Cyclic AMP metabolism and adenylate cyclase concentration in patients with advanced hepatic cirrhosis

The clinical importance of the trimethadione tolerance test as a method for quantitative assessment of hepatic functional reserve in patients with biliary atresia

“…However, when using such tests, hepatic function and prognosis at the time of evaluation are estimated based on the degree of liver injury and not on the hepatic reserve capacity. Methods that have been used for the evaluation of hepatic reserve capacity in patients with biliary atresia include the indocyanine green (ICG) tolerance test (3–8, 19, 20), the bile acid tolerance test (21–24) and the glucagon tolerance test (25–27). In the ICG tolerance test, errors in measurements are prone to be made in cases such as biliary atresia, where end‐stage obstructive jaundice and reduced hepatic blood flow are present.…”

The glucagon test in obstructive and hepatocellular jaundice

“…These tests have involved either continuous infusions of glucagon (Felig et al, 1970;Francavilla et al, 1978) or repeated bolus doses (Van Itallie and Bentley, 1955) whereas the present test involves only a single bolus injection of glucagon.…”

“…Glucagon acts to stimulate adenylate cyclase in liver cells resulting in glycogenolysis and gluconeogenesis (Francavilla, Jones and Starzl, 1978). Van Itallie and Bentley (1955) infused glucagon into normal subjects and cirrhotic patients in the presence and absence of subcutaneously administered adrenaline and suggested that glucagon-adrenaline induced hyperglycaemia may be of value as an index of liver function.…”

Respuesta activa profibrótica en sangre periférica en pacientes cirróticos

“…proteína G: se encarga de convertir el ATP en AMP cíclico y pirofosfato. Se ha visto como esta enzima presenta un comportamiento anómalo en los hepatocitos de pacientes con cirrosis terminal(113), dando lugar a diversas alteraciones metabólicas en estos pacientes, fundamentalmente falta de respuesta a glucagón. Otros ensayos, sin embargo, demuestran como el AMP cíclico (producto de su activación) inhibe el crecimiento de las HSC (114) dando a entender que la activación de la adenilciclasa contrarresta el desarrollo de fibrosis.…”