Transaminases index

Another common liver disease, alcoholic liver damage produced by moderate to heavy alcoholic intake, is also reflected by an elevation of the serum GOT and GPT activities. The serim glutamyl transferase activity is reported to be a sensitive index of alcoholic intake and can serve to monitor persons on alcoholic withdrawal programs (60). The LD-5 isoenzyme arises mainly from liver tissue, but has a short half-life (61), which is about 1/5 and 1/2 of the half life of the transaminases, GPT and GOT respectively. Some authors consider that a normal LD-5 isoenzyme activity in a jaundiced patient is sufficient evidence to exclude primary liver disease and that obstruction is probably responsible for the jaundice (62). In hemolytic jaundice the LDH-1 and 2 isoenzymes are elevated. 

Recently we have evaluated several exogenous and endogenous tests of liver function in rainbow trout following intoxication by the model hepatotoxicant CCl. The results of these studies indicate that elevated plasma activity of the enzyme glutamate-pyruvate transaminase (GPT) is the most sensitive endogenous index of... 

GPT = glutamic pyruvic transaminase GSH = glutathione Hemato = hematological hr = hour(s) LCso= lethal concentration. 50% kill LOAEL = lowest-observed-adverse-effect level LI = labeling index M = male min = mlnute(s) mo = moth(s) musc/skel = musculoskeletal NOAEL = no-observed-adverse-effect level NS = not specified Resp = respiratory ... 

Bedogni, G., Miglioli, L., Battistini, N., Masutti, F., Tiribelli, C., Bellentani, S. Body mass index is a good predictor of an elevated alanine transaminase level in the general population hints from the Dionysos study. Dig. Liver Dis. 2003 35 648-652... 

Viral mutants As the duration of lamivudine therapy increases, the number of mutants rises, especially those resulting from YMDD-polymerase mutation. Viral mutants are found in about 20% of cases after 1 year, in 35-40% after 2 years and in 60-70% after 4 years. (159) Clinically, lamivudine resistance is recognizable due to an increase of transaminases and a recurrence of vir-aemia. Risk factors include high GPT (ALT) values, an elevated HBV-DNA level and a pathological body mass index. In the case of resistance, the use of adefovir is recommended, since this nucleoside is also efficacious against HBV mutants. 

Of 123 patients who had taken flutamide, 33 had liver disorders, mostly within 9 months (16). Three variables, body mass index, a past history of hver disorders, and raised transaminases were significantly related to the incidence of hver disorders. Smoking was related to a lower incidence. 

All of 10 patients taking mitotane for Cushing s syndrome had rises in either gamma-glutamyl transpeptidase or alanine transaminase, with a maximum increase six times basal value (7). The only variable that correlated with hepatic increase was the body mass index. In contrast, the severity of the disease, alcohol intake, and other biological characteristics did not correlate with transaminase rises. 

Determination of the effective functioning of particular enzymes or metabolic pathways potentially may be useful in demonstrating adequacy of provision. Enzymes in plasma that may be helpful in this regard are glutathione peroxidase as an index of selenium status, and red cell enzymes, such as transketolase (thiamine), glutathione reductase (riboflavin) or transaminase (pyridoxine), or glutathione peroxidase (selenium) are all widely used. Methyltetrahydrofolate reductase is involved in metabolism of homocysteine, hence assessment of plasma homocysteine is a useful measure of... 

FIGURE 1.6 In vitro inhibition of enzyme activity by metal ions is correlated with the absolute value of the logarithm of the first hydrolysis constant (i.e., K(,h for M"++ HjO —> MOH"" + H+) and the softness index (Op). Inhibition data for these three enzymes were produced by Christensen (1971/1972) and Christensen and Tncker (1976). White diamonds=catfish carbonic anhydrase ICjq, grey sqnares=white sucker lactic dehydrase ICjo and black triangles = white sucker glutamic oxaloacetic transaminase ICjo-... 

In 63 patients with liver disease, the levels of vitamin A, RBP, and TTR were all markedly decreased and were highly significantly correlated with each other over a wide range of concentrations (Smith and Goodman, 1971). Nineteen patients with acute hepatitis were studied with serial samples as the disease improved, the plasma levels of vitamin A, RBP, and TTR all increased. In these patients, the RBP concentrations correlated negatively with the values of standard tests of liver function (plasma bilirubin, glutamic-oxaloacetic transaminase, and alkaline phosphatase). It has been reported that the level of RBP is of value clinically in assessing the course of acute infectious hepatitis and, to a limited extent, in the differentiation of various forms of jaundice (Kindler, 1972). It seems clear that measurements of plasma RBP levels in patients with liver disease could, if available, be used as an index of hepatic parenchymal functional status and hence could serve as a useful clinical liver function test. 

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