Effects of S-adenosyl methionine and essential phospholipids on serum biochemical parameters in simulated acute liver disease in late pregnancy

AIM: Liver diseases, developing in late pregnancy, remains a very important problem in obstetrics. In present study, the aim was to evaluate the effectiveness of monotherapy by “essential phospholipids” and by S-adenosyl methionine for simulated acute liver pathology during pregnancy using the biochemical parameters of blood serum.

STUDY DESIGN AND METHODS: Acute liver injury was simulated in rats from 15^th to 18^th day of pregnancy using tyloxapol (300 mg / kg daily). As drugs for monotherapy, Essentiale (Sanofi-Aventis, France) and Heptral (Abbott srl, Italy) were used separately and were administered to rats daily from the 16^th to the 18^th day of pregnancy (50 mg / kg and 35 mg / kg, respectively). On the 19^th day of pregnancy, blood serum biochemical parameters were analyzed.

RESULTS: In the model, the concentrations of triglycerides and cholesterol were sharply increased, which can be caused not only by the inhibitory effect of tyloxapol on the lipoprotein lipase of the lumen of blood vessels, but also by damage to liver cells with the accumulation of lipids in them. The activities of aminotransferases (ALT, AST), glutamate dehydrogenase and lactate dehydrogenase were statistically significantly increased. In healthy pregnant rats, the activity of alkaline phosphatase (ALP) decreased from 15^th to 19^th day of gestation, but under the treatment by tyloxapol in some cases the increase of ALP activity was observed. After using essential phospholipids in the model of acute liver injury, normal values of ALT and ALP activities were observed, and a significant decrease in triglycerides was revealed, which did not reach the normal values. After using S-adenosyl methionine in this model, the significant changes in blood serum parameters were not observed. By themselves, the drugs change several biochemical parameters in the serum of healthy pregnant rats. Heptral increases urea levels and Essentiale appears to increase AST activity.

CONCLUSION: The use of essential phospholipids or S-adenosyl methionine as monotherapy in a model of acute liver damage in late pregnancy has demonstrated their low efficiency. It is possible that the combined use of drugs is necessary to increase the effectiveness. The use of S-adenosyl methionine should be carried out under the control of the urea level and glutamate dehydrogenase activity in serum. While using essential phospholipids, it is advisable to control the AST activity.