[Regulators of fibrinolysis in chronic viral pathology of the liver].

AIM: To investigate a clinicopathogenetic role of fibrinolysis regulators in chronic viral hepatitis (CVH) and viral cyrrhosis of the liver (CL). MATERIAL AND METHODS: Seventy patients entered the study: 10 patients with CVH B, 33--with CVH C, 6--with CVH D, 21--with viral CL (HCV-associated in 14 cases and HBV-associated in 7 cases. A concentration and activity of tissue plasminogen activator (TPA), the level of plasminogen-1 activator inhibitor (PAI-1) in blood plasma were estimated with enzyme immunoassay (Technoclone GmbH, Austria). PAI-1/TPA was estimated. RESULTS: Increased TPA, PAI-1 concentrations and TPA activity in plasma with maximal values in CL were found. Most severe imbalance in the system of fibrinolysis regulators occurs in poor-prognosis cirrhosis and decompensated portal hypertension. High TPA concentration and activity in CL have a positive correlation with the Child-Pugh index, while low PAI-1/TPA correlates negatively with this index. CONCLUSION: TPA and PAI- 1 correlations with hemorrhagic manifestations and prognosis of the disease suggest an essential clinical role of fibrinolysis regulators in chronic viral pathology of the liver.

[The protein C system in chronic hepatic diseases, and anti-viral therapy].

The purpose of the investigation was to study the condition of the protein C system in chronic virial hepatitis (CVH) and viral hepatic cirrhosis (HC) during the course of antiviral therapy. The total protein C system activity (in a form of normalized ratio - NR) was studied before and 6 month after antiviral therapy in 27 patients with CVH B, in 79 patients with CVH C, and in 5 patients CVH D, as well in 29 patients with viral HC and 29 patients with alcoholic HC/. The total protein C system activity was decreased in chronic viral hepatic disease, and was minimal in patients with HC; the most severe disturbances were observed in patients with poor prognosis of HC and decompensated portal hypertension. The study found a correlation between NR values and histological manifestation of the pathology, which demonstrates an important role of the protein C system in the progress of chronic hepatic diseases. Anti-virial drugs had a positive effect of the functioning of the protein C system, which may be one of the ways of the realization of their antifibrotic effect.

[Growth factors and the hystologic picture of the liver in chronic viral hepatitis and hepatic cirrhosis].

The authors of the article present the results of studying correlations between growth factors and histological changes in the liver in 48 patients with chronic viral hepatitis and hepatic cirrhosis. The results show that the blood level of transforming growth factor-beta1 (TGF-beta1) increases, whilst the level of insulin-like growth factor-1 (IGF-1), epidermal growth factors (EGF), and regeneration index (RI) in general decrease according to increase in histological activity and the degree of hepatic fibrosis. There was a positive correlation between TGF-beta1 and a negative one between IGF-1 and EGF, as well as RI, on the one part, and the degree of hepatic inflammation and fibrosis, on the other. Measurement of the serum levels of growth factors with RI calculation broadens the possibility to evaluate inflammation and fibrosis in chronic viral hepatic diseases.

[Thrombocytic dysfunctions and potentialities of their differential correction in chronic viral hepatitis]. / Trombotsitarnye disfunktsii i vozmozhnosti ikh differentsirovannoi korrektsii pri khronicheskom virusnom gepatite.

The paper presents the results of examination in 88 patients with chronic viral hepatitis (CVH), the parameters of spontaneous and induced platelet aggregation (IPA), cyclic nucleotides (cAMP and cHMP) in the platelets, and the plasma levels of thrombocyte-specific peptides--beta-thromboglobulin and thrombocytic factor IV in dynamics of the first administration of alpha-interferon (alpha-IFN) and 24-week interferon therapy. According to the values of IPA, the patients with CVH are a heterogeneous group with a predominance of cases of diminished aggregation. The first administration of alpha-IFN causes heterodirectional changes in the functional activity of platelets with a general tendency for their normalization. Supplementation of curantyl in case of increased IPA leads to a more rapid and profound normalization of platelet activity, which is of value in cases at risk for thrombotic complications.

[Effects of interferonotherapy on functional activity of platelets in chronic viral hepatitis and cirrhosis of the liver]. / Vliianie interferonoterapii na funktsional'nuiu aktivnost' pri khronicheskom virusnom gepatite i tsirroze pecheni.

AIM: To characterize effects of interferon alpha (If-a) on functional activity of platelets in patients with chronic viral hepatitis (CVH) and viral hepatic cirrhosis (VHC). MATERIAL AND METHODS: Induced platelet aggregation (PA), spontaneous PA, levels of cAMP, cGMP and glycogen in platelets, plasm beta-thromboglobulin (bTG) and activity of thrombocytic factor 4 (TF4) were measured in 95 patients before, 4.5 h after the first If-a introduction, after 12 and 24 weeks of If-a treatment. RESULTS: The patients demonstrated low induced PA, intracellular glycogen and high cAMP, b-TG and TF4. The initial administration of If-a led to normalization of most of functional platelet indices. A 24-h course of If-a therapy normalized platelet functions irrespective of stability of the virusological response. CONCLUSION: If-a preparations in single and multiple administrations normalize platelet function.

[Effect of interferon-alpha on the platelet aggregation and cyclic nucleotide system in chronic viral hepatitis]. / Vliianie interferona-alpha na agregatsiiu i sistemu tsiklicheskikh nukleotidov trombotsitov pri khronicheskikh virusnykh zabolevaniiakh pecheni.

Platelet aggregation (PA) and the content of cyclic nucleotides (CN) was studied in a group of 44 patients with chronic viral hepatitis (CVH) and liver cirrhosis (LC) in comparison to 10 healthy volunteers. The analyses were performed before and 6 h after interferon-alpha (IFN-alpha) administration. The CN content was increased in CVH cases and was maximum in LC patients, while the platelet aggregation was reduced in CVH patients and was minimum in the LC group. The CN level increased and the functional activity of platelets decreased, depending on the degree of disorder. After the first introduction of IFN-alpha, the CN content in thrombocytes decreased in LC and low-PA CVH patients, but increased in high-PA CVH cases. IFN-alpha produced a normalizing effect on the platelet functioning in the patients with CVH and LC.