Study of plasma methionine in chronic hepatic schistosomiasis

ABSTRACT

Plasma methionin enkephalin [PME] and noradrenalne were estimated in 40 subjects [10 healthy individuals as control [Group I] and 30 Ch. B. hepatic fibrosis patients [Group II] 10 non-ascitic non-bleeder [Group IIa], 10 ascitic non-bleeders [Group IIb] and 10 non-ascitic bleeders [Group IIc]. A significantly higher [P < 0.01] PME [191.3 +/- 17.7 pg/ml] and non-adrenaIine [1182.30 +/- 327.28 pg/ml] in ch. B. fibrosis patients than the control groups [66.5 +/- 5.87 pg/ml and 228.8 +/- 41.37 pg/ml respectively] was detected. Moreover, the study showed that patients with bleeding varices and or ascitis had a significantly higher PME and noradrenaline. A + ve correlation was found between PME and noradrenaline against portal pressure in the diseased groups [r = 1.748, P < 0.01] r = 0.809, P < 0.01 respectvely]. Lastly, PME levels were correlated negatively with plasma albumin [r = 0.922, P < 0.001 r = 0.881, P < 0.001 in group IIb and IIc] and positively with plasma nor-adrenaline [r = 0.937, P < 0.001 r = 0.652, P < 0.001 in group IIb and IIc]. In conclusion, the noticed rise in PME and nor-adrenaline in Ch. B fibrosis patients indicate that the liver might play a significant role in the metabolism of PME. Also, the strong correlation between PME and both portal pressure and nor-adrenaline may give a clue to the role played by this peptide in the pathogenesis of portal hypertension either directly through splanchnic vasodilatation and or indirectly through stimulation of sympathetic activity. Moreover, the highest level of PME in ascitic patients may interpret the pathogeneitc role of this peptide in ascitis formation through salt retention, enhancement of sympathetic activity and stimulation of lymphatic leakage from the diseased liver