Clinical and experimental studies on the profiles of serum proteins in acute hepatic injury.

The change with time in profiles of five serum proteins in acute hepatitis were studied. Prealbumin (Pre) decreased in the initial stage and made a peak to be normal thereafter. Alpha 1 antitrypsin (alpha 1AT) showed a slight increase in the initial stage but no remarkable change thereafter. Haptoglobin (Hp) decreased in the initial stage and then increased gradually to be normal. Alpha 2HS glycoprotein (alpha 2HS) and beta 1CA globulin (beta 1CA) showed no decrease, but they later increased in the 2nd or 3rd week. In fulminant hepatitis, alpha 1AT was somewhat high in the initial stage but decreased gradually to the lower normal limits; Pre and Hp decreased markedly; and alpha 2HS and beta 1C/A decreased from the initial stage. Alpha 2HS and beta 1C/A were found useful for estimation of the severity of acute hepatitis in the initial stage. It was found that when Hp showed a marked decrease, especially ahaptoglobinemia, the hepatic injury was serious. Various degrees of hepatic injury were produced by Gal-N in rats and mice were compared with the amount of these proteins. The level of albumin (Al), transferrin (Tr), alpha 1AT and Hp was inversely proportional to the amount of liver cell necrosis, Particularly, Hp showed a marked decrease in submassive or massive necrosis, while a moderate decrease in minimal change of focal necrosis. Al and Tr showed a slight decrease of about the same degree, and the decrease of alpha 1AT was somewhat greater. beta 1C/A decreased in inversely proportion with the amount of liver cell necrosis and its decrease in massive necrosis was more pronounced than the other proteins.