ABSENCE OF ANTI-TRIFLUOROACETATE ANTIBODY AFTER HALOTHANE ANESTHESIA PATIENTS EXHIBITING NO OR MILD LIVER-DAMAGE

It has been shown that the circulating antibodies, which bind to rat h epatic microsomal proteins obtained after in vivo exposure to halothan e, are detectable by immunoblotting in patients with ''halothane hepat itis (HH),'' and that rabbit immunized anti-sera against trifluoroacet ylated rabbit serum albumin (TFA-RSA) recognizes rat microsomal distor ted polypeptides in almost the same way as do sera from patients with HH. In this paper, we report first the development of a novel method o f synthesizing TFA-RSA using p-nitrophenyl TFA, and second the results of tests for circulating anti-TFA antibodies in the serum of 86 patie nts who had received halothane anaesthesia and developed no (67 patien ts) or mild (19 patients, the maximum activity of serum alanine aminot ransaminase 519 IU.L(-1)) liver damage. Serum was selected from stored sera of post-transfusion patients. The new method of synthesizing TFA -RSA war convenient and was able to be done at neutral pH. Rabbit sera obtained after immunization with the newly synthesized TFA-RSA recogn ized the same polypeptides (109 kDa, 92 kDa, 80 kDa, 76 kDa, 64 kDa an d 59 kDa) as the established anti-sera against TFA-RSA, and there reac tions were inhibited in the presence of TFA-lysine. Circulating antibo dies were not detected in our patients who had developed no or mild li ver damage. The present finding supports the hypothesis that the appea rance of circulating antibodies against microsomal distorted proteins are specific to patients with HH. Furthermore, we have shown here that the halothane-induced mild increase in ALT activity is not associated with the appearance of those circulating antibodies, supporting the p athophysiological difference between HN and halothane-induced mild hep atic damage.