Study of substance P, renin and aldosterone in chronic liver disease in Egyptian children

Abstract

Substance P is the most powerful endogenous vasodilator peptide produced by the enteric nervous system and partly cleared by the liver. Failure of the diseased liver to metabolize a vasodilator substance may be responsible for the rebound increased plasma level of vasoconstrictor intestinal peptide.

Aim: To investigate the plasma level of Substance P and to study its relationship to aldosterone and plasma renin activity changes occurring in pediatric patients with chronic liver disease.

Methods: Forty patients with chronic liver disease and 10 healthy children were tested for AST, ALT, total and direct bilirubin, creatinine, aldosterone, plasma renin activity and plasma level of Substance P.

Results: The plasma level of Substance P was increased in all patients with chronic liver disease (119.5+/-68.2 pg/ml) compared to controls (16.2+/-4.6 pg/ml). The aldosterone concentration and plasma renin activity were significantly higher in patients [(84.1+/-38.3 ng/dl) and (11.1+/-7.3 ng/ml/h)] than controls [(8.2+/-3.9 ng/dl) and (2.0+/-1.1 ng/ml/h)]. The highest level of Substance P and aldosterone were observed in glycogen storage disease patients.

Conclusion: Substance P was found to be increased in chronic liver disease patients; this increase was accompanied by an increase of aldosterone and plasma rennin activity. This correlation raises its potential use as a prognostic marker in chronic liver diseases.