Human liver tissue has been assayed to determine the amount of hemoglobin production factors in normal and abnormal states. Standardized dogs made anemic by blood removal have been used in this biological assay. Normal animal liver as control is rated as 100 per cent.
Normal human liver tissue as compared with the normal animal control contains more of these hemoglobin production factors—a biological assay ratio of 120 to 160 per cent. Infections, acute and chronic, do not appear to modify these values, the concentration of hemoglobin-producing factors falling within the normal range.
Pernicious anemia and aplastic anemia both show large liver stores of hemoglobin-producing factors—a biological assay ratio of 200 to 240 per cent. Therapy in pernicious anemia reduces these liver stores as new red cells are formed.
Secondary anemia presents a low normal or subnormal liver store of hemoglobin-producing factors—an assay of 60 to 130 per cent.
Hemochromatosis, erythroblastic anemia, and hemolytic icterus in spite of large iron deposits in the liver usually show a biological assay which is normal or close to normal.
Polycythemia shows low reserve stores of hemoglobin-producing factors. Leukemias present a wide range of values discussed above.
Hypoproteinemia almost always is associated with low reserve stores of hemoglobin-producing factors in the liver—biological assays of 60 to 80 per cent. Hypoproteinemia means a depletion of body protein reserve stores including the labile protein liver reserves—a strong indication that the prehemoglobin material (or globin) is related to these liver stores.
Pregnancy, eclampsia, and lactation all may present subnormal liver stores of hemoglobin-producing factors. Exhaustion of protein stores lowers the barrier to infection and renders the liver very susceptible to many toxic substances.
It should not be difficult to correct hypoproteinemia under these conditions and thus relieve the patient of a real hazard.