Hepatic detoxification and hepatic function in chronic active hepatitis with and without cirrhosis

Abstract

The detoxification capacity of the liver in chronic active hepatitis (CAH) without liver cirrhosis (LC) is not sufficiently known. Therefore, we examined, in 156 patients with morphologically proven CAH of different stages, plasma ammonia, free phenols, indican, glucuronic acid and urea synthesis rate as parameters for liver detoxification. We found a significant increase of ammonia, phenols, and indican and a significant decrease of glucuronic acid and urea synthesis rate parallel to the stage of CAH without LC. In 34 CAH patients with complete recovery, a retrospective 10-year follow-up was possible. Parallel to the normalization of liver morphology and general liver tests, detoxification parameters also normalized. However, the detoxification disorders in CAH without LC are mild in nature and do not produce hepatic encephalopathy. Probably, they are caused by a reduced synthesis of the urea-cycle enzymes and of glucuronyltransferase in the liver.

Microbiota-derived uremic retention solutes: perpetrators of altered nonrenal drug clearance in kidney disease

“…Formation of p-cresol sulfate and indoxyl sulfate is decreased in chronic kidney disease patients and animal models with advanced liver cirrhosis (and thus impaired hepatic metabolism) [28]. Cirrhotic patients also exhibit higher serum concentrations of metabolic precursors like phenol and indole, suggesting decreased metabolic conjugation [29,30]. The role of hepatic metabolism in biotransformation of some microbiota-derived uremic toxins indicates a potential for competitive interactions with both Phase I and II metabolic pathways.…”

Functional metabolomics discover pentose and glucuronate interconversion pathways as promising targets for Yang Huang syndrome treatment with Yinchenhao Tang

“…In this process, compounds conjugated with toxic substances play an important role in detoxication, such as glucuronide conjugation in the pentose and glucuronate interconversion pathways. 1 Yang Huang syndrome (YHS), the exclusive syndrome of traditional Chinese medicine syndromes (TCM syndromes), is rst recorded in the classic Chinese medicine monograph 'Shang hanlun'. 2 YHS patients show bright yellowish discoloration of the white of the eyes, mucous membranes and the skin, which are also distinguishing features different from those of the Yinhuang syndromes.…”

Unravelling the metabolic impact of SBS-associated microbial dysbiosis: Insights from the piglet short bowel syndrome model

“…Amongst the bacterially modified metabolites, SBS-ALD was associated with increased excretion of the protein-bound uraemic toxins phenol sulphate, indoxyl sulphate, 4-cresol sulphate and hippuric acid whose metabolism includes both an initial bacterial fermentation within the large intestine 27 , followed by further metabolism within the liver. In chronic liver disease patients, increased levels of these ureamic toxins are associated with liver disease prognosis in patients with cirrhosis 28 and chronic active hepatitis 29 suggesting that our observation of increased levels of the ureamic toxin metabolite panel may reflect liver disease progression in the SBS-ALD model.…”