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Critical appraisal of 13 C breath tests for microsomal liver function: aminopyrine revisited
Author(s) -
Pijls Kirsten E.,
Vries Hanne,
Nikkessen Suzan,
Bast Aalt,
Wodzig Will K. W. H.,
Koek Ger H.
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12451
Subject(s) - breath test , fatty liver , liver function tests , microsome , liver biopsy , liver function , cirrhosis , medicine , liver disease , gastroenterology , enzyme , chemistry , disease , biochemistry , biopsy , helicobacter pylori
Abstract As liver diseases are a major health problem and especially the incidence of metabolic liver diseases like non‐alcoholic fatty liver disease ( NAFLD ) is rising, the demand for non‐invasive tests is growing to replace liver biopsy. Non‐invasive tests such as carbon‐labelled breath tests can provide a valuable contribution to the evaluation of metabolic liver function. This review aims to critically appraise the value of the 13 C‐labelled microsomal breath tests for the evaluation of metabolic liver function, and to discuss the role of cytochrome P450 enzymes in the metabolism of the different probe drugs, especially of aminopyrine. Although a number of different probe drugs have been used in breath tests, the perfect drug to assess the functional metabolic capacity of the liver has not been found. Data suggest that both the 13 C 2 ‐aminopyrine and the 13 C‐methacetin breath test can play a role in assessing the capacity of the microsomal liver function and may be useful in the follow‐up of patients with chronic liver diseases. Furthermore, CYP 2C19 seems to be an important enzyme in the N ‐demethylation of aminopyrine, and polymorphisms in this gene may influence breath test values, which should be kept in mind when performing the 13 C 2 ‐aminopyrine breath test in clinical practice.