Serum alpha-glutathione S-transferase as a sensitive marker of hepatocellular damage in patients with cystic fibrosis.

The aim of the study was to evaluate serum a-glutathione S-transferase (s-GSTA) levels in patients with cystic fibrosis (CF) and to compare s-GSTA with other liver function tests and with a hepatic ultrasound scan (US). The cytosolic enzyme, alpha-glutathione S-transferase is predominantly found in the liver and is distributed uniformly in the liver tissue. In our study s-GSTA levels were measured in 37 CF patients aged 1 to 28 years (mean age 10.4 years, 24 males). The control group consisted of 27 patients aged 2 to 17 years (mean age 8.5 years, 18 males). The presence of hepatobiliary abnormalities was assessed by clinical examination, ultrasound scan, s-GSTA, and conventional liver enzymes: alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate aminotransferase (AST) and gama-glutamyl transferase (GMT). The calculated 5-95 % range of s-GSTA for the control group was 0.098-2.54 microg/l, for the CF group 0.43-9.76 microg/l. Mean s-GSTA level in the control group was 1.55 microg/l (S.D.=1.57), and 2.05 micro/l (S.D.=2.60) in the CF group. In the group of CF patients, the serum levels were significantly higher than in the control group (P<0.01). No significant correlation existed in the CF group between s-GSTA and conventional liver tests (ALT, AST, ALP and GMT). Four patients in the CF group had hepatobiliary abnormalities detectable by conventional liver tests, s-GSTA and US. Four patients had abnormal s-GSTA, while conventional liver tests and US were normal. One other patient had abnormal hepatic US, but normal standard liver tests and s-GSTA. The study has suggested that a raised s-GSTA level might be a marker of possible pathological changes of the hepatobiliar system in CF patients. Serum GSTA seems to be a more sensitive marker than transaminases for the monitoring of hepatocellular integrity and as an early predictor of hepatic damage.

Inhibin B, follicle stimulating hormone, luteinizing hormone and testosterone during childhood and puberty in males: changes in serum concentrations in relation to age and stage of puberty.

Inhibin B is a gonadal dimeric polypeptide hormone that regulates synthesis and secretion of follicle stimulating hormone (FSH) in a negative feedback loop. The aim of the present study was to determine changes in serum inhibin B, gonadotropins and testosterone concentrations during childhood and puberty in males. We studied the relationship between circulating inhibin B, gonadotropins and testosterone in serum of healthy boys during the first two years of life and then in pubertal development. Using a recently developed two-side enzyme-linked immunosorbent assay (ELISA), inhibin B levels were measured in the serum of 78 healthy boys divided into eleven age groups from birth to the end of pubertal development. In addition, serum levels of gonadotropins and testosterone were measured. Serum inhibin B, gonadotropins and testosterone increased during the first months of postnatal life. A peak in serum inhibin B and gonadotropins concentrations was observed around 3-4 months of age. There was a significant positive correlation between serum inhibin B and gonadotropins and testosterone levels during the first 2 years of life. After this early increase, serum inhibin B, gonadotropins and testosterone levels decreased significantly and remained low until puberty followed by an increase beginning with the onset of puberty. Serum levels of inhibin B reached a peak at stage G3 of puberty. Around midpuberty, inhibin B lost its positive correlation with luteinizing hormone (LH) and testosterone from early puberty, and developed a strong negative correlation with FSH, which persisted into adulthood. We conclude that inhibin B plays a key role in the regulation of the hypothalamic-pituitary-gonadal hormonal axis during male childhood and pubertal development. Inhibin B is a direct marker of the presence and function of Sertoli cells and appears to reflect testicular function in boys.

Insulin-like growth factor binding protein-3 in patients with liver cirrhosis.

Aim of the study was to evaluate serum levels of insulin-like growth factor binding protein-3 in patients with liver cirrhosis and to compare serum IGFBP-3 levels with other liver function tests. Fifty-one patients with liver cirrhosis were selected for our study. We measured IGFBP-3 (1.67+/-1.06 mg/l, mean+/-SD), albumin (32+/-8 g/l), prealbumin (0.22+/-0.14 g/l), AST (2.29+/-2.38 microkat/l), ALT (2.11+/-4.83 microkat/l) and cholinesterase (mean 78.6+/-45.2 microkat/l) in the serum. There was a significant positive correlation of serum IGFBP-3 with serum albumin and serum cholinesterase. The correlation coefficient was much lower between serum IGFBP-3 and serum prealbumin. There was no significant correlation between serum AST, ALT and IGFBP-3. Serum IGFBP-3 proves to be a better marker for the hepatic synthetic capacity than serum albumin or cholinesterase.

[Importance of determination of cystatin C serum levels in pediatric patients with kidney diseases]. / Význam stanovení cystatinu C v séru u pediatrických pacientu s renálním postizením.

BACKGROUND: Serum level of cystatin C (MW 13,000) depends on the glomerular filtration and on the production by nucleated cells. S-cystatin C was proposed as a better glomerular filtration rate marker than serum creatinine or creatinine clearance. Possibility to avoid urine collection in children is another important advantage. The aim of the study was to estimate reliability of the test in the kidney transplant paediatric patients. METHODS AND RESULTS: We measured cystatin C on Monarch 2000 IL by particle-enhanced turbidimetric assay using commercial kit provided by DAKO. We analysed S-cystatin C levels in three groups: 19 children before kidney transplantation (A), 25 paediatric patients after kidney transplantation (B), 20 children hospitalized on intensive care unit (C). Creatinine was measured by enzymatic method on ADVIA 1650 Bayer. We demonstrated significant correlation between S-cystatin C and creatinine levels is both groups A (r2 = 0.865, P < 0.0001) and C (r2 = 0.812, P < 0.05). Correlation coefficient was much lower for group B (r2 = 0.689, P < 0.005). Cystatin C levels were compared with creatinine clearance (ml/s per 1.72 m2) and we found a very poor negative correlation in groups C (r2 = 0.24, P < 0.05) and B (r2 = 0.036, P < 0.006). In group A there was significant correlation between S-cystatin C and creatinine clearance (r2 = 0.769, P < 0.05). Negative correlation coefficient between calculated creatinine clearance (according Schwartz) and S-cystatin C was (r2 = 0.76, P < 0.005) in group B and (r2 = 0.75, P < 0.005) in group C. CONCLUSION: There is a significant correlation between S-cystatin C and creatinine levels in both groups: in group before kidney transplantation and in patients hospitalized at intensive care reanimation unit. In the group after kidney transplantation correlation coefficient is much lower.

[Dynamic liver function study using the lidocaine test]. / Dynamické vysetrení funkce jater pomocí lidokainového testu.

Lidocaine clearance test may reflect the integrity of various oxidative pathways of hepatocytes. Lidocaine is a highly sensitive indicator of hepatic dysfunction. This test is applicable to assessment of stage and prognosis of the liver disease, to timing of the liver transplantation, and to assessment of the pretransplant prognosis in the end-stage of chronic liver disease. Formation of the major lidocaine metabolite monoethylglycinexylidide (MRGX) depends on the hepatic cytochrome P-450 activity and on the liver blood flow.