title: Increased plasma carbon monoxide in patients with viral cirrhosis and hyperdynamic circulation.
abstract: 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.
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Florence, Florence, Italy. rtarquini@unifi.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Tarquini
authors.forename: Emanuela
authors.initials: E
authors.lastname: Masini
authors.forename: Giorgio
authors.initials: G
authors.lastname: La Villa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barletta
authors.forename: Marco
authors.initials: M
authors.lastname: Novelli
authors.forename: Rosanna
authors.initials: R
authors.lastname: Mastroianni
authors.forename: Roberto Giulio
authors.initials: RG
authors.lastname: Romanelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Vizzutti
authors.forename: Ugo
authors.initials: U
authors.lastname: Santosuosso
authors.forename: Giacomo
authors.initials: G
authors.lastname: Laffi
mesh_terms: 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
chemical_list: D007527:Isoenzymes; D002248:Carbon Monoxide; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1; C105245:heme oxygenase-2