Methionine enkephalin is increased in plasma in acute liver disease and is present in bile and urine.
Plasma immunoreactive methionine enkephalin is increased in cirrhosis. To determine whether it was increased in acute liver disease and chronic renal failure and whether the peptide was present in bile and urine, it was measured by radioimmunoassay in appropriate samples. Plasma immunoreactive methionine enkephalin, while at its peak in 15 patients with acute liver disease (median 425 pmol/l, range 220-1460), was approximately six times greater (P less than 0.001) than in 15 patients with chronic renal failure (70 pmol/l, 50-140), 15 controls with other diseases (75 pmol/l, 50-115) and 15 healthy controls (65 pmol/l, 50-95). In eight of the patients recovering from acute liver disease, the decline of the peptide's plasma level correlated with that of the alanine aminotransferase (r = 0.813, P less than 0.01) and prothrombin time (r = 0.682, P less than 0.05) measured in the simultaneously taken blood. Immunoreactive methionine enkephalin was found to be excreted in bile and urine. The possibility that increased plasma methionine enkephalin, and possibly other opioid peptides, may contribute to some of the manifestations of acute liver failure is worthy of further investigation.
Thornton
J R
JR
Department of Medicine, St. James's University Hospital, Leeds, U.K.
Losowsky
M S
MS
D000208:Acute Disease; D058186:Acute Kidney Injury / Q000097:blood; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001646:Bile / Q000378:metabolism*; D002763:Cholecystectomy; D004744:Enkephalin, Methionine / Q000097:blood* / Q000652:urine; D006501:Hepatic Encephalopathy / Q000097:blood; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000378:metabolism / Q000652:urine; D008875:Middle Aged; D011517:Prothrombin Time; D011863:Radioimmunoassay
D004744:Enkephalin, Methionine; D000410:Alanine Transaminase