SPLANCHNIC AND RENAL EXTRACTION OF CIRCULATING TYPE-III PROCOLLAGEN AMINOTERMINAL PROPEPTIDE IN PATIENTS WITH NORMAL LIVER-FUNCTION AND IN PATIENTS WITH ALCOHOLIC CIRRHOSIS
SPLANCHNIC AND RENAL EXTRACTION OF CIRCULATING TYPE-III PROCOLLAGEN AMINOTERMINAL PROPEPTIDE IN PATIENTS WITH NORMAL LIVER-FUNCTION AND IN PATIENTS WITH ALCOHOLIC CIRRHOSIS
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DOI：
10.1002/hep.1840110608
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发表时间：
1990-06-01
期刊：
影响因子：
13.5
通讯作者：
LORENZEN, I
中科院分区：
文献类型：
--
作者：
BENTSEN, KD;HENRIKSEN, JH;LORENZEN, I
本文对12例肝功能正常和19例酒精性肝硬变患者留置导尿管时，从内脏和肾脏提取循环中的III型前胶原氨基端前肽及其相关抗原进行了研究。血清中的III型前胶原肽有两种测定方法：III型前胶原肽放射免疫分析试剂盒，这是一种选择性地测定完整的前肽(和较大的III型前肽结合抗原)的新方法，以及III型前胶原Fab试验，它既测定血清中的完整前肽，又测定血清中定量占主导地位的较小片段。肝功能正常组(p<；0.01)和肝硬化组(p<；0.01)动脉和肝静脉间完整前肽浓度显著降低(p<0.01)。而肝硬化组的内脏提取率(中位数=0.04，范围为-0.03~0.16)明显低于肝功能正常组(中位数=0.17，范围=0.05~0.36，p<；0.01)。肝静脉内完整前肽浓度与肝压力呈正相关(n=18，r=0.51，p<；0.05)，与吲哚青绿清除率呈负相关(n=15，r=-0.61，p<；0.05)。在III型前肽Fab试验中未发现内脏提取液。在Fab分析中发现了显著的肾脏提取物，但在III型前胶原肽放射免疫分析试剂盒中没有发现。在健康患者(中位数=0.11，范围=0.00~0.21)和肝硬变患者(中位数=0.14，范围=0.06~0.22)中观察到相似的拔牙率。因此，循环中完整的III型前胶原多肽在肝脏中被提取，酒精性肝硬变患者的提取比率降低。较小的III型前胶原肽相关抗原由肾脏从循环中提取。
Splanchnic and renal extraction of circulating aminoterminal propeptide of type III procollagen and related antigens were studied in 12 patients with normal liver function and in 19 patients with alcoholic cirrhosis during catheterization. Type III procollagen peptide in serum was measured in two assays: the Type III procollagen Peptide Radioimmunoassay Kit, a new assay that selectively determines the intact propeptide (and larger type III propeptide-holding antigens) and the Type III procollagen Fab assay that measures both the intact propeptide and the smaller fragments that quantitatively dominate in serum. A significant decrease in thne concentration of the intact propeptide between the artery and the hepatic vein was found in the group with normal liver function (p < 0.01) and in patients with cirrhosis (p < 0.01). In patients with cirrhosis, however, the splanchnic extraction ratio of the intact propeptide (median = 0.04, range = -0.03 to 0.16) was significantly lower than in patients with normal liver function (median = 0.17, range = 0.05 to 0.36, p < 0.01). The concentration of the intact propeptide in the hepatic vein was positively correlated to hepatic pressure (n = 18, r = 0.51, p < 0.05) and inversely correlated to indocyanine green clearance (n = 15, r = -0.61, p < 0.05). No splanchnic extraction could be demonstrated in the Type III propeptide Fab assay. A significant renal extraction was found in the Fab assay, but not in Type III Procollagen Peptide Radioimmunoassay Kit. Similar extraction ratios were observed in both healthy patients (median = 0.11, range = 0.00 to 0.21) and cirrhotic patients (median = 0.14, range = 0.06 to 0.22). Thus intact circulating type III procollagen peptide is extracted in the liver, and the extraction ratio is decreased in alcoholic cirrhosis. Smaller type III procollagen peptide-related antigens are extracted from the circulation by the kidneys.