Increased plasma carbon monoxide in patients with viral cirrhosis and hyperdynamic circulation.
OBJECTIVE
Our aim was to measure plasma carbon monoxide (CO) in patients with liver cirrhosis and portal hypertension.


METHODS
In 36 cirrhotic patients (24 with ascites) and 9 healthy volunteers, we evaluated CO plasma levels and systemic hemodynamics (using ultra-trace gas chromatography and echocardiography, respectively). Heme oxygenase (HO) activity and expression were measured in isolated polymorphonuclear (PMN) cells.


RESULTS
Plasma CO level (mean+/-s.d.) was 5.81+/-1.31 p.p.m. in healthy subjects (HS), significantly higher in non-ascitic patients (16.24+/-4.61 p.p.m., P<0.01), and even more high in ascitic patients (28.50+/-7.27 p.p.m., P<0.01 vs. the other two groups). HO activity in PMN cells was significantly greater in patients than in HS, with the highest levels being observed in patients with ascites. Western blot analysis showed enhanced expression of HO-1, but not HO-2. In the whole series of cirrhotic patients, plasma CO levels directly correlated with cardiac output, and inversely with systemic vascular resistance and mean arterial pressure.


CONCLUSIONS
The HO/CO system is activated in patients with liver cirrhosis. This could contribute to the hyperdynamic circulatory syndrome observed in this condition.
Tarquini
Roberto
R
Department of Internal Medicine, School of Medicine, University of Florence, Florence, Italy. rtarquini@unifi.it
Masini
Emanuela
E
La Villa
Giorgio
G
Barletta
Giuseppe
G
Novelli
Marco
M
Mastroianni
Rosanna
R
Romanelli
Roberto Giulio
RG
Vizzutti
Francesco
F
Santosuosso
Ugo
U
Laffi
Giacomo
G
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015153:Blotting, Western; D002248:Carbon Monoxide / Q000097:blood*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006419:Heme Oxygenase (Decyclizing) / Q000096:biosynthesis; D051547:Heme Oxygenase-1 / Q000096:biosynthesis; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D007527:Isoenzymes; D008103:Liver Cirrhosis / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000201:enzymology; D012189:Retrospective Studies; D014655:Vascular Resistance
D007527:Isoenzymes; D002248:Carbon Monoxide; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1; C105245:heme oxygenase-2