Protein-Lipid Relationships in Human Plasma: In Biliary Cirrhosis, Obstructive Jaundice, and Acute Hepatitis 1

Abstract

In 1862, Austin Flint (1) found that cholesterol accumulated in the blood in obstructive jaundice.Fifty years later Widal, Weill, and Laudat (2) pointed out that the hypercholesterolemia of obstructive jaundice is due in large measure to increase in serum free cholesterol in contradistinction to that of nephrosis, where both free and esterified cholesterol are greater than normal.More recently (3-5) it has been shown that plasma phospholipid increases even more than cholesterol, so that the ratio of total cholesterol to phospholipid is appreciably less than normal.The serum lipoproteins have also been measured in patients with liver disease. Pierce and Gofman (6) examined the sera of thirty-two patients with cirrhosis and found levels of the Sf 10-20 class slightly higher than normal. They also studied forty-eight cases of acute hepatitis (7) and found elevations of the Sf 0-100 components with the largest increase in the Sf [12][13][14][15][16][17][18][19][20] class. The increased concentrations correlated most closely with the presence of jaundice and tended to decrease when the jaundice subsided. McGinley, Jones, and Gofman (8) found a huge increase in the Sf 6 and Sf 8 groups, with varying increase in Sf 10-17 in five cases of biliary cirrhosis. By starch zone electrophoresis, Kunkel and Slater (9) observed that in biliary cirrhosis there was a high peak consisting predominantly of phospholipid which had the same relative mobility as normal beta lipoproteins. The concentration of alpha lipoproteins was extremely low.

The Lipid Composition of Serum in Patients With Liver Disease*

“…Similar findings have been reported by others (15)(16)(17)(18)(19). The minimal, if any, deviation from the normal in these fractions in the nonjaundiced patients with cirrhosis and with bile fistula suggests that these changes are related to bile retention.…”

“…filter paper electrophoresis ( 16,17) and ultracentrifugation (17)(18)(19). Abnormalities in these lipoprotein fractions, moreover, have been demonstrated by both chemical ( 15,17,19) and immunological means (20). By ultracentrifugal analysis, Havel, Eder and Bragdon (19) In the present investigation, a chromatographic technique for the estimation of the main individual phospholipids of serum (21,22) was employed in order to characterize further the serum lipid abnormalities of patients with liver disease.…”

“…Marked increases in the Sf6 and Sf8 with varying increases in the Sf10-17 ultracentrifugal classes of lipoproteins have been reported in patients with biliary cirrhosis (13). In patients with hepatitis, increases in the SA12, [12][13][14][15][16][17][18][19][20], and 20-100 classes, which correlated positively with the icteric index, and decreases in the Sf00-400 class, which correlated negatively with the icteric index, have been found (14). Increased concentrations of /3-lipoprotein and decreased-to-absent concentrations of a-lipoprotein have been observed with zone electrophoresis of serum from patients with jaundice (15).…”

“…Similar findings have been reported with * This investigation was supported in part by a research grant (H-2907) from the National Heart Institute, Be-.thesda, Md., and in part by a research grant from the American Heart Association. filter paper electrophoresis ( 16,17) and ultracentrifugation (17)(18)(19). Abnormalities in these lipoprotein fractions, moreover, have been demonstrated by both chemical ( 15,17,19) and immunological means (20).…”

The Α2 LIPOPROTEINS OF HUMAN SERUM. CORRELATION OF ULTRACENTRIFUGAL AND ELECTROPHORETIC PROPERTIES

“…Consideration of this further resolution and the finding (4,25) for the low density lipoproteins on the basis of their solubility properties is apparent from the present study.…”