[The role of interleukin-6 and nitric oxide in pathogenesis of portal hypertension and decompensation of liver cirrhosis].

The study included 49 patients (29 men and 20 women) aged 23-65 years with liver cirrhosis (LC) and 12 (7 men and 5 women) with chronic hepatitis (CH). Etiological factors of LC were hepatitis B and C viruses (in 22 and 16 patients respectively) and alcohol (n=11). Patients with LC showed high levels of blood nitrates and their impaired urinary excretion. In patients with class A LC, nitric oxide levels tended to increase while in those with class B and C LC they were significantly higher than normal. Correlaion analysis revealed the strong dependence of blood nitric oxide level on portal blood flow, hepatic congestion index, the presence of ascitis, and the degree of varicose dilation of oesophageal veins. It also correlated with the serum IL-6 level that increased with deterioration of hepatic function. Patients with class C LC had high IL-6 levels than those with class A and B LC.

[Cell immunity and hepatocyte apoptosis in chronic cholestatic hepatitis].

The aim of the study was to evaluate activity and accumulation of natural T-killers (NK-cells, CD16+) and lymphocytes with apoptosis marker (CD95+) in peripheral blood and hepatic tissue of patients with chronic viral hepatitis, in connection with presence or absence of cholestasis. The subjects were 14 patients suffering from chronic hepatitis (CH) without cholestasis, and 16--with CH and cholestasis, aged 18 to 56 years. The study revealed significant elevation of the number of NK-cells in hepatic tissue of CH patients with cholestasis, not only vs. controls, but also vs. CH patients without cholestasis. Accumulation of natural T-killers in hepatic tissues was accompanied by reduction of their absolute number in peripheral blood and increase of the number of apoptotic bodies in the liver. There was a positive correlation between parameters of apoptosis of hepatocytes, on the one part, and the number of regenerating hepatocytes and serum indicators of cholestasis, on the other.

[Some parameters of carbohydrate and lipid metabolism in patients with non-alcoholic steatohepatitis].

The pathogenesis of non-alcoholic steatohepatitis (NASH) has not been fully studied yet. At the same time, some key points of its forming are already clear. In this regard, the authors studied disturbances of carbohydrate and lipid metabolism in patients with NASH. This included evaluation of fatty acid (FA) and lipoprotein (LP) spectrum, as well as measurement of triglyceride (TG), malonic aldehyde and glucose blood concentrations. The study found that an important role in the pathogenesis of NASH is played by carbohydrate and lipid dysmetabolism, manifested by hyperglycemia, glucose tolerance disorder, and type II diabetes. Other manifestations include hyperlipoperoxidcholia, high concentrations of chylomicrons, low density lipoproteins, and triglycerides, as well as low concentration of high-density lipoproteins. The spectrum of higher fatty acids is characterized by high concentration of saturated fatty acids and deficit of polyunsaturated fatty acids.

[Efficacy of combined use of ursodeoxycholic acid and heptral in the treatment of primary biliary cirrhosis]. / Effektivnost' kombinirovannogo primeneniia ursodeoksikholevoi kisloty i geptrala v lechenii pervichnogo biliarnogo tsirroza.

The efficacy of UDCA (10 mg/kg/day) in combination with SAMe (heptral, 800-1600 mg/day) vs UDCA alone was evaluated in the treatment of 19 patients (age 36-57) with primary biliary cirrhosis. It was found that the combination UDCA + SAMe promoted earlier and steadier disease remission. Normalization of biochemical parameters of cholestase (serum bilirubin, cholesterol, total bile acids, alkaline phosphatase, 5-nucleotidase and jamma-glutamyl transpeptidase) was recorded in 33%, and a significant reduction--in the rest patients. Heptral potentiates cytoprotective and anticholestatic actions of UDCA, but has a weak action on its immunomodulatory and antiapoptotic effects.

[Efficacy of combined administration of ursodeoxycholic acid and hepthral in the treatment of primary biliary cirrhosis]. / Effektivnost' kombinirovannogo primeneniia ursodeoksikholevoi kisloty i teptrala v lechenii pervichnogo biliarnogo tsirroza.

The efficacy of ursodeoxycholic acid (UDCA) combined with s-adenosylmethionine (SAMe, heptral) and UDCA alone was studied in the treatment of 19 patients (age 36-57 years) with primary biliary cirrhosis (PBC). UDCA was given in a dose 10 mg/kg/day, heptral--in a dose 800-1600 mg/day. It was found that UDCA + SAMe treatment results in earlier and longer remission. Normalization of biochemical indicators of cholestase (levels of serum bilirubin, cholesterol, total bile acids, alkaline phosphatase, 5-nucleotidase and gamma-glutamyl transpeptidase) was recorded in 33% patients, cholestase diminished in the rest patients. Heptral potentiates cytoprotective and anticholestatic actions of UDCA but does not essentially influence its immunomodular and antiapoptotic effects.