PRODUCTION OF PIPECOLIC ACID FROM INTESTINAL BACTERIA - PLASMA-LEVELSOF PIPECOLIC ACID IN PATIENTS WITH LIVER-CIRRHOSIS DECREASED AFTER ORAL KANAMYCIN ADMINISTRATION
Y. Matsuda et al., PRODUCTION OF PIPECOLIC ACID FROM INTESTINAL BACTERIA - PLASMA-LEVELSOF PIPECOLIC ACID IN PATIENTS WITH LIVER-CIRRHOSIS DECREASED AFTER ORAL KANAMYCIN ADMINISTRATION, HEPATOLOGY RESEARCH, 4(1), 1995, pp. 26-34
We analyzed the changes in plasma levels of pipecolic acid before and
after the oral administration of kanamycin in patients with liver cirr
hosis and investigated the relationship between plasma pipecolic acid
and clinical laboratory tests. Twenty patients received oral kanamycin
1.5-3.0 g/day for 7-14 days. Plasma levels of pipecolic acid, which w
ere determined by high-performance liquid chromatography after dansyl
derivatization, significantly decreased following kanamycin administra
tion (before 3.16 +/- 2.91 nmol/ml, after 2.37 +/- 2.48 nmol/ml; P = 0
.0002). In addition, plasma ammonia concentration also decreased, alth
ough there were no significant changes in plasma lysine and the BCAA/A
AA ratio. Plasma pipecolic acid correlated closely with plasma ammonia
concentration (P < 0.0001), but not with other hepatic function tests
such as ICGR(15), serum albumin, prothrombin time, the BCAA/AAA ratio
, lysine and serum bilirubin. Plasma levels of pipecolic acid in patie
nts with esophageal varices were significantly higher than those witho
ut esophageal varices (P = 0.032). Plasma level of pipecolic acid in a
patient with cirrhosis complicated with hepatic encephalopathy was lo
wered after kanamycin administration concomitantly with the remission
of hepatic encephalopathy. These results show that plasma pipecolic ac
id is derived in part from intestinal bacteria and is correlated with
the degrees of porto-systemic shunt volume.