肝のアンモニア解毒に関する酵素学的研究 : 第2篇 各種肝疾患における肝内のグルタミン酸脱水素酵素およびグルタミン合成酵素の測定値と血中グルタミン酸値

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概要

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• It is well known that ammonium produced in vivo is mainly detoxicated in the liver. With regards to the ammonium detoxication, there are two important metabolic pathways, i.e. urea cycle and glutamic acid pathway.The author clarified in the first report that enzymatic activities in these pathways were decreased in the liver of rats treated with CCl4.From the above experimental results, it is reasonable to assume that similar metabolic disturbances could be occurred in patients with serious liver diseases.In order to investigate on this problem in clinical materials, 115 patients with hepatic disease and 21 control patients were selected. To avoid the false estimation of hepatic disability on ammonium detoxication, resulting from measurement of a portion of ammonium escaping from the metabolic process in liver thru intra or extrahepatic porto-systemic shunt formations, the hepatocellular ability of ammonium detoxication was evaluated by the activities of glutamic dehydrogenase, glutamine synthetase in liver specimens obtained by needle biopsies, and plasma contents of glutamic acid.The activities of hepatic glutamic dehydrogenase and glutamine synthetase were decreased in the patients with serious liver diseases. The findings were most prominently encountered in the patients with severe hepatitis in which hepatic cell necrosis was highly recognized, and in those with hepatic coma accompanied by hyperammoniaemia. All cases of liver cirrhosis with hyperammoniaemia showed low activities of hepatic glutamic acid dehydrogenase and glutamine synthetase with high plasma content of glutamic acid.It was noteworthy that the same results were obtained even in the cases of porto-systemic encephalooathy, in which hepatic cell damage was not so prominent.From these results above mentioned, it was concluded that the impaired activities of hepatic enzymes in urea cycle and metabolic pathway of glutamic acid were an essential aetiologic factor accounting for the incidence of hyperammoniaemia as well as intra- or extra hepatic porto-systemic shunt formations.

著者

• 玉井 義朗

  京都大学医学部 第二内科

• 玉井 義朗

  京都大学医学部内科第二講座

関連論文

• 肝のアンモニア解毒に関する酵素学的研究 : 第2篇 各種肝疾患における肝内のグルタミン酸脱水素酵素およびグルタミン合成酵素の測定値と血中グルタミン酸値
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• Enzymological studies on ammonium detoxication in liver:I. Measurement of the activities of urea cycle enzymes and the enzymes concerning with glutamic acid metabolism in liver after ammonium chloride administration

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