The Correlation Between Liver Cirrhosis and Lactic Acidosis
The Correlation Between Liver Cirrhosis and Lactic Acidosis
Lactic acid is an organic compound which produces the conjugate base lactate through a dissociation reaction. Due to it being a chiral compound, two optical isomers of lactate exist; D-Lactate and L-Lactate. The lactate dehydrogenase (LDH) enzyme can produce and metabolise both isomer forms to pyruvate, however due to the isomer-specific nature of LDH different forms of the enzyme are required. D-Lactate requires a D-LDH form whereas L-Lactate requires L-LDH. As a result of this requirement, combined with the fact that mammalian cells only contain L-LDH, the lactate produced in humans is almost exclusively L-Lactate.
One of the roles of L-Lactate is its involvement in the Cori Cycle, a metabolic pathway involved in the production of glucose. The cycle involves the rotatory transportation of lactate and glucose from the liver and the muscle. Lactate is produced in the muscle through glycolysis which is then transported to the liver through the blood stream. In the liver, the lactate is oxidised to pyruvate and then converted to glucose by gluconeogenesis, which is then transported back to the muscle for the process to start again. 1500 mmol of lactate is produced daily by the body and is cleared at a constant rate via the liver.
Problems can arise if the liver fails to regulate the lactate produced. Hyperlactamia is the name given to elevated levels of lactate in the body, as a result of the rate of production exceeding the rate of disposal. This is due to a lack of oxygen that reduces blood flow to the tissues. If levels continue to rise a patient is at risk of lactic acidosis.
The liver is an important tissue in the regulation of lactate, it is therefore no surprise that liver damage can prevent this process resulting in a further diagnosis of lactic acidosis. A healthy liver is a vital part of lactate regulation as it acts as the main consumer of lactate and contributes to 30-40% of lactate metabolism. Potential victims are patients who suffer with cirrhosis, a complication of liver disease, which is commonly caused by alcohol abuse and viral Hepatitis B and C.
Patients with liver cirrhosis have a higher risk of increased lactate levels. Increased levels of the lactate ions disturbs the acid-base equilibrium, causing a tilt towards lactic acidosis. The mortality rate of patients who develop lactic acidosis is high, prompt recognition and treatment of the underlying cause remain the only realistic hope for improving survival.
The Randox L-Lactate reagent allows for a prompt and accurate diagnosis of lactic acidosis.
Randox L-Lactate Reagent
The Randox L-Lactate key benefits include:
- Excellent working reagent stability of two weeks when stored at + 15 – +25°C
- Exceptional correlation of r = 0.99 when compared against other commercially available methods
- A wide measuring range of 0.100 – 19.7 mmol/l and so is capable of detecting abnormal levels in a sample
Other features:
- Colorimetric method
- Lyophilised reagents for enhanced stability
If you are a clinician or laboratory who are interested in running assays for Lactic Acidosis or Liver Disease, Randox offer a range of high-quality routine and niche assays including:L- Lactate, Ethanol, Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Albumin which can be used to diagnose conditions commonly affecting the liver. These assays can be run on most automated biochemistry analysers.
Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers. Contact us to enquire about your specific analyser.
For more information, visit: https://www.randox.com/lactate/ or email: reagents@randox.com
Sri Lanka taking measures to tackle the opium abuse crisis
Cannabis continues to be the most reported drug abused in Sri Lanka, however cannabis related offences have decreased from 66.2% to 61.9% in April – May 2018. Heroin is the second highest drug abused at 28.8% of those arrested in April and 35.9% of arrestees in May engaging in heroin related offences. Hashish, babul, madana modaka, opium, methamphetamine and tablets are other prevalent drugs abused in Sri Lankan drug related offences that have been noted. Although cannabis related crime has decreased, drug prevalence and drug related offences are increasing in the country.
Sri Lanka has been taking measures to tackle the abuse of opium, cannabis and certain psychotropic substances since its independence in 1948. Opium is not cultivated in Sri Lanka, however over the past decade Sri Lanka has been used as a trans-shipment point for heroin from South West Asia and India to other destinations outside of the subcontinent. Heroin seized prior to reaching Sri Lanka is roughly two – three times the quantity of heroin seized in Sri Lanka itself.
Randox Toxicology are the leading manufacturer of the patented Biochip Array Technology (BAT). BAT is a precision multiplex testing platform allowing for the simultaneous quantitative or qualitative detection of a wide range of analytes from a single sample. After the addition of a sample to the biochip, analytes present in the sample bind to the specific biochip bound ligands. The degree of binding is determined using a chemiluminescent light source and quantified using a Charge Coupled Device (CCD) camera and imaging system.
Additionally, our range of immunoanalysers include the Evidence, the Evidence Evolution, the Evidence Investigator and the Evidence MultiSTAT which individually utilise our Biochip Array Technology for the screening of drugs of abuse. Our extensive toxicology test menu covers a broad range of classical, prescription, synthetic drugs and new psychoactive substances. With multiple matrices available, Randox Toxicology are a global leader in the Toxicology market.
Randox Toxicology offer the most comprehensive Drugs of Abuse (DoA) test menu across multiple forensic matrices. Our DoA II panel can detect opium and generic opioids. Our level of expertise in toxicology research and development allows us to adapt quickly to ever changing market influences and develop assays for current and novel drug trends.
To find out more about the DoA II panel and our other available test menus, email info@randoxtoxicology.com or visit randoxtoxicology.com.
