CLINICAL CHEMISTRY Original Article Erythrocyte Antioxidant Activity, Serum Ceruloplasmin, and Trace Element Levels in Subjects with Alcoholic Liver Disease GIANCARLA GERLI, M.D., 1 GIOVANNI F. LOCATELLI, M.D., 1 RENATO MONGIAT, M.D., 1 LUCA ZENONI, M.D., 1 ANGELO AGOSTONI, M.D., 1 GIULIANO MOSCHINI, PH.D., 2 DEMETRE ZAFIROPOULOS, PH.D., 3 SAVINO BRUNO, M.D., 4 SONIA ROSSI, M.D., 4 ALBERTO VIGNATI, M.D., 5 GIANLUIGI TAROLO, M.D., 5 AND MAURO PODDA, M.D. 4 Erythrocyte antioxidant enzymes (superoxide dismutase, cata- lase, glutathione peroxidase) and reduced glutathione, serum ce› ruloplasmin, and serum trace elements (copper, zinc, iron, and selenium) related to antioxidant enzymes were assayed in subjects with alcoholic liver disease of different degrees of severity. The erythrocytes of subjects with moderate and severe alcoholic liver cirrhosis had an unbalanced antioxidant system (normal super› oxide dismutase, low catalase and glutathione peroxidase activ› ities, and low glutathione content). Serum ceruloplasmin levels were in the normal range. Levels of the serum trace elements zinc and selenium were significantly low in subjects with moderate Researchers have demonstrated strong evidence that re› active oxygen species are important in the genesis of al› coholic liver cirrhosis because they cause membrane lipid peroxidation. 1 Studies in humans and animals have shown that alcoholic liver damage is due to increased production of oxygen free radicals and to decreased defense mecha› nisms. 2 Malonyldialdehyde production in liver biopsy specimens of human alcoholic subjects is high. 3 Rats fed ethanol showed increased microsomal production of su› peroxides and peroxides. 4 Experiments in baboons that were fed alcohol chronically demonstrated high levels of hepatic lipid peroxidation (measured as diene conjugate formation) and depleted levels of hepatic glutathi› one (GSH). 2 From the ’Clinica Medica, "Cattedrd di Medicina Interna, and i Medicina Nucleare. Universita di Milano, Ospedale San Paolo, Italy; 2 Dipartimento di Fisica, Universita di Padova; and the 3 Laboratori Na- zionali, Istitulo Nazionale di Fisica Nucleare, Legnaro, Padova, Italy. Received May 24, 1991; received revised manuscript and accepted for publication September 30, 1991. Address reprint requests to Dr. Gerli: Clinica MedicaUniversit a di Milano, Ospedale S. Paolo, Via di Rudini 8, 20142 Milano, Italy. and severe cirrhosis, whose red cell half-life was also significantly short, as measured by radioactive chromium. These data suggest that the erythrocytes of subjects with moderate and severe al› coholic liver cirrhosis are less protected against oxidant stress. The particular erythrocyte antioxidant system and serum trace element pattern may play a role in the genesis of hemolytic dis› orders and of alcoholic hepatic damage. (Key words: Alcoholic liver disease; Ceruloplasmin; Catalase; Glutathione peroxidase; Reduced glutathione; Serum trace elements; Superoxide dis› mutase) Am J Clin Pathol 1992; 97:614-618 It has been suggested that the erythrocytes of subjects with alcoholic liver disease may be involved in oxidant damage and may be more sensitive to oxidant stress as a consequence of well-known structural and metabolic ab› normalities. In fact, changes in membrane lipid compo› sition due to the altered cholesterol/phospholipid mole ratio have been described. 5 In addition, impairment of the methylene blue-stimulated hexose monophosphate shunt, Heiriz body formation, and low levels of GSH have been reported. 6 Our aim was to study the antioxidant system in eryth› rocytes and sera of patients with alcoholic cirrhosis to evaluate its possible relationship to hemolytic disorders. MATERIAL AND METHODS Subjects The following subjects were studied: 21 patients, 17 men and 4 women, aged 30 to 61 years, with alcoholic liver disease with no cirrhosis; 73 patients, 54 men and 19 women, aged 30 to 77 years, with alcoholic liver cir- 614 Downloaded from https://academic.oup.com/ajcp/article-abstract/97/5/614/1792701 by guest on 28 July 2018