Abstract:
BACKGROUND/AIMS:Adrenomedullin recently discovered in human pheochromocytoma is a potent vasodilatory peptide mainly derived from vascular endothelial and smooth muscle cells. Hyperdynamic circulation, ultimately leading to ascites formation, has been attributed to peripheral vasodilatation in liver cirrhosis. However, little is known about the role of adrenomedullin in this condition. METHODS:Plasma adrenomedullin concentrations were measured by radioimmunoassay after extraction and purification in 28 cirrhotic patients without ascites, 12 cirrhotic patients with ascites and 10 healthy subjects. RESULTS:Plasma adrenomedullin concentrations in cirrhotic patients with ascites (12.7+/-4.5 fmol/ml) were significantly higher than those in cirrhotic patients without ascites (8.2+/-2.3 fmol/ml, p<0.005) and healthy subjects (5.8+/-0.8 fmol/ml, p<0.005). Interestingly, plasma adrenomedullin concentrations were highest in patients with refractory ascites (n=5, 15.8+/-3.0 fmol/ml) and were positively correlated with the Child-Pugh score (r=0.44, p<0.01). Moreover, plasma adrenomedullin concentrations were positively correlated with plasma renin activity (r=0.63, p<0.0001), plasma aldosterone (r=0.60, p<0.0001) and plasma norepinephrine concentrations (r=0.60, p<0.0001), and negatively correlated with creatinine clearance (r=-0.61, p<0.0005) and urinary sodium excretion (r=-0.44, p<0.02). Stepwise multiple regression analysis using certain independent variables, including Pugh's score, vasoactive substances, renal function and hemodynamic parameters, showed that the adjusted R square was highest when plasma renin activity and creatinine clearance (standard coefficient=0.53, -0.49, respectively) were considered (adjusted R square=0.61, p<0.0001). CONCLUSIONS:Plasma adrenomedullin concentrations increased with the progression of liver cirrhosis and were highest in cirrhotic patients with refractory ascites. In addition, elevated adrenomedullin was associated with activation of the renin-angiotensin-aldosterone and sympathetic nervous systems, and with functional renal impairment in cirrhosis. Considering the potent vasodilatory action of adrenomedullin, increased adrenomedullin may participate in the hyperdynamic circulation, ultimately leading to ascites formation, in patients with liver cirrhosis.
journal_name
J Hepatoljournal_title
Journal of hepatologyauthors
Kojima H,Tsujimoto T,Uemura M,Takaya A,Okamoto S,Ueda S,Nishio K,Miyamoto S,Kubo A,Minamino N,Kangawa K,Matsuo H,Fukui Hdoi
10.1016/s0168-8278(98)80235-3subject
Has Abstractpub_date
1998-05-01 00:00:00pages
840-6issue
5eissn
0168-8278issn
1600-0641pii
S0168-8278(98)80235-3journal_volume
28pub_type
杂志文章abstract::Hepatitis C infection is common in patients undergoing liver transplantation. Few studies have focused on the prevalence and epidemiology of hepatitis C infection among liver transplant recipients since the implementation of donor screening for antibodies against the hepatitis C virus (anti-HCV). Using reverse transcr...
journal_title:Journal of hepatology
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更新日期:1995-01-01 00:00:00
abstract:BACKGROUND/AIMS:The glycosphingolipid alpha-galactosylceramide has been shown to activate invariant natural killer T cells when presented in the context of CD1d and induces powerful antiviral immune responses via the production of inflammatory cytokines. The aim of this study was to investigate the safety and the antiv...
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abstract:BACKGROUND/AIMS:Osteopenia is a common complication in some chronic cholestatic liver diseases. Our aims were to determine the prevalence and severity of bone disease in patients with primary sclerosing cholangitis; and identify risk factors to predict the presence and progression of osteopenia. METHODS:Eighty-one pat...
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pub_type: 临床试验,杂志文章,随机对照试验
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abstract:BACKGROUND/AIMS:Acyclic retinoid (AR; all trans-3,7,11,15-tetramethyl-2,4,6,10,14-hexadecapentaenoic acid) prevented hepatocarcinogenesis in animal models and in a randomized clinical trial by eradicating premalignant and latent malignant clones of transformed cells from the liver. We investigated the possible mechanis...
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abstract:BACKGROUND/AIMS:To study whether the host's immune response determines viral clearance in chronic hepatitis C, virological markers and antigen-specific T cell reactions were analysed in 30 chronic HCV carriers followed up during interferon-alpha therapy, 11 untreated anti-HCV positive individuals and 10 healthy control...
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pub_type: 杂志文章
doi:10.1016/s0168-8278(98)80146-3
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abstract:BACKGROUND & AIMS:Clinical cases of viral infections possibly involving the transfusion of blood components are systematically investigated. METHODS:Serological and molecular markers of hepatitis B virus were used including HBsAg, anti-HBc, anti-HBs, HBV DNA, and viral load. Full genome sequencing and phylogenetic ana...
journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2011.07.034
更新日期:2012-03-01 00:00:00
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pub_type: 杂志文章
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/j.jhep.2010.09.019
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND & AIMS:Recent studies have suggested that insulin resistance exerts a strong influence on chronic hepatitis C virus (HCV) infection. We analyzed pretreatment factors useful for predicting sustained virological response (SVR), especially interleukin (IL) 28B polymorphism and Homeostasis Model Assessment of In...
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pub_type: 杂志文章
doi:10.1016/j.jhep.2012.04.027
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND/AIMS:Norfloxacin is useful to prevent infections in hospitalized cirrhotic patients with low ascitic fluid protein concentrations. It is also effective in preventing the recurrence of spontaneous bacterial peritonitis. The aim of our study was to determine the efficacy of norfloxacin in the primary prophylax...
journal_title:Journal of hepatology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0168-8278(98)80061-5
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND & AIMS:The pathomechanisms underlying non-alcoholic fatty liver disease (NAFLD) and the involved molecular regulators are incompletely explored. The nuclear factor-kappa B (NF-κB)-cofactor gene B cell leukemia-3 (Bcl-3) plays a critical role in altering the transcriptional capacity of NF-κB - a key inducer o...
journal_title:Journal of hepatology
pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
abstract::The hepatitis B virus (HBV) is a small enveloped DNA virus, which primarily infects hepatocytes and causes acute and persistent liver disease. Epidemiological studies have provided overwhelming evidence for a causal role of chronic HBV infection in the development of hepatocellular carcinoma, but the molecular mechani...
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pub_type: 杂志文章,评审
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更新日期:2010-04-01 00:00:00
abstract:BACKGROUND & AIMS:Urgency-based allocation that relies on the MELD score prioritizes patients at the highest risk of waitlist mortality. However, identifying patients at greatest risk for short-term post-transplant mortality is needed in order to optimize the potential gains in overall survival obtained through improve...
journal_title:Journal of hepatology
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更新日期:2015-09-01 00:00:00
abstract:AIMS:To estimate the cost of population screening for haemochromatosis in Australia and to compare the cost of alternative screening strategies. METHODS:The costs of screening for haemochromatosis were analysed in a hypothetical study using transferrin saturation as the primary screening test, with confirmation of the...
journal_title:Journal of hepatology
pub_type: 杂志文章
doi:10.1016/s0168-8278(97)80357-1
更新日期:1997-09-01 00:00:00
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journal_title:Journal of hepatology
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1016/j.jhep.2016.07.010
更新日期:2017-01-01 00:00:00
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pub_type: 杂志文章,评审
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abstract::Symptomatic hepatic involvement is a rare complication of hereditary hemorrhagic telangiectasia and most commonly consists of fibrosis or cirrhosis. We describe a 33-year-old woman in whom multiple hepatic arteriovenous malformations led to high output cardiac failure and liver failure due to biliary necrosis with ref...
journal_title:Journal of hepatology
pub_type: 杂志文章
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更新日期:1995-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:1997-03-01 00:00:00
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更新日期:2001-05-01 00:00:00
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journal_title:Journal of hepatology
pub_type: 杂志文章
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更新日期:1995-11-01 00:00:00
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