Liver Pathology: Enzyme Analysis and Patient Case Studies

This report examines the liver's crucial role and the impact of various conditions on its function. It focuses on three patient cases: an alcoholic, an obese individual, and a patient with heart failure, all exhibiting symptoms of liver damage. The report details the biochemical processes involved, such as the role of hepatic macrophages, lipid peroxidation, and the effects of obesity on liver metabolism and immune function. It also explores the connection between heart failure and liver damage, discussing the impact of reduced oxygenation and increased pressure on the liver. The report then outlines the use of liver function tests, including ALT, AST, bilirubin, and albumin tests, for diagnosing liver diseases and monitoring patient conditions. Finally, the report concludes by summarizing the various tests and their expected results for each patient, emphasizing the importance of these tests in assessing and determining the health conditions of the liver and providing appropriate medical interventions. The report highlights that liver diseases can occur through alcohol, obesity and heart failure.

THE LIVER AND ITS ENZYMES IN
PATHOLOGY

Table of Contents
INTRODUCTION...........................................................................................................................1
TASK ..............................................................................................................................................1
1........................................................................................................................................................1
2........................................................................................................................................................1
3........................................................................................................................................................2
PART 2 ...........................................................................................................................................2
CONCLUSION ...............................................................................................................................3
REFERENCES ...............................................................................................................................4

INTRODUCTION
Liver is very important organ of the human body and functioning of liver can be greatly
impaired in various conditions. It is essential that functioning of liver should be maintained so
that smooth functioning of human body should be ensured.
TASK
1
There are 3 different patients naming Mr X, Y and Z. They all are exhibiting symptoms
that are associated with the liver damage. Blood and urine samples of this type of patients is
taken so that necessary medical analysis should be performed. Mr X is alcoholic and when an
individual consumer alcohol than chronic exposure towards alcohol lead towards activating
Hepatic Macrophages which is a third site of metabolism (Sebrell, and Harris,eds., 2014). It
produces TNF-ALPHA and it induces reactive oxygen species in the body tissue mitochondria.
People who regularly consumes Alcohol are having deficiency of antioxidants and it includes
Vitamin E and Glutathione (Liver. 2017.).
These type of patients are subjected towards hepatocyte necrosis and stress level
promotes apoptosis in this type of patients. Lipid peroxidation is also induced among these
patients and it causes fibrosis and inflammation. Alcoholic patients are more prone towards liver
damage and due to this they face issues such as liver damage. Free radicals that are produced in
this process creates lipid peroxidation. In the whole process when cellular proteins are bound
together with the metabolic acetaldehyde than due to that antigenic adducts are produced. It
creates and induces inflation in the body and due to that functioning of intestinal mucosa is
affected. It aid for production of endotoxaemia and hepatic inflammation is created in the
patients.
2
Mr Y is suffering from obesity and it is the cause behind liver damage. Alcoholic liver
disease are major cause that lead towards creating fibrosis and cirrhosis. Due to obesity
malfunctioning of liver occurs and metabolic dysfunctionality occurs in the individual (Zachary,
and McGavin, 2013). Organ dysfunctionality also occurs and cardiac, intestinal, insulin resistant
and anti inflammatory diseases are caused due to this. Due to obesity immune dysfunctions also
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occurs and it is the major cause behind cancers which includes hepatocellular colon and
esophageal cancer.
Metabolic functioning of liver also gets affected and thus due to it overall functioning of human
body gets affected. Cellular metabolism of the body gets affected and with this energy
homeostasis in the human body also gets affected. This type of conditions also contributes for the
insulin resistance in the body. Obesity also creates secretion of cytokines which is the major
contributor towards vascular dysfunction of the human body.
3
Heart failure is the major cause of death among individuals and due to that also liver
damage in individual occurs. Along with this, obesity is also a major cause associated with the
heart failure and it is the major risk factor for cardiovascular diseases. Right side pressure on
liver increases and due to that patients suffering from such diseases are having lower arterial
oxygenations (Rouiller, ed., 2013.). This type of patients are also having difficulties in dramatic
infestation of liver diseases and diseases including hypoxic hepatitis occurs due to pulmonary
conditions.
Heart failure is characterized by inability shown by heart for meeting the metabolic
demand of the human body. Dysfunction of cardiac also lead towards creating irregular supply of
the oxygen in the human body. Heart failure is also symbolized by dysfunction of cardiac pump
and due to this low cardiac output is received as a result. The pathophysiology that is associated
with the hepatic functioning is increasing filling pressure in the heart and due to this central
venous pressure increases in the human body. In addition of that it causes elevation of liver
enzymes and direct and indirect serum bilirubin the human body. Impaired perfusion in the
cardiac output rate is the major cause behind the as a consequences of this paired perfusions
occurs.
PART 2
Liver function test are performed for assessing and determining the health conditions of
liver. In liver test level of proteins, enzymes, billrubin and other liver enzymes in the liver and it
also helps for identifying diseases and health issues in the liver (Battelli, Bolognesi and Polito,
2014). Liver function test are performed in the situation for screening out the liver infections that
might occur due to several reasons. Liver test also aid for monitoring the side effects that occurs
due to the medications that have been provided to the patient.
2

If individuals are suffering from any liver diseases than also tests are performed.
Monitoring of diseases and measure of degree of cirrhosis on the liver is measured (Balmer, and
et.al, 2014.). There are various types of tests that are performed on liver and most commonly
used test includes ALT and AST test. Alanine Transaminase (ALT) and Asparate
aminotransferase (AST) are most commonly performed test. Mr X, Y and Z are subjected to this
tests so that their actual health conditions could be identified and on the basis of that medication
could be provided to them. In addition to that Bilirubin and Albumin test are also performed by
the doctor for assessing how well the liver is producing Albumin, protein and Bilirubin. In all the
cases different types of results are expected by the doctor which are as follows :-
Mr X :- Alanine transaminase test will be performed by the doctor and this test is performed by
the body to metabolize protein. In case of Mr X high results in this test are expected which will
be reflecting high sign of liver damage.
Mr Y :- Asparate Aminotransferase test will be performed and in this test probability of gaining
higher results in case of Mr Y is higher. High results in AST results will be indicating problems
in the liver muscles and tissues.
Mr Z :- Alkaline Phosphate test and Albumin test will be performed by the doctors and in this
case also probability of gaining liver diseases are high.
CONCLUSION
Summing up the present report it can be concluded that liver diseases can occur through
alcohol, obesity and heart failure. There are various types of test that are performed for assessing
the liver damage and it comprise of Asparate aminotransferase test, Alkaline phosphate test and
albumin test.
3

REFERENCES
Books and journals
Balmer, M.L. and et.al2014. The liver may act as a firewall mediating mutualism between the
host and its gut commensal microbiota.Science translational medicine. 6(237). pp.237ra66-
237ra66.
Battelli, M.G., Bolognesi, A. and Polito, L., 2014. Pathophysiology of circulating xanthine
oxidoreductase: new emerging roles for a multi-tasking enzyme.Biochimica et Biophysica
Acta (BBA)-Molecular Basis of Disease. 1842(9). pp.1502-1517.
Rouiller, C. ed., 2013.The liver: morphology, biochemistry, physiology. Academic Press.
Sebrell, W.H. and Harris, R.S. eds., 2014.The vitamins: chemistry, physiology, pathology,
methods. Academic Press.
Zachary, J.F. and McGavin, M.D., 2013.Pathologic Basis of Veterinary Disease-E-Book.
Elsevier Health Sciences.
Online
Liver. 2017. [Online ]. Available through: <https://www.ncbi.nlm.nih.gov/pubmed/>.
[Accessed on 7 July , 2017].
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