Clinical and biochemical features of autoimmune hepatitis in 36 pediatric patients

RACIONAL: Poucos estudos sobre hepatite autoimune têm sido conduzidos em pacientes não-caucasianos. OBJETIVOS: Avaliar crianças brasileiras com hepatite autoimune tipos 1 e 2 em relação à evolução clínica e parâmetros clínicos e bioquímicos. MÉTODOS: Trinta e seis pacientes foram incluídos em um protocolo que registrou os dados da história clínica, exame físico, dados bioquímicos e evolução da doença. Vinte e quatro crianças tinham hepatite autoimune tipo 1, sete pacientes hepatite autoimune tipo 2 e em cinco casos, a hepatite autoimune não pôde ser classificada. A maioria dos pacientes pertencia ao sexo feminino (77%), a mediana de idade ao diagnóstico foi de 11 anos e a mediana de duração dos sintomas foi de 5,5 e 8 meses, para os tipos 1 e 2, respectivamente. Icterícia e colúria foram as manifestações clínicas mais freqüentes. RESULTADOS: A terapia com azatioprina e prednisona foi eficaz para os pacientes com os tipos 1 ou 2 de hepatite. As enzimas AST e ALT apresentaram decréscimo em relação aos valores no diagnóstico, após 4 a 8 semanas de tratamento, nos pacientes com hepatite autoimune do tipo 1. Os valores de GGT tornaram-se mais elevados após o início da terapia e retornaram aos níveis pré-tratamento após 1 ano, nos dois tipos de hepatite. Três pacientes foram a óbito e outros três realizaram transplante hepático. CONCLUSÕES: Crianças não-caucasianas apresentaram doença semelhante a pacientes caucasianos com hepatite autoimune. Níveis elevados de GGT no primeiro ano de tratamento não devem ser o único marcador da existência de colangiopatia.

[Influence of some essential and non essential amino acids on plasma lipids and gamma glutamyl transferase [GGT] activity in rats]

Long-term administration of L-essential amino acids including isoleucine [Ile], leucine [leu] and valine [Val] to young rates for 70 consecutive days caused significant increase in plasma cholesterol triglycerides, LDL-cholesterol and total LDL and gammaGT activity, whereas Lysine [Lys] produced the same effects in these parameters but the plasma triglycerides were not changed. Administration of L-non-essential amino acids including arginine [Arg] cystine [Cys] and glycine [Gly] to another group of young rates did not affect cholesterol, triglycerides levels or [gamma GT] activity during the same period and under the same condition. Administration of glutamic acid [Glu] caused significant decreases in plasma cholesterol, LDL cholesterol and total LDL levels IIE, Leu, Val, Cys and Arg produced a significant decrease in HDL-cholesterol but Glu caused a significant increase. These results demonstrated that long-term feeding of pure L-essential amino acids caused a significant increase in plasma lipids along with plasma gamma GT activity of young rates. Furthermore, our result indicates that Glu causes reductions in plasma cholesterol levels, with its ability to protect the myocardium against insulting stimuli that precipitate ischemia and arrhythmias [31] may has therapeutic value in correcting hypercholesterolemia and improving cardiac performance

Effects of stress on gamma glutamyl transpeptidase (GGT) activity in lymphoid system of rats: modulation by drugs.

Effects of stress and its modulation by adaptogens were evaluated on gamma glutamyl transpeptidase (GGT) activity in different tissues of the lymphoid system in rats. Restrain stress (RSx5) suppressed the GGT activity in different tissues of lymphoid system viz. the lymphocyte, the spleen, the thymus and the macrophage, and the maximum effect was seen in the spleen. Chlordiazepoxide, a prototype anti-stress agent, which did not alter GGT activity per se, reversed the effect of RS on this enzyme activity in tissues of lymphoid system studied. Azardirachta indica (Al, Neem), an indigenous adaptogen stimulated the GGT activity per se and nearly normalised RS induced suppression of GGT in lymphoid system. The observed suppression of GGT activity in lymphoid system by stress and its modulation by natural and synthetic adaptogens indicates that GGT could be a consistent cellular/biochemical marker of stress responsiveness and stress-induced immunomodulation.

Picroliv affects gamma-glutamyl cycle in liver and brain of Mastomys natalensis infected with Plasmodium berghei.

Picroliv, the standardized preparation of iridoid glycosides from Picrorhiza kurrooa, at the dose of 6 mg/kg, po for two weeks provided significant protection against depletion of reduced glutathione levels in liver and brain of Plasmodium berghei infected Mastomys natalensis. The activation of gamma-glutamyl transpeptidase enzyme and decreased levels of cysteine, sulphydryl groups as well as glutathione synthesis in both tissues due to P. berghei infection were reversed by picroliv. Enzymatic and non enzymatic lipid peroxidation in microsomes in vitro was significantly reduced by picroliv along with the recovery of reduced glutathione.