An Analysis of Lipoproteins , Bile Acids , and Red Cell Membranes Associated with T arget Cells and Spur Cells in Patients with Liver Disease RICHARD

two syndromes were studied in 27 patients with target cells and 17 patients with spur cells, all of whom had advanced cirrhosis. The cholesterol and phospholipi(d content of red cell membranes effectively distinguished target cells from spur cells. Target cells alone were rich in lecithin, and both the cholesterol/phospholipid and cholesterol/lecithin mole ratios were greater in spur cells. The cholesterol/phospholipid mole ratio of both types of red cells correlated closely with the free cholesterol saturation of serum lipoproteins, as defined by the anmount of free clholesterol relative to phospholipid and protein in these lipoproteins. Lecithin: cholesterol acyltransferase (LCAT) activity was decreased in most patients with target cells and spur cells; however, the relationship between this activity and the lipid abnormiialities observed was weak. Serum bile acid levels also correlated poorly witlh serum and cell lipids. However, in patients with target cells the amount of cholic and (leoxycholic acids in serumi was approximately equal to the amount of chenodeoxycholic acid, whereas in patients with spur cells chenodeoxycholic acid (the precursor of lithocholic acid) pre(lominatedl.