Patients with severe liver cirrhosis followed up by L-[1- 13 C] phenylalanine breath test

Abstract

Compared to healthy subjects, patients with severe liver cirrhosis (LC) are reported to show lower values in the L-[1-(13)C] phenylalanine breath test (PBT). We performed this test several times during the clinical course in two patients with severe liver cirrhosis (LC). Patient 1 was a 67-year-old woman with non-B, non-C LC and hepatocellular carcinoma (HCC) in the lateral hepatic segment. Because the patient wanted to receive nonsurgical treatment for HCC, intraarterial administration of zinostatin stimalamer was performed. The patient was hospitalized four times before her death from liver failure on December 20, 2000. During her clinical course, PBT was performed four times. Values for both the rate of hepatic phenylalanine oxidation (%(13)C dose h(-1)) and %(13)C cumulative excretion gradually decreased during her clinical course. Patient 2 was a 57-year-old man with hepatitis C virus (HCV)-positive LC. He was hospitalized seven times between December 1998 and his death on May 24, 2001. During his clinical course, PBT was performed four times. Values for both %(13)C dose h(-1) and %(13)C cumulative excretion decreased during his clinical course. We confirmed that PBT was useful for following the course of LC.

l-[1-13C] phenylalanine breath test results reflect the activity of phenylalanine hydroxylase in carbon tetrachloride acute injured rat liver

“…They found that 13 CO 2 excretion decreased by up to 80% after intake of l-[1-13 C] phenylalanine ( 13 C-Phe). Similar results were subsequently obtained in different populations by other researchers (Tugtekin et al, 1999;Lara Baruque et al, 2000;Kobayashi et al, 2001;Ishii et al, 2003a;Festi et al, 2005). Our clinical research has also supported the clinical value of PheBTs Sun et al, 2003).…”

“…Studies have.found that after intravenous administration of phenylalanine to patients with liver diseases, decreased elimination was consistent with a loss in tyrosine production (Matthews et al, 1993), and that the phenylalaine elimination rate in the central vein was highly correlated with the total amino acid elimination rate (Levine and Conn, 1967). Many researchers (Burke et al, 1997;Tugtekin et al, 1999;Lara Baruque et al, 2000;Kobayashi et al, 2001;Ishii et al, 2003a;Festi et al, 2005;Yan et al, 2003;Sun et al, 2003) have independently evaluated hepatocyte function and liver functional reserve by PheBTs, and found that breath test parameter levels were reduced. The extent of this decrease was somewhat correlated with many blood biochemical indices and the results of Indocyanine Green (ICG) examination.…”

Serum Phenylalanine Concentration as a Marker of Liver Function in Obese Patients Before and After Bariatric Surgery

“…Liver injury can cause a lower rate of phenylalanine metabolism (and uptake) and consequently the increase of serum phenylalanine concentration [4]. Some studies indicated that 13 C-phenylalanine breath test could be useful for determination of liver function [5][6][7]. Nonalcoholic fatty liver disease (NAFLD) represents different clinical conditions characterized histologically by an excessive accumulation of fat in the liver of subjects not consuming alcohol or consuming minimal amount of ethanol [8].…”

Liver function assessment with three13C breath tests by two-point measurements

“…With respect to 13 C breath tests for cytosol, the usefulness of the l-[1-13 C]phenylalanine breath test (PBT) [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and [ 13 C]galactose breath test [26][27][28][29][30][31] has been reported. Several studies focusing on mitochondria indicated the usefulness of the α-ketoisocaproate breath test [32][33][34][35][36][37][38] and methionine breath test (MethioBT) [39][40][41][42][43][44][45][46][47][48][49][50].…”