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Klinische Wochenschrift

, Volume 61, Issue 6, pp 277–283 | Cite as

Der Tryptophan-Belastungstest als Funktionsparameter bei Lebererkrankungen

  • M. Rössle
  • R. Herz
  • W. Hiss
  • W. Gerok
Originalien

Oral tryptophan loading test: A specific and quantitative test of hepatic function

Summary

Because of its specific hepatic degradation tryptophan was orally administered (50 mg/kg) to patients with various chronic liver diseases (n=30) and to healthy volunteers (n=8) as a test for hepatic function. The plasma half life of tryptophan was determined between 4 and 8 h after the amino acid load. It was found that in patients with cirrhosis (n=25) the half life of tryptophan was prolonged to 4.7±0.4 h (x±SD), compared to 2.0±0.1 h in the controls. The tryptophan half life also correlated with the plasma concentration of albumin, bilirubin, cholinesterase and prothrombin time in these patients. In addition a significant correlation was observed with the galactose elimination capacity and the 45 min retention of BSP. Thus, the oral tryptophan loading test may be suitable for a more specific determination of functional impairment of the liver in chronic liver disease. In decompensated cirrhotic patients alterations of the tryptophan metabolism seen to be related to indicators of hepatic encephalopathy. The test may therefore be used to assess the degree and risk of hepatic encephalopathy in such patients.

Key words

Tryptophan loading test Liver function 

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Literatur

  1. 1.
    Baur H (1951) Über den normalen und pathologischen Histidinstoffwechsel des Menschen. Z Exp Med 119:143–194Google Scholar
  2. 2.
    Bloxam DL, Warren WH (1974) Error in the determination of tryptophan by the method of Denkla and Dewey. A revised procedure. Anal Biochem. 60:621–625PubMedGoogle Scholar
  3. 3.
    Denkla WD, Dewey HK (1967) The determination of tryptophan in plasma, liver and urine. J Lab Clin Med 69:160–169PubMedGoogle Scholar
  4. 4.
    Gerok W (1963) Quantitative Bestimmung der Aminosäuren im Serum bei Erkrankungen der Leber. Dtsch Med Wschr 88:1188–1197Google Scholar
  5. 5.
    Gerok W, Bornhäuser P (1966) Störungen des Stoffwechsels einzelner Aminosäuren bei Hepatitis und Lebercirrhose. Verh Dtsch Ges Inn Med 72:692–697Google Scholar
  6. 6.
    Gerok W (1972) Veränderungen der Argininosuccinatsynthetase-Aktivität in der Leber bei chronischen Lebererkrankungen. Klin Wochenschr 50:887–889PubMedGoogle Scholar
  7. 7.
    Heberer M, Talke II, Maier KP, Gerok W (1980) Metabolism of phenylalanine in liver diseases. Klin Wochenschr 58:1189–1196PubMedGoogle Scholar
  8. 8.
    Hirayama C (1971) Tryptophan metabolism in liver disease. Clin Chim Acta 32:191–197PubMedGoogle Scholar
  9. 9.
    Keiding S, Johannsen S, Tønnesen K (1977) Kinetics of ethanol inhibition of galactose elimination in perfused pig liver. Scand J Clin Lab Invest 37:487–494Google Scholar
  10. 10.
    Matolo NM, Stadalnik RC, Krohn KA (1978) Biodistribution studies of labeled tryptophan. Am J Surg 136:735–739PubMedGoogle Scholar
  11. 11.
    Michael AF, Drummond KN, Doeden D, Anderson JA, Good RA (1964) Tryptophan metabolism in man. J Clin Invest 43:1730–1746PubMedGoogle Scholar
  12. 12.
    Salaspuro MP, Salaspuro AE (1968) The effect of ethanol on galactose elimination in rats with normal and cholinedeficient fatty livers. Scand J Clin Lab Invest 22:49–53PubMedGoogle Scholar
  13. 13.
    Salaspuro MP, Shaw S, Jayatilleke E, Ross WA, Lieber CS (1981) Attenuation of the ethanol-induced hepatic redox change after chronic alcohol consumption in baboons: metabolic consequences in vivo and in vitro. Hepatology 1:33–38PubMedGoogle Scholar
  14. 14.
    Schreier K, Schönsee H (1952) Methioninbelastung als Leberfunktionstest. Dtsch Med Wochenschr 77:418–420PubMedGoogle Scholar
  15. 15.
    Tygstrup N, Winkler K, Lund E, Engell HC (1954) A clinical method for determination of plasma galactose in tolerance tests. Scand J Clin Lab Invest 6:43–48PubMedGoogle Scholar
  16. 16.
    Ugarte G, Pino ME, Valenzuela J, Lorca F (1963) Urea cycle enzymatic abnormalities in patients in endogenous hepatic coma. Gastroenterology 45:182–188PubMedGoogle Scholar
  17. 17.
    Yoshida K, Hirayama C (1980) Clinical evaluation of serum levels of tryptophan in hepatobiliary disease. Clin Chim Acta 101:235–240PubMedGoogle Scholar
  18. 18.
    Zoli M, Marchesini G, Cecchini L, Dondi C, Bianchi FB, Pisi E (1981) Binding of tryptophan to albumin in liver cirrhosis. A reappraisal of the problem. Hepato-Gastroenterology 28:87–89PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1983

Authors and Affiliations

  • M. Rössle
    • 1
  • R. Herz
    • 1
  • W. Hiss
    • 1
  • W. Gerok
    • 1
  1. 1.Med. Univ.-KlinikFreiburgBundesrepublik Deutschland

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