483
Clinica Chimica Acta, 95 (1979) 483-486 @ Else~er/No~h-Holland Biomedical Press
CCA 1057
PLASMA GAMMA-GLUT~YL
TRANSPE~IDASE
J.P. COLOMBO
COLOMBO
at* and JACQUELINE
IN HEROIN
ADDICTS
b
a Chemisches Zentrallabor der Universitiitskliniken, Inselspital, and b Sozialpsychiatrische U~iversit~tskZinik, Universitiit Bern, Berne (Switzerland) (Received
February
15th, 1979)
Summary Plasma y-glutamyl transpeptidase was measured in 25 heroin addicts. The purpose was to find out if the long term administration of heroin would lead to a stimulation of GGTP due to the detoxication of this drug in the endoplasmatic reticulum of the liver. In 10 patients the elevation of GGTP could be attributed to liver damage, since other liver enzymes were also increased. 15 patients had normal GGTP activities, in 4 of them accompanied by minor elevations of single other hepatic enzymes. In 11 patients the GGTP activity as well as that of the other enzymes was normal despite heavy chronic heroin abuse. It is therefore improbable that GGTP can be used to diagnose abuse of this drug and to evaluate the progress of drug detoxication treatments and drug abstention as has been proposed in chronic alcoholism.
Introduction An elevation of plasma glutamyl transpeptidase (EC 2.3.2.2, GGTP) is found in hepatobiliary disorders [ 11, chronic alcoholism [ 2-41 and after administration of certain ph~acolo~cal agents [5] as e.g. anticon~s~t drugs, phenobarbital, aminopyrine and antipyrine [ 6,7 ] . The present study was undertaken to see whether the use of narcotic drugs such as heroin lead to similar changes of GGTP in plasma. Patients
and methods
25 patients (20 males, 5 females, aged 18 to 24 years) attending the “counselling center for drug addicts” of the psychiatric outpatient clinic were + Correspondence should be addressed to: Professor J.P. Colombo. Chemisches Zentrallabor der Universit&skliniken, Inselspital, CH-3010 Beme. Switzerland.
examined. They were all chronic drug addicts, injecting heroin intravenously several times a day over a period of up to three years. The daily dosage was approx. 1-3 g (highest degree of purity 4056, impurities mostly sucrose or lactose). Since the patients attended the “counselling center” irregularly, only one blood sample could be taken. The majority of the patients refused an urinary drug examination. Only 3 of the patients were aware of having had an episode of jaundice. The blood taken was anticoagulated with ammonium heparinate. The following enzymes were determined in the plasma: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), glutamate dehydrogenase (GLDH), leucine aminopeptidase (LAP) [ 81 and GGTP [9]. The preparation and fractionation of a rat liver homogenate was done according to the methods of De Duve et al. [lo]. The protein was determined according to Lowry et al. [ 111. Results 10 of the 25 individuals showed increased levels of GGTP activity in plasma. All these cases also had an elevation of the two aminotransferases and several other enzymes (Table I). TABLE
I
-y-GLUTAMYL ADDICTS
TRANSPEPTIDASE
AND
OTHER
LIVER
ENZYMES
IN THE PLASMA
OF 25 DRUG
Enzyme activities in U/I. Reference values from Ref. 18. N = normal. Patient
GGTP
Referencevalue.5
4-18 6-28
R.W. L.H. K.G. K.R. H.H. L.C. * H.H. I.M. B.B. H.H.P.
127 40 136 62 34 25 49 31 39 112
62 20 31 26 33 28 79 23 50 84
221 37 75 82 70 52 186 68 124 116
15 17 8 7 8 14 12 9 7 28 25 7 11 17 5
1 12 23 6 13 10 16 14 16 12 179 17 14 17 12
9 38 36 9 7 14 34 16 17 17 160 22 16 8 10
F.D. H.M. A.C. Z.H. B.G. F.G. M.H. R.U. C.M. H.F. B.O. H.R. G.B. F.U. W.G.
*
*
*
* *
Women.
AST *
5-15 5-17
AP
ALT *
5-19 5-23
*
GLDH
LAP
Clinica Chimica Acta, 95 (1979) 483-486 @ Else~er/No~h-Holland Biomedical Press
CCA 1057
PLASMA GAMMA-GLUT~YL
TRANSPE~IDASE
J.P. COLOMBO
COLOMBO
at* and JACQUELINE
IN HEROIN
ADDICTS
b
a Chemisches Zentrallabor der Universitiitskliniken, Inselspital, and b Sozialpsychiatrische U~iversit~tskZinik, Universitiit Bern, Berne (Switzerland) (Received
February
15th, 1979)
Summary Plasma y-glutamyl transpeptidase was measured in 25 heroin addicts. The purpose was to find out if the long term administration of heroin would lead to a stimulation of GGTP due to the detoxication of this drug in the endoplasmatic reticulum of the liver. In 10 patients the elevation of GGTP could be attributed to liver damage, since other liver enzymes were also increased. 15 patients had normal GGTP activities, in 4 of them accompanied by minor elevations of single other hepatic enzymes. In 11 patients the GGTP activity as well as that of the other enzymes was normal despite heavy chronic heroin abuse. It is therefore improbable that GGTP can be used to diagnose abuse of this drug and to evaluate the progress of drug detoxication treatments and drug abstention as has been proposed in chronic alcoholism.
Introduction An elevation of plasma glutamyl transpeptidase (EC 2.3.2.2, GGTP) is found in hepatobiliary disorders [ 11, chronic alcoholism [ 2-41 and after administration of certain ph~acolo~cal agents [5] as e.g. anticon~s~t drugs, phenobarbital, aminopyrine and antipyrine [ 6,7 ] . The present study was undertaken to see whether the use of narcotic drugs such as heroin lead to similar changes of GGTP in plasma. Patients
and methods
25 patients (20 males, 5 females, aged 18 to 24 years) attending the “counselling center for drug addicts” of the psychiatric outpatient clinic were + Correspondence should be addressed to: Professor J.P. Colombo. Chemisches Zentrallabor der Universit&skliniken, Inselspital, CH-3010 Beme. Switzerland.
examined. They were all chronic drug addicts, injecting heroin intravenously several times a day over a period of up to three years. The daily dosage was approx. 1-3 g (highest degree of purity 4056, impurities mostly sucrose or lactose). Since the patients attended the “counselling center” irregularly, only one blood sample could be taken. The majority of the patients refused an urinary drug examination. Only 3 of the patients were aware of having had an episode of jaundice. The blood taken was anticoagulated with ammonium heparinate. The following enzymes were determined in the plasma: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (AP), glutamate dehydrogenase (GLDH), leucine aminopeptidase (LAP) [ 81 and GGTP [9]. The preparation and fractionation of a rat liver homogenate was done according to the methods of De Duve et al. [lo]. The protein was determined according to Lowry et al. [ 111. Results 10 of the 25 individuals showed increased levels of GGTP activity in plasma. All these cases also had an elevation of the two aminotransferases and several other enzymes (Table I). TABLE
I
-y-GLUTAMYL ADDICTS
TRANSPEPTIDASE
AND
OTHER
LIVER
ENZYMES
IN THE PLASMA
OF 25 DRUG
Enzyme activities in U/I. Reference values from Ref. 18. N = normal. Patient
GGTP
Referencevalue.5
4-18 6-28
R.W. L.H. K.G. K.R. H.H. L.C. * H.H. I.M. B.B. H.H.P.
127 40 136 62 34 25 49 31 39 112
62 20 31 26 33 28 79 23 50 84
221 37 75 82 70 52 186 68 124 116
15 17 8 7 8 14 12 9 7 28 25 7 11 17 5
1 12 23 6 13 10 16 14 16 12 179 17 14 17 12
9 38 36 9 7 14 34 16 17 17 160 22 16 8 10
F.D. H.M. A.C. Z.H. B.G. F.G. M.H. R.U. C.M. H.F. B.O. H.R. G.B. F.U. W.G.
*
*
*
* *
Women.
AST *
5-15 5-17
AP
ALT *
5-19 5-23
*
GLDH
LAP
