The effect of chronic ethanol consumption on iron absorption in rats.

Alcoholics often have an increased amount of iron in the liver which may contribute to the development of alcoholic liver disease, although the mechanism is unknown. It has been shown that chronic ethanol intake decreases the enterocyte turnover and enhances galactose absorption. Whether it affects iron absorption is still controversial. The aim of this study was to investigate the effect of chronic ethanol ingestion on whole body iron absorption in rats. Twenty-eight adult male Sprague-Dawley rats were pair-fed a liquid diet containing either ethanol as 36% of total calories or an isocaloric diet where fat was substituted for ethanol. On the 28th day, four-hour fasted rats were given an oral dose of 59Fe (0.5 microCi) and were immediately counted by a whole body counter. 59Fe levels were then monitored over the following nine days. Although ethanol- and control-fed rats had a similar hepatic iron content (59.5 +/- 5.8 vs 60.2 +/- 7.4 micrograms/100 mg dry liver weight) (mean +/- S.E.M.), the 59Fe total body content was greater in the ethanol group (75% +/- 3%) compared with the control group (45% +/- 4%). These results show that chronic ethanol ingestion increased iron absorption in rats. A reduction of enterocyte turnover may play a role in determining this effect.

D-penicillamine treatment improves survival in primary biliary cirrhosis.

The copper-chelating, immunological, and antifibrotic effects of D-penicillamine indicated that it might be suitable for the treatment of primary biliary cirrhosis (PBC). In a randomised clinical trail, 55 PBC patients received penicillamine (600 mg daily), and 32 received a placebo. Drug reactions developed in 16 patients on penicillamine. All deaths occurred in patients with stage 3 or 4 (late stage) liver histology on entry to the study. 5 (14%) of 37 penicillamine-treated patients and 10 (43%) of 23 placebo patients have died (p less than 0.01). Improvement in survival only became evident after 18 months. Survivors in the penicillamine group demonstrated a significant fall in serum aspartate transaminase, serum immunoglobulins, and liver copper concentrations. On follow-up liver biopsy 12-72 months (median 33) after joining the study, 21% of penicillamine-treated patients had less pronounced inflammation and piecemeal necrosis, whereas there had been no improvement in patients on placebo (p less than 0.02). Penicillamine did not retard the histological evolution of the liver disease from the early prefibrotic stages to the late fibrotic or cirrhotic stages. Both the copper-chelating and immunological effects of penicillamine are probably important in improving survival. The excellent prognosis of patients with PBC in its early histological stages, and the failure of penicillamine to prevent histological progression from early to late stages, suggests that penicillamine treatment should not be given to patients with PBC in the early (stage 1 or 2) histological phase of the disease. Penicillamine treatment is recommended in patients once liver biopsy has demonstrated histological results typical of late stage 3 or 4 PBC.

Hair copper in primary biliary cirrhosis.

Rats fed on a copper-enriched diet develop increased liver copper concentrations, which correlate well with hair copper content. It has been suggested that in man, hair copper analysis may be a useful noninvasive method for predicting liver copper concentrations. We have tested this hypothesis in 11 patients with primary biliary cirrhosis, a disease complicated by the accumulation of copper in the liver. Ten patients had increased liver copper concentrations, but only one had increased hair copper. In primary biliary cirrhosis, hair copper does not reflect liver copper content and is of no value as a biopsy material for copper analysis.

Amenorrhoea, body weight and serum hormone concentrations, with particular reference to prolactin and thyroid hormones in anorexia nervosa.

Twenty women with anorexia nervosa were investigated at varying stages during weight gain. Basal prolactin and TSH and prolactin responses to TRH were normal and unrelated to body weight. LH, FSH and 17 beta oestradiol were low in emaciated patients and rose with weight gain. There was no correlation between serum gonadotrophin and prolactin concentrations. T3 and T4 concentrations were low but T3 rose with weight gain during refeeding over 4-6 weeks, whereas T4 remained low. A positive correlation was found between the TSH response to TRH and body weight. The abnormalities in the hypothalamic-pituitary-thyroid axis were similar to those seen in a variety of chronic illnesses and appear to be unrelated to the amenorrhoea. The failure of restoration of normal function at least after short-term refeeding requires further investigation. It was concluded that the amenorrhoea in anorexia nervosa is not associated with changes in prolactin secretion but is determined primarily by changes in the hypothalamic-pituitary-gonadal axis. These changes are induced largely by nutritional factors but psychological factors may also be involved.