A Bile-acid-rich High-density Lipoprotein (HDL) in Acute Hepatitis

Abstract

Severe liver dysfunction is often associated with alterations of plasma lipids and lipoproteins. In this study the high-density lipoprotein (HDL) class has been further investigated. HDL from patients with acute, cholestatic hepatitis (n = 10) was isolated and compared with that of normals. Lipid and protein analyses were performed during the acute stage of the disease, with consequent follow-up studies. It was found that (1) only apo A-I was decreased by 50% in the isolated HDL fractions, whereas apo A-II remained unchanged; apo A-I in total plasma was normal; (2) immunoelectrophoresis of hepatitis HDL against monospecific anti-A-II revealed one precipitin line but two or more bands against anti-A-I; (3) concomitant with an increase of phospholipids and a decrease of triglycerides and the total cholesterol fraction, hepatitis HDL contained 10--12 times more bile acid than normal HDL. Chenodeoxycholic acid was the predominant bile acid. These alterations were fully reversible when patients recovered. These parameters seem to be sensitive markers for the degree of disturbance and restoration of liver function. The structural-functional implications of the observed compositional changes of HDL during cholestasis are discussed.

HDL and cholesterol: life after the divorce?

“…The position of the 3-␣ hydroxyl group in the steroid nucleus, specifi cally in cholate and taurocholate derivatives, was found to promote HDL binding ( 40 ), particularly the more hydrophilic BAs. In acute cholestatic hepatitis, HDL BAs were found to be increased more than 10-fold, which was reversible with treatment ( 41 ). In normolipidemic subjects, 11% of total BAs in serum were observed bound to HDL ( 39 ).…”

Lipid profile in children with acute viral hepatitis A

“…It is believed that apoA‐I is controlled at the post‐translational level and liver damage decreases the apoA‐I conversion from other isoforms 19,21 . In a study performed in adults with acute, cholestatic hepatitis, it was found that only apo A‐I was decreased by 50% in the isolated HDL fractions, whereas apo A‐II remained unchanged 22 . The decrease was fully reversible and considered as a sensitive marker for the degree of disturbance and restoration of liver function 22 .…”

“…In a study performed in adults with acute, cholestatic hepatitis, it was found that only apo A‐I was decreased by 50% in the isolated HDL fractions, whereas apo A‐II remained unchanged 22 . The decrease was fully reversible and considered as a sensitive marker for the degree of disturbance and restoration of liver function 22 . In our study, serum apo A‐I level was lower in children with AVH compared to healthy children and was lower in the case of cholestasis.…”