Effect of Liver Extract on Erythrocytes and Reticulocytes in Normal Individuals.

Abstract

The effect of liver extract in pernicious anemia may be analyzed from the point of view of the immediate reaction, as well as of the sustained reaction. The immediate reaction includes among other things 3 distinct morphological features: (1) the normoblastic response, (2) the reticulocyte response, and (3) the liberation of the mature erythrocytes. 1 It is a well established fact that the bone marrow in pernicious anemia is hyperplastic and contains large amounts of erythrocytes in various stages of development. In other words, there appears to be a difficulty in the maturation of the erythrocytes necessary for their discharge from the marrow into the circulation. This faulty maturation is in character probably morphological rather than chemical, for the cells in the marrow are completely filled with hemoglobin and products of hemoglobin have been deposited in the various tissues. Thus the hemosiderosis, in the classical interpretation of pernicious anemia looked upon as a proof of the hemolytic character of the disease, might indicate a destruction of erythrocytes in the foci where they were formed before they were ever delivered into the circulating blood. When liver therapy is instituted, the bone marrow presumably is stimulated to mature and release the cells. A slight retardation in the maturation as compared with the discharge thus explains the 3 features of the immediate reaction. Experiments on the effect of liver extract upon normal individuals are here presented as a confirmation of the view of the mode of action of the liver extract to accelerated the discharge of cells into the circulation.

Six normal individuals (doctors and assistants in our laboratory) whose erythrocyte counts were between 4,500,000 and 5,800,000 were given 3 vials of liver extract (343 Lilly), or the equivalent of 300 gm. of raw liver, daily for a period of 10 days.