A Morphometric Study of the Endoplasmic Reticulum in Human
Total Page:16
File Type:pdf, Size:1020Kb
Gut: first published as 10.1136/gut.15.9.737 on 1 September 1974. Downloaded from Gut, 1974, 15, 737-747 A morphometric study of the endoplasmic reticulum in human hepatocytes' Correlation between morphological and biochemical data in subjects under treatment with certain drugs A. M. JtZtQUEL2, M. KOCH, AND F. ORLANDI From the Digestive Diseases and Cell Pharmacology Units, University of Ancona School of Medicine, the Centre for the Study of the Action of Drugs on the Liver, University of Camerino, and the Division of Gastroenterology, General Hospital, Ancona, Italy SUMMARY The distribution of the endoplasmic reticulum in human hepatocytes is defined in quanti- tative terms using the techniques of morphometry. The subjects of the study are liver biopsies from normal, untreated subjects and patients being treated with various drugs. In contrast to rat hepato- cytes, the amount of smooth endoplasmic reticulum (SER) in man exceeds that of the rough endo- plasmic reticulum (RER) and accounts for 76.3 % of the total endoplasmic reticulum. This is to be taken into consideration in pharmacological or toxicological studies. In addition, two components of the SER have been identified: more prominent is the type 1 or vesicular which has a regular honeycomb pattern, made up ofcisternae with patent lumina and a mean width of 1500 A; the type 2, or non-vesicular, occurs in discrete foci of densely packed smooth membranes with a spacing of about 140 A. In subjects under short-term treatment with Benzodiazepin (diazepam) the RER re- http://gut.bmj.com/ mained unchanged but the SER membranes were significantly increased with a remarkable, two- to threefold increase of the SER type 2 in three out of four patients. A rise in incorporation of 14C-acetate into digitonin-precipitable sterols as measured in liver biopsy material was also noted in these three patients. The suggestion is made that the SER 2 represents the newly formed mem- branes whereas the SER 1 would represent 'adult' membranes. No changes were observed in two patients under short-term treatment with phenobarbital or Dilantin. on September 23, 2021 by guest. Protected copyright. A few morphometric studies have already been con- the normal base-line data necessary for comparative ducted on animal liver in normal (Loud, 1968; purposes. However, such a study appears essential, Weibel, Staubli, Gnagi, and Hess, 1969; Hess, especially when dealing with toxicological or Weibel, and Preisig, 1973) or in experimental con- pharmacological studies. The subjectivity or the ditions (Wiener, Loud, Kimberg, and Spiro, 1968; aesthetic feelings of the observer often interfere Staubli, Hess, and Weibel, 1969; Hope, 1970; with an objective interpretation of findings and do Riede, Seebass, and Rohr, 1971a; Riede, Strassle, not permit a quantitative estimation of the changes Bianchi, and Rohr, 1971b; Dobbins, Rollins, Brooks, observed. In the present study, we have applied the and Fallon, 1972; Bolender and Weibel, 1973) but technique of Weibel, Kistler, and Scherle (1966) and quantitative analyses of human liver are still lack- Weibel et al (1969) to the study of human liver, ing. Ethical and practical considerations make it using the material obtained by needle biopsy in difficult to collect the material necessary for defining normal, untreated patients and in patients treated with various drugs. Our attention was especially Received for publication 15 May 1974. concentrated on drugs metabolized by microsomal 1Supported by a research grant n. 7300691/04 of the CNR, Rome. 'Please address all correspondence to: Dr A. M. Jz6quel, Division of enzymes, influencing bilirubin or cholesterol metab- Gastroenterology, Ospedale Regionale 60100 Ancona, Italy. olism. We attempted to correlate the biochemical 737 3 Gut: first published as 10.1136/gut.15.9.737 on 1 September 1974. Downloaded from 738 A. M. Jezequel, M. Koch, and F. Orlandi findings with eventual changes in the endoplasmic Electron microscopy reticulum. The biochemical data concerning the For electron microscopy, a small piece of tissue was effect of these drugs on hepatic biosynthesis of cut in 1 mm3 fragments and fixed in 1 % osmium cholesterol as measured on needle biopsies have been tetroxide buffered with Sorensen's phosphate buffer published elsewhere (Bamonti and Dini, 1973; pH 7.4. After dehydration with alcohol and propyl- Orlandi, Bamonti, Dini, Koch, and Jezequel, 1974). ene oxide, the fragments were embedded in a mix- ture of Epon and Araldite. The blocks obtained were Material and Methods cut on a LKB Ultratome III. Thick (1 micron) sections were stained with Azur II-Methylene blue SELECTION OF PATIENTS for examination with the light microscope. Ultra- thin sections were stained with lead citrate and ex- Group 1: Normal untreatedpatients amined with the electron microscope Philips EM Four biopsies of normal, untreated patients were 201. analysed. The selection procedure considered the clinical examination, laboratory findings (BSP re- Quantitative analysis tention at 45 min, SGOT, SGPT, serum bilirubin, For quantitative analysis, five blocks of each biopsy serum alkaline phosphatase). Special attention was material were chosen at random and electron micro- paid to the drug-taking history and only patients graphs from each section were taken on 35 mm film, 'drug-free' for at least three weeks were retained. The first at a magnification of4000 on the screen, ie, 1490 selection also took into account the light micro- on the film due to the reduction in the microscope. scopy findings. The randomization of the areas to be photographed was obtained by placing the screen on the lower Group 2: Treatedpatients without liver involvement left corner of a mesh of the copper grid (Weibel et al, Four patients with normal liver function tests and in 1969). If the angle was not suitable (technical im- need of sedative treatment were given Benzodiazepin perfections, extrahepatocytic space, section edges) (diazepam) according to the following scheme: thestage was movedto another corner. Subsequently, Pe. M. received 20 mg per day for two days; Br. P. the primary magnification was brought to 8600 on received 60 mg per day for three days; Ta. P. and the screen (3200 on film) and 24 500 (9100) without Gi. M. received 40 mg per day for four days. The moving the centre of the picture. Six electron micro- http://gut.bmj.com/ needle biopsy was taken on the morning following graphs were taken at each level of magnification. A the cessation of therapy except in Ta. P. from whom total of 90 pictures was thus obtained for each it was taken at a four-day interval. biopsy. For the purpose of the present study, ie, One patient (Ca. V.) received 50 mg per day of the analysis of the endoplasmic reticulum, measure- diphenylhydantoin (Dilantin) for seven days. A ments were made on pictures taken at a magnifica- biopsy was taken at the beginning oftreatment and is tion of 9100. The films were examined on a project- included in group 1. Another biopsy was taken at ing screen with a secondary tenfold magnification on September 23, 2021 by guest. Protected copyright. the end of the seven-day period. upon which was superimposed a multipurpose test screen with 84 test lines of known length (Weibel et Group 3: Treatedpatient with hepatic dysfunction al, 1966, 1969). The evaluation of the membrane One patient with Gilbert's syndrome and serum bili- surface density Sv ofsmooth androughreticulumwas rubin of 2.06 mg% received 360 mg phenobarbital performed by countingthenumber ofintersections (I) per day for four days. A biopsy was taken before the ofmembrane profiles with the test lines and applying beginning of treatment and another one at the end of the formula Sv = 2 x 1/LT where LT is the length of therapy when the serum bilirubin had fallen to 0.60 the test lines enclosed in the cytoplasm. The results mg%. are expressed in u2 per 3 ofcytoplasm (Weibel et al, 1969). Estimation of the volumetric density (Vv) PROCESSING THE MATERIAL of the endoplasmic reticulum was given by the for- mula Vv = Pp where Pp is the fraction number of The hepatic biosynthesis ofcholesterol endpoints of the test lines enclosed within the pro- This was estimated on biopsy material as described files of the endoplasmic reticulum (Weibel et al, elsewhere (Orlandi et al, 1974). 1969). The mean width (d) of the cisternae was calcu- lated from the volume to surface ratio (v/s) (Weibel Light microscopy et al, 1969) such as v/s = d/2 for the cisternac of the For light microscopy, a fragment of the biopsy was Golgi apparatus which are likened to plates and fixed in formaldehyde, embedded in paraffin, and v/s = d/4 for the rough and smooth endoplasmic stained with haematoxylin-eosin. reticulum which are likened to cylinders. Gut: first published as 10.1136/gut.15.9.737 on 1 September 1974. Downloaded from A morphometric study of the endoplasmic reticulum in human hepatocytes 739 Fig 1 Low-power view ofparenchymal cells ofan untreated subject. In the cyto- plasm, the SER is diffusely distributed and has a regular honeycomb pattern; only the type 1 or vesicular is present. Some RER cisternae are seen in areas free ofglycogen. Numerous mito- chondria (M) contain crystalline formations seen as dense inclusions at this level ofmagnification. The Golgi apparatus (G) is seen next to bile canaliculi (bc) x 7500 http://gut.bmj.com/ on September 23, 2021 by guest. Protected copyright. Results human liver (Ma and Biempica, 1971; Jezequel and Orlandi, 1972; Klion and Schaffner, 1968). We need ELECTRON MICROSCOPY only to insist on the relative paucity of the rough Group 1: normal untreatedpatients endoplasmic reticulum (RER), usually distributed Previous observations have already given a detailed along the nucleus, around or between mitochondria, account of the ultrastructural features of the normal and along the sinusoidal border of the hepatocyte.