PLASMA ENDOTOXIN CONCENTRATION AND ENDOTOXIN BINDING-CAPACITY OF PLASMA ACUTE-PHASE PROTEINS IN CIRRHOTICS WITH VARICEAL BLEEDING - AN ANALYSIS BY NEW METHODS

Plasma endotoxin levels in 12 cirrhotics with bleeding from oesophagea l varices and 50 cirrhotics without bleeding were measured by the chro mogenic assay after the pretreatment of sample by perchloric acid (HCl O4) and triethylamine. Endotoxin in cirrhotics with bleeding from vari ces was significantly higher than those without bleeding. In patients with bleeding, endotoxin increased for 3 days after the bleeding, firs t in the supernatant fraction and then in the precipitate fraction by HClO4 treatment. Peak plasma alpha(1)-acid glycoprotein and haptoglobi n were observed 3 days after the bleeding. Alpha 1-antitrypsin gradual ly increased for 14 days. Transferrin did not markedly change. The end otoxin-binding capacity of transferrin and alpha(1)-acid glycoprotein increased immediately after bleeding and thereafter decreased, but tha t of alpha(1)-antitrypsin tended to increase in the recovery period. I n summary, the plasma endotoxin concentration and endotoxin-binding ca pacity of alpha(1)-acid glycoprotein and transferrin were shown to hav e increased after bleeding from varices by this new method. There may be a close relationship between endotoxaemia and acute phase reaction in this situation.