SERUM AMINOTERMINAL TYPE III PROCOLLAGEN PEPTIDE IN CRYPTOGENIC CHRONIC LIVER

DISEASE ,

P. Bonetti, G. Diodati, M. Plebani, M. Rugge , G. Realdi Istituto di Medicina

Clinica, Universit~ di Padova (Italy) and

* Ist. Anatomia Patologica, Universit~ di Padova (Italy).

In chronic liver diseases, persistent elevation of serum aminotransferase levels, lasting

al least 6-12 months, is an universally accepted marker of chronic liver disease; histlogica!

ly, this disease is often characterized by persistent inflammatory lesions and by a progressl

ve collagen overload inside the liver. The primary aim of our study was to evaluate the poss!

ble correlation between serum levels of Aminoterminal type III Procollagen Peptide (sP-III-P)

as a suitable marker of ongoing overload of collagen fibers, and the degree of histologic a£

tivity, as determined by piece-meal necrosis and lobular necrosis, or the biochemical activi

ty, as measured by serum levels of aminotransferases. We studied 64 patients with HBsAg-neg~

tive chronic liver disease, with or without cirrhosis. 244 healthy sujects were included in

the study, as controls, sP-III-P was investigated by a commercial radioimmunometric assay;

the degree of histologic activity, indicated by piece-meal necrosis and focal necrosis, was

evaluated according to the score of Knodell and his coworkers. A close correlation was found

between histologic activity and sP-III-P: 55% of the patients with histologic activity had i~

creased sP-III-P and only 5% of the patients without the same pattern of histologic activity

had increased sP-III-P (p<0.01). No correlation was found between this serum marker of liver

fibroplasia and histologic severity of the disease, as well as with serum aminotransferase

levels. We conclude that sP-III-P, as a suitable marker of liver fibroplasia may be an use-

ful marker of histologic activity in HBsAg-negative chronic liver disease, with a significant

sensitivity and a very high specificity.

A SIMPLE METHOD TO STIMULATE GALLBLADDER CONTRACTION IN MAN.

G . B o r g h i , E .Roda , D . F e s t i , A . S i m u r r o , P . S i m o n i , A .Roda- , L . B a r b a r a .

Istituto di Clinica Medica e Gastroenterologla , universit& di Bologna e "Istituto

di Chimica Analitica, Universit~ di Messina, Italia.

It is known that the parenteral administration of ceruletide, a synthetic decapeptide of cho

lecystokinin, is effective in causin E gallbladder contraction (Gastroenterology 1975; 69,

1006-22). However, side effects can limit its use in some cases. Since bile acids could im-

prove nasal absorption of peptides (Int J Pharm 1986; 145, 1009-11), gallbladder dynamics(ba

sal volume, emptyin E and refillin E rates) was evaluated, by means of an ultrasonoEraphic tech

nique, in response to intranasally administered ceruletide-deoxycholate aerosol in 6 healthy

subjects. Ceruletide powder was dissolved in normal saline, 80 ug/ml. Sodium deoxycholate was

added to give a final micellar concentration of I~ (wt/vol). Solutions were administered as a

single spray in each nostril within two hours of mixin E. A sprayer which delivered 4 ul of ce

ruletide in 50 ul per spray was used. Ceruletide alone was unable to induce Eallbladder volu-

me variations, while ceruletide-deoxycholate provoked a prompt (mean time = 13 mins.) and ef

fective (mean maximal decrease in gallbladder volume = 61~, ranEe = 27--89~) Eallbladder empty ÷

in E. The 80~ gallbladder refillin E was reached after 40 - 5 mins. Deoxycholate alone failed

to contract the gallbladder. No local or systemic side effects were encountered. Therefore,

nasal administration of ceruletide as an aerosol with bile salts may represent a possible al-

ternative to ceruletide parenteral administration for both diagnostic and theeapeutic purpo- ses.

SlO0