Content of Hepatic Reduced Glutathione in Chronic Alcoholic Patients: Influence of the Length of Abstinence and Liver Necrosis

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Abstract
The relationship between the content of hepatic reduced glutathione (GSH) and the length of abstinence was investigated in 45 chronic alcoholic patients. Hepatic GSH levels were significantly correlated (r = 0.58; P < 0.001) with the length of alcohol withdrawal in the whole group. According to liver histology, patients were divided into 2 groups with and without hepatic necrosis. Subjects without necrosis showed a significant positive corelation (r = 0.71; P < 0.001) between GSH values and the length of abstinence; no correlation (r = -0.22; P < 0.40) was observed in the group with necrosis. According to the period of abstinence, patients were separated into 2 groups, with a short (.ltoreq. 5 days) and a prolonged (> 5 days) alcohol withdrawal. Patients with and without necrosis exhibited comparable mean levels of liver GSH (2.04 .+-. SEM [standard error of the mean] 0.21 and 1.74 .+-. 0.23 .mu.mol/g, respectively; P < 0.30) when studied after short periods of abstinence. Alcoholics without liver necrosis showed significantly higher hepatic GSH levels than those with necrosis (3.23 .+-. 0.30 and 1.60 .+-. 0.33, respectively; P < 0.01) after prolonged periods of alcohol withdrawal. Similar results were obtained when liver GSH levels were expressed as a function of the mean surface area of hepatocytes, which was not significantly different between patients with and without hepatic necrosis. Parameters assessing the nutritional status of patients with and without necrosis were not significantly different. Steatosis, histologically scored and irrespective of the period of abstinence, was higher in patients with liver necrosis and it did not correlate with hepatic GSH (r = -0.17; not significant). Fibrosis was observed in 20 cases and it did not modify the positive correlation between liver GSH content and the period of abstinence (with fibrosis: r = 0.57; P < 0.01; without fibrosis: r = 0.58; P < 0.01). The changes observed in liver GSH content might be of pathogenic importance in alcoholic liver disease through alterations in lipoperoxidative processes in the hepatocyte.