[Enzymology of the liver in hydatidosis].

A research has been conducted studying the enzyme system of the liver using biopsy material of the organ taken during the operation from patients with echinococcosis and an experiment with infantile white mice. It is proved reduction of the activity of the alkaline and acid phosphatase as well as of the glycogen along with their progressive reduction during the disease progression. Compared with the other researches--histological and by electronic microscope, etc.--there are proved great hepatic damages due to the echinococcosis that have caused change of the treatment tactics: large preoperative period, including reconstructions of the glycogenic depot in the organ, gentle to the liver anesthesia, exact postoperative reanimation. Very good results have been obtained concerning the postoperative complications and operative mortality: observing the developed acute liver insufficiency--in the past the mortality has been 27.60% throughout 2.49% of the operated patients; after those measures the acute liver insufficiency after this kind of operation is seen just once (0.40% of the patients) and the mortality is 0.

[Activity of antioxidative defense enzymes in the blood of patients with liver echinococcosis].

BACKGROUND/AIM: Chronic echinococcocal disease is the parasite human disease caused by the penetration of larval (asexual) stages of the canine tapeworm (Echinococcus granulosus) in the liver of humans. After the penetration of the parasite, the host organism react by activating complement-depending immune response. The aim of this study was to elucidate the influence of larval form of Echinococcus granulosus in the liver on the activity of antioxidative defense enzymes in the blood of patients before and after the surgical intervention. METHODS: We investigated the activity of antioxidative defense enzymes: copper/zinc containing superoxide dismutase (CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR) and glutathione-S-transferase (GST) in the blood of patients before and after the surgical intervention in respect to the controls, clinically healthy persons. RESULTS: Our results showed that the activity of the GSH-Px was significantly decreased in the plasma of the patients with echinocococal disease before the surgery in respect to the controls. The activity of GST was significantly higher in the blood of the patients after the surgery in comparison to the controls. CONCLUSION: Chronic liver echinoccocal disease caused significant changes of some antioxidative defense enzymes, first of all Se-dependent enzyme GSH-Px, which could be a suitabile biomarker in the biochemical evaluation of the disease. This work represents a first comprehensive study of the activity of antioxidative defense enzymes in cronic liver echinococcocosis in the patients before and after the surgical intervention in respect to the clinically healthy persons.

Immunochemical characterization of alkaline phosphatase from the fluid of sterile and fertile Echinococcus granulosus cysts.

Alkaline phosphatase (ALP) from hydatid cyst fluid (HCF) was purified and characterized for comparison between fertile and sterile HCF. Samples were obtained from slaughtered sheep and then sterile and fertile cysts were separated. ALP was purified from aspirated cyst fluid and biochemical parameters were determined. Sera from patients with hydatid disease (15 samples) and patients with other parasitic diseases including fascioliasis (2 samples), taeniasis ( Taenia saginata, 5 samples) and also sera from uninfected controls (15 samples), were collected and used in immunoblotting experiments with ALP from sterile and fertile HCF as antigen. Our results showed that ALP activity in fertile HCF [10.75+/-3.78 (SD) U/ml) was significantly more than in sterile HCF (6.25+/-2.43 U/ml). There were also some differences between the kinetic parameters and biochemical characteristics of ALP in fertile and sterile HCF. Immunoreactive bands were clearly observed when sera from hydatid infected patients were tested with ALP from fertile HCF as the antigen. However, this method revealed no cross-reaction between purified ALP from sterile HCF and sheep liver tissue. These findings suggest that there is some variation in the immunochemical characteristics of ALP from fertile and sterile HCF.

[Clinical and morphofunctional characteristics of hydatid liver echinococcosis]. / Klinicheskaia i morfofunktsional;naia kharakteristika gidatidoznogo ékhinokokkoza pecheni.

AIM: To examine the levels of aspartate aminotransferase (AsAT) and alaninaminotransferase (AlAT) in homogenates of hepatic biopsies from patients with echinococcosis. MATERIAL AND METHODS: Clinical, biochemical examinations, ultrasonic examination of the liver were made in 49 patients with hydatid echinococcosis of the liver and 5 control patients operated on for extrahepatic pathology. Morphological picture of the liver was examined with light microscopy. AsAT and AlAT activity in hepatic tissue were estimated with 2,4-dinitrophenilhydrazin method. RESULTS: There were marked cellular and extracellular disorders and significant lowering of transaminases in the pericystic zone of hepatic tissue vs such indices for far from the echynococcal cyst sites of the liver. CONCLUSION: In hepatic echinococcosis hepatic tissue undergoes diffuse alteration associated with severe morphofunctional disorders which require adequate preoperative preparation of the patients, in postoperative period adequate intensive therapy is needed.

[Clinico-laboratory and morphological parallels in hepatic echinococcosis]. / Kliniko-laboratornye i morfologicheskie paralleli pri ékhinokokkoze pecheni.

The trial included 50 patients with hydatid echinococcosis of the liver and 5 control patients operated urgently for extrahepatic pathology. The patients underwent clinical and biochemical tests, ultrasound investigation of the liver. Structural and functional changes in the liver were analysed with reference to the stage of the echinococcal cyst. Morphological picture of the liver was studied by light microscopy, its functional picture--by activity of AsAT and AlAT in hepatic tissue. Morphological and biochemical tests were made on hepatic biopsies obtained from the pericystic and far from the cyst zones. The most severe histological changes affecting all structures of the liver were registered in the parasite's life cycles II and III. AsAT and AlAT changes in the liver were not related to the biological cycle of the parasite; echinococcal patients' liver contained them in lower concentrations than that of control subjects. Moreover, blood serum levels of AsAT and AlAT are higher than in liver tissue. Thus, growth of the echinococcal cyst in the liver is accompanied with marked morphofunctional disorders. This necessitates early detection and surgical treatment of hepatic echinococcosis. To prevent postoperative complications, adequate preoperative preparation and postoperative intensive treatment must be conducted.

Partial purification and comparison of the kinetic properties of ovine liver Echinococcus granulosus hydatid cyst fluid malate dehydrogenase and the cytoplasmic enzyme from the host liver.

Ovine liver Echinococcus granulosus hydatid cyst fluid and cytoplasmic healthy ovine liver malate dehydrogenases were purified 24- and 30-fold by Sephadex G-200 and DEAE-Sephadex chromatography. Both enzymes were eluted with the same elution volume and the same salt concentration from the respective columns. The pH optimum of the enzymes from both sources was 8.4 in either Tris-HCl or barbital buffer. The Km values for oxaloacetate were 0.211 and 0.200 mM for hydatid cyst fluid and healthy ovine liver enzymes, respectively. The Km values for NADH were 0.220 and 0.213 mM for hydatid cyst fluid and healthy ovine liver enzymes, respectively. Enzyme from both sources demonstrated similar heat denaturation patterns. Both enzyme preparations were inhibited at high concentrations of either substrate. Neither enzyme was inhibited by para-hydroxymercuribenzoate or fumarate, and both enzyme preparations were specific for NADH as a cofactor. The results are discussed in terms of the possible infiltration of the host enzyme into the cyst fluid.

[Surgical management of liver echinococcosis]. / A máj echinococcosis sebészi kezelése.

In the last ten years 62 patients were operated on by the authors because of liver echinococcosis. Each of the infections caused by echinococcus granulosus. In the course of the examination ultrasonography, abdominal X-ray, Casoni test and ELISA were used. Angiography and ERCP were applied only to answer special questions. The echinococcus cysts were removed in 15 cases by atypical liver resection, in 42 cases by pericystectomy and in 5 cases by partial cystectomy using the Pringle's manoeuvre in all of them. Operative mortality was 3.22%. Jaundice was observed in three cases, fever in five cases, wound infection in two cases. Reoperations had to be performed in two cases. All of the patients were treated postoperatively with mebendasol (Vermox). Recurrence of the infection could not be observed.

Effects of ethyl N-N-benzyl-methyl-oxamate in Meriones unguiculatus infected with Echinococcus multilocularis metacestodes. Biochemical and ultrastructural observations.

Ethyl N-N-benzyl-methyl-oxamate is a N-substituted derivative of the oxamic acid, well-known as inhibitor of the lactate dehydrogenase activity. The biochemical and ultrastructural effects of this drug in Echinococcus multilocularis metacestodes and the repercussions in the livers of receptive host, Meriones unguiculatus, were investigated. This compound decreased the specific activity of the lactate dehydrogenase in the metacestodes and the host liver by 81 and 86.8%, respectively. This N-methyl compound has shown an important repercussion on the lactate dehydrogenase activity due to its greater lipophilicity and thus allows a better penetration of the molecule. In the host liver, a fall of the alkaline and acid phosphatases activity was observed. The glucose and glycogen concentrations were also decreased. The ultrastructural study provided an alteration of the tegument of the metacestodes and damages of the muscular system. The parenchyma was disorganized. In conclusion, these biochemical and ultrastructural data obtained with ethyl-N-N-benzyl-methyl oxamate in E. multilocularis metacestodes show clearly the importance of the lactate dehydrogenase activity in the metacestodes.

A comparative study of UTP-D-glucose-1-phosphate uridylyl transferase in the cysts of Echinococcus multilocularis and the livers of infected and control Meriones unguiculatus.

Kinetic and physical parameters of UDP-glucose pyrophosphorylase were determined in Meriones unguiculatus infected with Echinococcus multilocularis metacestodes (cestoda). Studies were carried out on parasite cysts, and on livers from control and infected animals after purification of the enzyme by affinity chromatography on UTP-agarose. The enzyme from infected and control livers had km values for UTP of 0.01 mM and 0.5 mM, respectively; for glucose-1-phosphate values were 0.46 mM and 0.07 mM, respectively. On the other hand the enzyme from cysts was found to have a higher Km for UTP (1 mM) and for glucose-1-phosphate (1.5 mM) than from infected or non-infected livers. Physical characteristics (pI = 6 and Mr = 160,000) of UDP-glucopyrophosphorylases were the same in controls and infected host livers but were different from the cyst enzyme (pI = 7 and Mr = 251,000). These results provide evidence for the existence of significant differences between parasitic and host enzymes, which could possibly be exploited in chemotherapy.