New Methods for the Determination of Serum and Breath Mercaptans and Its Application in Liver Cirrhosis and Hepatic Encephalopathy
Mercaptans are extremely toxic compounds that appear to be largely derived from colonic bacterial metabolism of methionine. They have been suggested as being one of the endogenous factors responsible for hepatic coma.1,2 The reports in literature on breath3,4 and serum or blood mercaptans5–7 are highly conflicting. This is probably due to differences in assay and to technical difficulties to measure mercaptans in a reproducible way. The reports on serum and blood mercaptans4–6 all focus on the use of zinc and acid to release the mercaptans, assuming that the mercaptans are largely covalently bound to proteins in a disulfide linkage. However, this reaction is a very agressive and aspecific one. It gives all kinds of unwanted side reactions, such as degradation of methionine, resulting in falsely elevated levels of methanethiol and dimethylsulfide.
KeywordsLiver Cirrhosis Hepatic Encephalopathy Hepatic Coma Disulfide Linkage Volatile Sulfur Compound
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