S-Adenosyl-L-methionine (SAMe) is a physiologic precursor of thiols and sulfurated compounds, which are known to be decreased in patients with liver disease. The effect of its administration on the hepatic glutathione content of liver patients was investigated. Four groups of subjects were selected: a) 9 patients with alcoholic liver disease treated with SAMe (1.2 g/day orally for 6 months); b) 7 patients with non-alcoholic liver disease treated as above; c) 8 placebo-treated patients with alcoholic liver disease; and d) 15 normal subjects as a control group. Total and oxidized glutathione were assayed by high-performance liquid chromatography of liver biopsy specimens before and after the treatment period. In all patients pre-treatment hepatic glutathione was significantly decreased as compared with controls. SAMe therapy resulted in a significant increase of hepatic glutathione levels both in patients with alcoholic and in those with non-alcoholic liver diseases as compared with placebo-treated patients. SAMe may therefore exert an important role in reversing hepatic glutathione depletion in patients with liver disease.

Thirty-two patients suffering from migraine without aura were assessed during in interictal period to evaluate the contribution of cytokines to the pathophysiology of migraine. To this end, plasma levels of IFN-gamma, IL-4, IL-5, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) techniques. Plasma levels of both IFN-gamma and IL-10 were not increased in the patients and did not differ significantly from healthy controls. Of interest, we observed a strong increase of IL-5 levels in 84.3% as well as increased IL-4 levels in 37.5% of patients with migraine without aura. These results suggests a preferential enhancement of some Th2-type cytokines, and may support the growing arguments of an immunoallergic mechanism in the pathophysiology of migraine.

The effect of octreotide, a long-acting synthetic analog of somatostatin, on fasting and postprandial splanchnic hemodynamics was investigated in cirrhotic patients. Splanchnic hemodynamics were assessed using an echo-Doppler duplex system in a prospective, double-blind, placebo-controlled, crossover study performed on 2 separate days, 1 week apart, in 30 cirrhotic patients. Measurements of portal vein (PV) cross-sectional area (PV-A) and mean velocity (PV-V), and of superior mesenteric artery (SMA) mean velocity (SMA-V) and pulsatility index (SMA-PI) (an index of vascular resistance) were performed at baseline, 30 minutes after octreotide (200 micrograms subcutaneously) or placebo administration, and 30 and 60 minutes after the ingestion of a liquid meal. In the fasted state, octreotide induced a significant decrease in PV-V (-7%) and in SMA-V (-10%) and an increase in PI (+16%). On the day of placebo administration, meal ingestion induced a significant increase in PV-V (+21%) and in SMA-V (+43%) and a decrease in PI (-21%). In contrast, meal ingestion on octreotide day induced significantly smaller increases in PV-V (+10%) and in SMA-V (+18%) and a significantly smaller decrease in PI (-10%). Octreotide, although producing a mild reduction in PV-V and SMA-V in the fasted state, markedly blunts postprandial splanchnic hyperemia in cirrhotic patients.

.). Compared with the results observed in a group ofwith HBeAg-positive chronic hepatitis B without significant 15 patients never treated with IFN-a and followed for 12 side effects. 7 Moreover, clinical trials using T-a 1 in the treatmonths, the rate of complete response was significantly ment of patients with immunodeficiency or cancer indicate higher in the IFN-a group at the end of therapy (1 of 15 that this agent is nontoxic, enhances immune responsiveness vs. 7 of 16, respectively; P õ .05) and in the T-a 1 group and augments specific lymphocyte functions, including at the end of follow-up (1 of 15 vs. 7 of 17, respectively; lymphoproliferative responses to mitogens, maturation of T P õ .05). Unlike IFN-a, T-a 1 was well tolerated by all cells, antibody production, and T-cell-mediated cytotoxicity.8,9patients. The only side effect, reported by some, was loOn the basis of these observations, we started a multicencal discomfort at injection sites. The results of this trial ter randomized trial to compare the efficacy and the safety suggest that T-a 1 is able to reduce HBV replication in of T-a 1 versus IFN-a therapy in anti-HBe-and HBV-DNApatients affected by anti-HBe-positive chronic hepatitis.positive chronic active hepatitis. Furthermore, compared with IFN-a, T-a 1 is better tolerated and seems to induce a gradual and more sustained PATIENTS AND METHODS ALT normalization and HBV-DNA loss. In conclusion, T-a 1 appears to be a safe and effective alternative treatPatients. A total of 33 patients were enrolled in the study on the basis of the following criteria for entry: age between 18 and 60 years; presence of HBsAg in serum for at least 12 months; positive serum Abbreviations: HBsAg, hepatitis B surface antigen; HBeAg, hepatitis B e antigen; HBV, tests for anti-HBe and HBV DNA, documented on four occasions, hepatitis B virus; anti-HBe, hepatitis B e antibody; IFN-a, interferon alfa; T-a1, thymosinat least 3 months apart, during the 12 months before entry; and a1; HC, historical control; ALT, alanine transaminase. aminotransferase levels higher than 1.5 times the upper normal limit From the