal and the benefits clearly greater than those of screening for HTLV-I and for Treponema pallidum (in the United States) or HIV-2 (in West Germany). A first-generation assay specific for antibody to hepatitis C will probably be available within a year.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Controversies in transfusion medicine. Alanine aminotransferase screening of blood donors: pro. 234 35

We have retrospectively studied the clinical and histological features of 55 cases of acute post-transfusion non-A, non-B hepatitis. Histological findings in the liver biopsies taken in the acute stage covered the whole spectrum of acute and chronic hepatitis, the incidence of acute hepatitis or non-specific reactive hepatitis was 12.7% and 16/4%, respectively, while that of chronic active hepatitis was 56.4%. There was no correlation between histological features in acute stage and the mean peak levels in serum alanine aminotransferase (ALT). Post-transfusion hepatitis, non-A, non-B with histological signs of chronic hepatitis in acute stage frequently results in biochemical evidence of chronic liver disease during long-term follow-up periods. Therefore, our results suggest that the histological features of chronic hepatitis in the acute stage are indicative of long-term elevation in serum ALT level.
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PMID:[Clinical and histological features of acute post-transfusion non-A, non-B hepatitis: histological diagnosis in acute stage and clinical outcome]. 251 63

Clinical and experimental investigations have suggested that ursodeoxycholic acid (ursodiol) may have cytoprotective or choleretic action and therefore be beneficial in patients with intrahepatic cholestasis or chronic liver disease. In an open-label study, we treated 45 patients with chronic hepatitis with 300 mg of ursodiol three times daily for six months. At four months, gamma-glutamyl transpeptidase (gamma-GTP) and leucine aminopeptidase levels had decreased. SGOT and SGPT levels also decreased significantly. Evaluation of histologic changes has not yet been completed. No significant differences in improvement of liver function tests were found in a comparison with 19 historical controls. We also studied eight patients with primary biliary cirrhosis, treated for more than one and a half years with 600 mg of ursodiol per day. At one month, itching diminished in five patients who had pruritus. ALPase and gamma-GTP levels decreased significantly, and GOT and GPT levels were also reduced. IgM levels did not change, but the titer of antimitochondrial body decreased by half in two patients. Levels of glycoursodeoxycholic acid increased, and in three patients follow-up liver biopsy showed marked improvement. These preliminary results suggest that ursodiol is safe and effective for the treatment of chronic hepatitis and primary biliary cirrhosis, but a large-scale, controlled trial is needed.
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PMID:Effect of ursodeoxycholic acid in chronic hepatitis and primary biliary cirrhosis. 257 57

Twenty one patients with chronic liver disease (CLD), type B, who were persistently positive for anti-HBe after disappearance of HBeAg, were studied for serial measurement of HBV DNA and DNA-P in serum in relation to the elevation of alanine aminotransferase (ALT). Patients were selected and allocated to two groups on the basis of having been seen for at least 3 years and having been found to have either fluctuating, or normal ALT levels during the course of their disease activity. Nine patients have had fluctuating or sustainingly abnormal ALT levels and the remaining 12 have had sustainingly normal ALT levels for at least 3 years follow-up period after anti-HBe seroconversion. In 2 patients, ALT levels were persistently elevated with positive HBV DNA and DNA-P in serum, and in 6, ALT levels were fluctuated between normal range and more than six times the normal, in whom serum HBV DNA and DNA-P became also positive with ALT elevation. In one patient, serum HBV DNA and DNA-P became transiently positive with ALT elevation. On the contrary, 12 patients with normal ALT levels were persistently negative for both HBV DNA and DNA-P in serum. Therefore, we may conclude that in patients with anti-HBe positive CLD, type B, ALT elevation is associated with reactivation of HBV replication.
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PMID:Spontaneous reactivation of hepatitis B virus replication in HBsAg carriers who seroconverted from HBeAg to anti-HBe. 272 47

This study examined the effect of exercise on liver function in patients with chronic liver disease (CLD). 1) Twenty-five patients with CLD (21 with chronic hepatitis (CH) and 4 with liver cirrhosis (LC] and 10 healthy subjects were administered an exercise test employing a treadmill. The load applied was 6.5 Mets and was administered for a period of 10 min. The serum levels of S-GOT, S-GPT, LDH, CPK, triglyceride, GOTm and GLDH were measured before exercise and 1 h, 24 h and 7 days after exercise in the patients with CLD, and before and 24 h after exercise in the healthy subjects. i. The patients with CLD showed an increase in GLDH 24 h after exercise (p less than 0.005), a decline in LDH 1 h (p less than 0.05) and 24 h (p less than 0.01) after exercise, and a decrease in triglyceride 24 h after exercise (p less than 0.005) as compared with pre-exercise values. No significant changes were observed in S-GOT, S-GPT, CPK or GOTm levels. ii. The mean values and standard deviations (SD) of S-GOT and S-GPT during the 3-month period immediately preceding the study were calculated for all 25 patients. Increases in S-GOT of more than 1 SD were observed after exercise in 5 patients (20%); another 5 patients (20%) showed similar increases in S-GPT. The number of overlapping cases in which increases in both S-GOT and S-GPT were observed was 2 (8%). iii. No significant differences were found in mean HR during exercise/predicted max HR, or mean BP during exercise between patients with increased S-GOT and those without, or between patients with increased S-GPT and those without. iv. In the healthy subjects, there was a significant increase in GOTm (p less than 0.05) following exercise, but no such increase in S-GOT, S-GPT, CPK or GLDH. 2) The number of steps taken per day measured by a pedometer was selected as a parameter of daily exercise and examined in 14 patients with CLD (9 with CH and 5 with LC). No significant correlation was found between mean number of walking steps and S-GOT and S-GPT levels for patients with either type of CLD. The results of this study indicate that moderate exercise was well tolerated in the majority of patients with CLD.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The effects of exercise on liver function in patients with chronic liver disease]. 273 8

Controversial data concerning thyroid function in chronic alcoholics prompted us to evaluate some aspects of thyroxine transport and metabolism in these patients. We studied 45 patients with a history of alcohol consumption of at least 160 g a day for 10 years or more. Only patients without clinical and histopathological evidence of chronic liver disease have been included in the study. All patients were clinically euthyroid and there was no history of thyroid disease. Serum thyroxine (T4), free thyroxine (FT4) and thyroxine-binding globulin (TBG) were measured by radioimmunoassay methods within 48 hours of admission and after 30 day of alcohol abstinence. At admission the mean values of T4 and TBG in alcoholics were significantly reduced when compared to those of healthy controls (6.8 +/- 1.4 vs 8.4 +/- 1.2 micrograms/dl; p less than 0.01 and 17.5 +/- 3.2 vs 20.5 +/- 1.2 micrograms/ml; p less than 0.01). Contrarily FT4 levels did not differ significantly between the groups (9.8 +/- 1.6 vs 10.8 +/- pg/ml). A close relationship between T4 and TBG (r = 0.684; p less than 0.0001) demonstrated that the decrease of T4 in alcoholics depended on a decrease in circulating TBG. We could not find any correlation between TBG and serum albumin, gamma-glutamyl-transpeptidase, aspartate aminotransferase, alanine aminotransferase and mean corpuscular volume. Indeed there was a strong relationship between TBG and mean daily alcoholic intake (r = 0.712; p less than 0.0001). T4 and TBG increase rapidly during withdrawal and after 30 days of abstinence their values did not differ significantly from those of healthy controls. In conclusion these data provide evidence that alcohol abuse causes a decrease in T4 which depends on a decrease in circulation TBG and is not associated with a reduction of FT4. Such "low TBG syndrome" seems to be due more probably to a primary effect of alcoholic on TBG synthesis that to the liver injury secondary to the alcohol abuse.
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PMID:[Low T4 syndrome in alcoholism: role of the decrease in TBG]. 287 25

In the diagnosis of chronic (as opposed to acute) liver diseases, combinations of indicators are needed to improve specificity. Alanine aminopeptidase (AAP; microsomal aminopeptidase, EC 3.4.11.2) activity in serum reportedly is a very sensitive indicator of intrahepatic cholestasis and biliary obstruction; it is also particularly useful in diagnosing chronic liver disease when combined with an indicator of hepatocyte damage such as aspartate aminotransferase or alanine aminotransferase. We optimized the assay of AAP in serum, automated the assay by using a centrifugal analyzer, then used this automated assay to determine activity in 202 individuals, ages one to 73 years. The preliminary results were analyzed in terms of the effects of age, sex, smoking, and alcohol consumption on AAP activity in serum. Striking sex-related differences were observed: AAP activity in males declined 2.5 times more rapidly with age than did that in females; indeed, activity in adult females remained essentially constant. Moreover, AAP values were higher in men who smoked than in those who did not, the difference being of borderline significance by analysis of covariance (p = 0.0865) but significant by partial correlations (p = 0.02). No similar differences were seen for women smokers and non-smokers. When the effects of other variables were held constant, alcohol consumption alone did not significantly correlate with AAP activity in men or women.
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PMID:Alanine aminopeptidase in serum: automated optimized assay, and effects of age, sex, smoking, and alcohol consumption in a selected population. 288 Jun 80

Natural killer (NK) activity in the peripheral blood of patients with chronic liver disease was measured using 51Cr labeled K562 cells as target cells. NK activity was elevated but not significantly in patients with chronic hepatitis compared with healthy controls and significantly lower in the patients with hepatocellular carcinoma. The activity decreased in the order of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Although the level of NK activity in patients with chronic hepatitis did not correlate with the level of alanine aminotransferase (ALT), it tended to be elevated in association with elevation of ALT in patients treated with OK432, interferon-beta, glycyrrhizin or adenine arabinoside. In chronic liver disease, phytohemagglutinin (PHA) skin test showed a positive correlation with NK activity. In all patients who were treated with the immunopotentiator, OK432, and whose HBeAg became negative, NK activity was elevated during the treatment. These results suggest that the NK activity in peripheral blood may be related to hepatocytic injury even if this is not the effector mechanism of the injury.
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PMID:Natural killer activity in patients with chronic hepatitis treated with OK432, interferon, adenine arabinoside and glycyrrhizin. 304 May 9

Sera and biopsied liver specimens from 45 hepatitis B surface antigen (HBsAg) carriers both with or without overt liver diseases and negative for anti-delta antibody, were examined for markers of hepatitis B virus (HBV) infection: hepatitis B e antigen (HBeAg), hepatitis B virus deoxyribonucleic acid (HBV-DNA) in serum and hepatitis B core antigen (HBcAg) in liver. HBV-DNA in serum was assayed by the spot hybridization technique, and HBcAg in the liver was investigated by the peroxidase anti-peroxidase method. Among the parameters showing active replication of HBV, serum HBeAg, serum HBV-DNA and intrahepatic HBcAg were found in 27 (60%), 27 (60%) and in 22 (48.9%) of 45 HBsAg carriers, respectively. The presence of serum HBV-DNA and of intrahepatic HBcAg in HBeAg positive cases and the absence of serum HBV-DNA and of intrahepatic HBcAg in anti-HBe positive cases was the rule with few disparate cases among those with chronic liver disease. These parameters were not useful in predicting the histology on liver biopsy. The activity of hepatic inflammation in the HBsAg chronic carriers assessed by serum alanine aminotransferase level closely paralleled HBV-DNA in serum but not HBeAg in serum, HBcAg in liver or histologic picture on biopsy. HBV-DNA may be the most sensitive parameter of replication of hepatitis B virus and of the activity of inflammation in the liver.
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PMID:Relationship between hepatitis B virus deoxyribonucleic acid, HBeAg/anti-HBe status in serum and HBcAg in liver: its clinical significance in chronic HBsAg carriers. 305 67


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