Liver Pathophysiology: Its Revelance to Human Disease

Abstract

Relating high serum levels of fetoglobulin to hepatoma, Australia antigen to serum hepatitis, and lithocholate to alcoholic hepatitis and cirrhosis, Dr. Davidson details recent concepts of the liver's responses to injury and disease. The test for fetoglobulin, he notes, facilitates curative resection of solitary hepatomas. Finding the Australia antigen identifies acute, and perhaps chronic, serum hepatitis. And reducing lithocholate formation and absorption, with antibiotics and cholestyramine, may benefit cirrhotic patients. Nor does Davidson slight the long-established tests for hepatic injury. He considers the cephalin flocculation and thymol turbidity tests valuable indicators of hepatocellular disease and discusses the autoimmune phenomena distinguishing primary biliary cirrhosis and chronic hepatitis. High concentrations of γ-globulin (where most antibodies reside), frequently positive LE cell tests, and antibodies to tissues including liver, denote altered immune mechanisms. However, he finds that suppressing the immune responses of patients with chronic hepatitis (with adrenal steroids, azathioprine, and mercaptopurine) is temporarily