Blood viscosity and red cell morphology in subjects suffering from cirrhosis before and after treatment with S-Adenosyl-L-Methionine (SAM)

Alterations of fluidity of the hepatocytic membrane and of the transport re lated systems are the basis of the cholesteatic syndrome and favour the tis sue accumulation of cytotoxic metabolites. S-Adenosyl-L-Methionine (SAM) is a natural molecule which acts as a giver of methylic groups and as an enzy matic activator in several enzymatic actions of transmethylase and of trans ulphuration and plays a key role in biochemical processes of hepatic cell. The aim of our study was to evaluate the effects of SAM on the restoration of the membrane fluidity and on the hepatic function in general. In studyin g the fluidity of the cell membrane we evaluated some hemorheological param eters (total blood viscosity and red cell morphology). Fluidity of the red cell membrane is one of the most important elements of red cell rheology. W e studied 15 patients (Group A) suffering from micro- and macro-nodular cir rhosis verified through hepatic biopsy, with alcoholic or post-viral causes . We evaluated the values of: blood viscosity (with a cone-plate rheometer by Carri-med), haematocrit, plasma fibrinogen and the erythrocytic morpholo gy at the optical microscope with the Zipursky-Forconi method before and af ter 7 days of therapy with SAM iv. Data were compared with those of a simil ar group (Group B) treated with traditional therapy only (hyposodic and hyp oprotein diet supplemented with multivitamin preparations, vitamin K in par ticular, if necessary, and potassium sparing diuretics). We also measured b iliary salts, alkaline phosphatase, transaminase and gamma-GT. In the first group we observed a statistically significant reduction of blood viscosity , haematocrit didn't change significantly; biliary salts reduced in a stati stically significant way. Evaluation of red cell morphology showed in all c ases a pathological percentage (> 15%) of echinocytes and knizocytes which reduced to a mean of 5% after SAM therapy. We observed no further modificat ions of the other hemorheological parameters. Results demonstrate that SAM has a positive action on the fluidity of the membrane, as indicated by the improvement of haemorheological parameters and by the significant decrease of biliary salts, indicating the presence of cholesteasis.