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Fibronectin in acute and subacute hepatic failure
A C Anand1, M Irshad, S K Acharya
1Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Journal of Clinical Gastroenterology
|June 1, 1989
Summary
Patients with severe liver failure have significantly lower plasma fibronectin (FN) levels. Failure of FN levels to increase indicates a poor prognosis, potentially linked to impaired immune function and increased infection risk.
Area of Science:
- Hepatology
- Immunology
- Biochemistry
Background:
- Fulminant hepatic failure (FHF) and subacute hepatic failure (SAHF) are severe conditions characterized by rapid liver damage.
- Plasma fibronectin (FN) is a crucial protein involved in immune responses and tissue repair.
- Reduced FN levels have been observed in various critical illnesses, but their specific role in severe liver failure requires further investigation.
Purpose of the Study:
- To investigate plasma fibronectin (FN) concentrations in patients with FHF and SAHF.
- To explore the correlation between plasma FN levels and clinical parameters in these patients.
- To assess the prognostic value of plasma FN levels in severe hepatic failure.
Main Methods:
- Measurement of plasma fibronectin (FN) concentrations in patients with FHF, SAHF, normal controls, and viral hepatitis.
- Correlation analysis between plasma FN levels and serum glutamic pyruvate transaminase (SGPT) and prothrombin time (PT).
- Serial monitoring of plasma FN levels in relation to treatment and patient outcomes.
Main Results:
- Significantly lower mean plasma FN concentrations were found in FHF and SAHF patients compared to controls and viral hepatitis patients (p < 0.001).
- Plasma FN levels negatively correlated with SGPT in FHF (p < 0.02) and PT in SAHF (p < 0.02).
- Failure of plasma FN levels to rise despite fresh plasma infusions indicated a poor prognosis.
Conclusions:
- Reduced plasma fibronectin (FN) is a hallmark of severe hepatic failure (FHF and SAHF).
- Plasma FN levels serve as a potential prognostic marker in these critical conditions.
- Decreased FN availability may contribute to impaired Kupffer cell function, leading to increased susceptibility to endotoxemia and bacterial infections.