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Old 08-30-2011
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Liver Why AST first in Alcoholics!

It is said in Kaplan biochemistry that in alcoholics AST increases than ALT while in viral hepatitis occurs the opposit can anyone explain the pathogenesis for both that causes this distinguish difference ?! thanks
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Old 08-31-2011
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ALT is more specific for liver as it is only found in hepatocyte (cytoplasma) whereas AST is found in muscle, RBC's, hepatocytes (mitochondria)
If u have viral hepatitis with liver cell damage and necrosis ALT is elevated as ALT is found in the cytoplasm of hepatocytes
In alcoholics, as alcohol affects as an uncoupler in mitochondria, AST which is present in mitochondria of hepatocytes, AST increases. ALT is not increased as it is present in cytoplasm
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Old 08-31-2011
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Keeping in mind the location of the enzymes, AST in mitochondria and ALT in the cytoplasm of hepatocytes, now in alcoholics this leads to mitochondrial damage which causes AST> ALT ( usually in2 :1 ratio) while viral hepatitis causes hepatocellular necrosis ( breakdown of cells resulting in release of cytoplasmic ALT)
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Biochemistry-, Gastrointestinal-Tract-, Physiology-

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