LIVER-REGENERATION IN FULMINANT-HEPATITIS AS EVALUATED BY SERUM TRANSFORMING GROWTH-FACTOR-ALPHA LEVELS

Transforming growth factor alpha (TGrF alpha) is supposed to act as a mitogen for hepatocytes in an autocrine manner in vitro and in vivo. R etarded liver regeneration is a possible reason for poor prognosis of fulminant hepatitis (FH), We analyzed serum TGF alpha levels in patien ts with FH and patients with acute nonfulminant hepatitis (AH), Also, the relation of those levels to serum hepatocyte growth factor (HGF) l evels and their changes after glucagon-insulin (G-I) therapy were stud ied, Maximal serum TGF alpha levels achieved in each case after admiss ion until recovery from disease or death were correlated positively wi th maximal serum alanine transaminase (ALT) and total bilirubin levels in patients with AH, but negatively with maximal total bilirubin leve ls in patients with FH, Maximal serum TGF alpha levels in patients wit h FH were significantly higher in survivors than in nonsurvivors, Maxi mal serum HGF levels were positively correlated with maximal serum TGF alpha levels in patients with AH, but not in patients with FH, Multip le regression analysis indicated that G-I therapy was related to the i ncrement of serum TGF alpha levels in patients with FH, These results suggest that serum TGF alpha levels are increased in accordance with L iver regeneration after necrosis in patients with AH, but such liver r egeneration may be retarded, depending on the extent of Liver damage i n patients with FH. G-I therapy seems to stimulate liver regeneration after liver damage, The possible contribution of TGF alpha and HGF to liver regeneration merits consideration for recovery hom AH.