The Electrophoretic Analyses of the Serum Proteins

The intimate association of the liver with the maintenance of normal serum proteins is well established. An increase in serum globulin, with inversion of the albumin-globulin ratio, is a common finding in cirrhosis of the liver, but normal serum proteins are observed frequently in the acute parenchymatous diseases of the liver like catarrhal jaundice and arsenical hepatitis (1). The serum protein fractions in cancer of the liver are quite variable. Determination of the serum proteins by the usual precipitation methods has led to the conception that the proteins may be considered normal when the serum albumin or globulin content falls within the empirically determined normal range. By electrophoretic analysis, however, the protein constituents within the serum globulin may be markedly abnormal, although their sum total by chemical analysis falls within the normal range. Electrophoretic studies by Luetscher (2) and Longsworth (3) indicate that an increase in beta and gamma globulin, associated with a decrease in albumin, occurs in cirrhosis of the liver. Only a few cases of liver cirrhosis were studied, and most of these investigations were made in the advanced stages of the disease, in which the serum proteins already appeared abnormal by the usual clhemical methods. Little is known, however, about the electrophoretic distribution of these proteins in different types of liver disease and in various stages of hepatic insufficiency, particularly in the early stages of liver disease where the serum proteins are presumably normal by chemical analysis. The present investigation includes the electrophoretic analysis of the serum proteins of patients with acute parenchymatous liver disease, cirrhosis of the liver, and cancer of the liver. Patients with extrahepatic jaundice caused by gall stones were also studied, and the results obtained by electrophoretic and chemical analysis in the various types of liver disease and in extrahepatic jaundice were compared. Patients with varying degrees of liver insufficiency were studied in each group.