Drug Metabolizing Activity in Chronic Liver Disease: A Study Using Ultrasonically-Guided Needle Biopsy

Abstract

Drug metabolizing activity in chronic liver disease was examined. In 53 patients with chronic liver disease, 7-methoxycoumarin (7-MC) 0-demethylase and 7-ethoxycoumarin (7-EC) 0-deethylase activities in liver specimens obtained by ultrasonically-guided liver biopsy were measured and compared with the elimination half-life (T1/2) of theophylline and biochemical liver function tests. Both the 0-dealkylase activities toward 7-MC and 7-EC in the liver were gradually decreased with progressive histological impairment of the liver to 32. 8% and 39. 6% of the control level, respectively, in patients with liver cirrhosis. Both the 0-dealkylase activities toward 7-MC and 7-EC in the liver inversely and exponentially correlated with the T1/2 of theophylline. These two 0-dealkylase activities correlated well with serum albumin content (Alb) , cholinesterase (ChE) , prothrombin time (PT), hepaplastintest (HPT) , cholesterol ester ratio (E/T) , zinc sulfate turbidity test (ZTT) , the ratio of branched chain amino acids to aromatic amino acids (BCAA/AAA) or indocyanine green test (ICG) , but not with GPT, LAP or total cholesterol. These findings indicate that the activity of drug metabolizing enzymes reflect hepatic functional capacity, and the measurement of these activities in specimens obtained by liver biopsy is useful for the clinical estimation of liver functions.