39 STUDY ON THE INTRADIEM ACTIVITY OF THE ADRENERGIC SYSTEM IN CIRRHOSIS.

RELATIONSHIP WITH RENIN ACTIVITY AND SYSTEMIC HAEMODYNAMICS.

M. Bernardi, F. Trevisani t C. Santini 7 R. DePalma t A. Ligabue~ M. Ba-

raldini~ G. Gasbarrini.

Patologia Medica III, Univ. of Bologna;*Lab. Analisi, Osp. M. Malpighi

Intradiem activity of the adrenergic system was investigated in 7 controls and

cirrhotics without (7) and with (9) ascites by determining urinary norepine-

phrine (UNEV) and vanylmandelic acid (UVMAY) excretions 6 hourly, while supine

Plasma renin activity (PRA), mean arterial pressure (AP), heart rate (HR) were

also evaluated 4 hourly. UNE V and UVMA V decreased at night in controls, as ex-

pected, but increased significanlty in compensated patients. Cirrhotics with

ascites had higher levels than controls through the whole day. Compensated pa-

tients had normal AP, slighty increased HR (ns) and reduced PRA (p40.05). In

cirrhotics with ascites AP was decreased and HR and PRA increased (p~O.05). AP

was never related to U V, but was inversely correlated with PRA (p<O.05) in

ascitic patients. On the contrary HR was direct function of U V both in com-

pensated and decompensated cirrhotics (p<O.05). Both catecholamine synthesis

(UvMAV) and release (UNE V) are increased in cirrhosis with ascites, but deran-

gements in the renal excretion pattern of NE and VMA are already present in

compensated patients. In spite of the increased adrenergic activity AP is de-

creased in ascitic patients and thus a possible main cause of renin release.

These data suggest a reduced vascular response to sympathetic stimulation,wh~

reas #-receptor mediated response still is preserved under steady state.

40 LIVER PERISINUSOIDAL FIBROSIS IN THE SPONTANEOUSLY DIABETIC "BB" WISTAR RAT

D. Bernuau ~ R. Guillot ° , A.M. Durand-Schneider , P. Poussier °° , A. Moreau, G. Feldmann INSERM U 24, HSpital Beaujon, Clichy, "Laboratoire d'Embryologie, UER Biom~dicale des

Saints-P~res, Paris, France and °"Nutrition & Food Sciences Center, Royal Victoria Hospital, Montreal, Quebec, Canada.

Perisinusoidal fibrosis has been described in the liver of patients with insulin-dependent diabetes. To investigate further the relationship between this lesion and type I diabetes, we studied the structure of liver sinusoids in a genetically susceptible strain of rats, the "BB" Wistar rats, which develop a spontaneous diabetes strikingly similar to human type I diabetes. Fourteen "BB" Wistar rats, 7 with insulin-treated diabetes (group I) and 7 without diabetes (group II), and 7 control "non BB" Wistar rats, were studied. Light and electron microscopic examination of liver samples was performed. Sami-quantitation of abnormalities of the sinusoi- dal collagen framework was made on trichrome-stained sections. The point-counting method was used to quantify perisinusoidal fibrosis at the ultrastructural level. All control "non BB" Wistar rats had a normal liver at the optical and ultrastructural levels ; collagen fibers occupied 1.75 ± 0.24 % of the sinusoidal volume. Eleven (78 %) "BB" Wistar rats (6 rats of group I and '5 rats of group II) displayed localized thickenings of the sinusoids, with ultras- tructurally abundant perisinusoidal deposits of collagen fibers, and elevated percentages of collagen fibers per sinusoid unit (3.16 to 12.32 %) compared to controls. Fibrous septae (2 rats in group I and 5 rats in group IX) and cirrhosis (2 rats in group I) were also visible. Three "BB" rats were normal.

In summary, liver perisinusoidal fibrosis is a frequent lesion in "BB" Wistar rats. Septum formation and cirrhosis may also be found. These lesions are strain-related, and clearly inde- pendent of the presence of diabetes. Liver perisinusoidal fibrosis in patients with type I diabetes might likewise represent a distinct, genetically-dependent collagen abnormality.

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