title: Quantitation of tissue polypeptide antigen (TPA) in hepatic and systemic circulation in patients with chronic liver diseases.
abstract: OBJECTIVE
  Abnormal serum tissue polypeptide antigen (TPA) values are commonly found in patients with chronic liver damage and liver cirrhosis even in the absence of malignancies. The aim of this study was to compare serum TPA levels in patients with cirrhosis, to examine correlations between TPA levels and the degree of portal hypertension, and to evaluate TPA concentrations in paired hepatic and peripheral blood samples.
  
  
  METHODS
  A total of 128 patients with chronic liver disease of various severity were studied prospectively. TPA concentrations in hepatic vein and peripheral blood were determined, and Hepatic Vein Pressure Gradient (HVPG) was measured.
  
  
  RESULTS
  TPA levels were significantly higher in patients with cirrhosis than in those with chronic hepatitis, and in systemic circulation than in hepatic vein blood. Peripheral but not hepatic TPA levels did correlate with the HVPG. Subjects with clinically significant portal hypertension (HVPG > 10 mmHg) showed significantly higher peripheral TPA levels than those with HVPG < 10 mmHg.
  
  
  CONCLUSIONS
  Our data suggest that the increased TPA levels observed in cirrhotic patients and the high systemic-to-hepatic blood TPA gradient are probably due to the presence of portal-systemic shunts rather than to hepatic necro-inflammatory activity. In clinical practice, TPA determination could help us to identify and to follow up cirrhotic patients with more severe portal hypertension.
authors.affiliation: Department of Internal Medicine and Liver Unit, Marino General Hospital, Rome, Italy. puoti@epatologia.org
authors.forename: Claudio
authors.initials: C
authors.lastname: Puoti
authors.forename: Lia
authors.initials: L
authors.lastname: Bellis
authors.forename: Riccardo
authors.initials: R
authors.lastname: Guarisco
authors.forename: Olga Mitidieri
authors.initials: OM
authors.lastname: Costanza
authors.forename: Renata
authors.initials: R
authors.lastname: Felici
authors.forename: Lucia
authors.initials: L
authors.lastname: Spilabotti
authors.forename: Federica
authors.initials: F
authors.lastname: Paglia
authors.forename: Alessandra
authors.initials: A
authors.lastname: Galossi
authors.forename: Orlando
authors.initials: O
authors.lastname: Dell' Unto
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000276:immunology; D005260:Female; D006503:Hepatic Veins / Q000503:physiopathology; D019694:Hepatitis B, Chronic / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000276:immunology; D006801:Humans; D006975:Hypertension, Portal / Q000276:immunology* / Q000503:physiopathology; D008102:Liver Circulation; D008103:Liver Cirrhosis / Q000276:immunology; D008107:Liver Diseases / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D008113:Liver Neoplasms / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012720:Severity of Illness Index; D019396:Tissue Polypeptide Antigen / Q000097:blood*; D014690:Venous Pressure
chemical_list: D015415:Biomarkers; D019396:Tissue Polypeptide Antigen