Djalali M, Champigneulle B, Guéant J L, el Kholty S, Gérard P, Nicolas J P
Unité INSERM U308, Faculté de Médecine, and CHU de Nancy-Brabois, Vandoeuvre-lès-Nancy, France.
Digestion. 1988;41(4):215-22. doi: 10.1159/000199793.
Relationship between increased serum cobalamin level and liver disease have been recently reported. In this work, levels of total corrinoids, cobalamin (vitamin B12) and cobalamin analogues and levels of IgA were determined by radioisotope dilution assay and nephelometric laser analyses. They all have been measured in superior vena cava, inferior vena cava and hepatic vein of controls and of alcoholic cirrhotic patients grouped according to the Child-Pugh classification. Compared with normal subjects, venous blood content of total corrinoids, of cobalamin and of IgA in alcoholic cirrhotics increased significantly with the severity of the disease (p less than 0.01). In severe, moderate, and mild alcoholic cirrhosis total corrinoids and cobalamin were, respectively, about 5-, 2-, and 1.5-fold higher than in controls, whereas IgA was 3-, 2.5- and 1.5-fold higher, respectively. The serum IgA level was significantly correlated with the level of seric saturated haptocorrin (r = 0.54; p less than 0.01) and with the seric total corrinoids (r = 0.39; p less than 0.01). In the absence of significant hepatic cytolysis, the enhanced level of seric corrinoids in cirrhosis could be partly explained by a competitive inhibition of the liver uptake of haptocorrin by circulating asialoglycoproteins, including IgA.
近期有报道称血清钴胺素水平升高与肝脏疾病之间存在关联。在本研究中,通过放射性同位素稀释法和激光散射比浊法测定了总类咕啉、钴胺素(维生素B12)和钴胺素类似物的水平以及IgA的水平。这些指标在对照组以及根据Child-Pugh分类法分组的酒精性肝硬化患者的上腔静脉、下腔静脉和肝静脉中均进行了测量。与正常受试者相比,酒精性肝硬化患者静脉血中总类咕啉、钴胺素和IgA的含量随疾病严重程度显著增加(p<0.01)。在重度、中度和轻度酒精性肝硬化患者中,总类咕啉和钴胺素分别比对照组高约5倍、2倍和1.5倍,而IgA分别高3倍、2.5倍和1.5倍。血清IgA水平与血清饱和钴胺传递蛋白水平显著相关(r = 0.54;p<0.01),与血清总类咕啉水平也显著相关(r = 0.39;p<0.01)。在无明显肝细胞溶解的情况下,肝硬化患者血清类咕啉水平升高的部分原因可能是循环中的去唾液酸糖蛋白(包括IgA)对肝脏摄取钴胺传递蛋白的竞争性抑制。