[Endogenous digitalis-like factor in liver cirrhosis and cholestasis].
Endogenous digitalis-like factor (EDLF), an inhibitor of membrane Na+/K(+)-ATPase, is discussed to be involved in the pathogenesis of cirrhogenic portal hypertension, ascites formation and development of functional hepatorenal failure. Therefore, we investigated the serum content of this mediator in patients with liver cirrhosis Child-Pugh stage A, B, and C (n = 27) by means of enzyme immunoassay with a specific digoxin antibody. Furthermore, a correlation analysis was performed in order to find out correlations between signs of cell injury, cholestasis, synthetic cell function, ascites formation, and hepatorenal failure. Our results demonstrate that EDLF is significantly elevated in Child C cirrhosis (0.61 +/- 0.15 ng/ml) in comparison to Child A cirrhosis (0.013 +/- 0.2 ng/ml) and is also higher than in Child B cirrhosis (0.23 +/- 0.25 ng/ml). In patients without ascites EDLF (0.056 +/- 0.19 ng/ml) differs significantly from that of patients with non-complicated ascites (0.156 +/- 0.176 ng/ml) and from that of patients with therapy refractory ascites (0.66 +/- 0.17 ng/ml) or hepatorenal failure (1.56 ng/ml). There are no correlations between EDLF and renal function. Significant correlations were demonstrated for cholestasis (serum bilirubin), synthesis function (serum protein, Quick's value, cholinesterase, fibrinogen, albumin), and the degree of portasystemic encephalopathy (number connection test). We conclude that EDLF may act as a mediator in the process of progressive portal hypertension and its complications due to cirrhosis. This process of progression is caused by the inhibition of Na+/K(+)-ATPase, vasoconstriction, and endothelin secretion.
D000328:Adult; D001201:Ascites / Q000503:physiopathology; D001663:Bilirubin / Q000097:blood; D001798:Blood Proteins / Q000502:physiology*; D002298:Cardenolides; D004077:Digoxin; D004791:Enzyme Inhibitors; D005260:Female; D006501:Hepatic Encephalopathy / Q000503:physiopathology; D006530:Hepatorenal Syndrome / Q000503:physiopathology; D006801:Humans; D006975:Hypertension, Portal / Q000503:physiopathology; D007124:Immunoenzyme Techniques; D007677:Kidney Function Tests; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000145:classification / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D011517:Prothrombin Time; D012503:Saponins; D012709:Serum Albumin / Q000378:metabolism; D000254:Sodium-Potassium-Exchanging ATPase / Q000037:antagonists & inhibitors / Q000502:physiology
D001798:Blood Proteins; D002298:Cardenolides; D004791:Enzyme Inhibitors; D012503:Saponins; D012709:Serum Albumin; C034504:digoxin-like factors; D004077:Digoxin; D000254:Sodium-Potassium-Exchanging ATPase; D001663:Bilirubin
Endogenous digitalis-like factor bei Leberzirrhose und Cholestase.