Protein-losing enteropathy and trichuriasis - abstract

The phenomenon of protein-losing enteropathy (PLE) is defined as the abnormal loss of serum proteins into the gastrointestinal tract resulting from a variety of gastrointestinal abnormalities. Infestation of the large bowel and terminal ileum by adult Trichuris trichiura results in inflammatory reactions surrounding the sites of attachment. This study establishes Trichuris dysentery syndrome as one of the clinical disorders characterized by PLE. The clearance by the gut alpha-1-antitrypsin (OAT), a serum protein that resists proteolysis by digestive enzymes, was assessed in (i) subjects infected by the parasitic nematode and presenting with the Trichuris dysentery syndrome, and (ii) subjects manifesting no gastrointestinal diseases nor having conditions or receiving drugs likely to cause PLE. All subjects were within the age range 3 through 11 years, inclusive. A linear regression analysis showed a significant correlation between clearance of O AT and adult worm count (r = 0.4, p<0.05). The daily loss of this amount of serum protein is likely to be a considerable part of the cost to the host of this chronic parasitic infection (AU)

Reference ranges for thirteen biochemical parameters in Barbadian blood donors - abstract

At the Queen Elizabeth Hospital, the reference ranges of thirteen (13) biochemical constituents in plasma where determined, using blood donors. Prior to the establishment of these reference ranges, we were using either the European or the North American reference ranges. Differences between the Barbadian population and both of these groups are expected since we have different diets and optimal nutritional standards. Significant differences were found to be present in the plasma potassium, albumin and urate levels (p<0.01). In Jmaica, it has been shown that a reversal of the usual albumin/globulin ratio is associated with the nutritional and infectious disease status of that population. The total protein and albumin ranges appear to be wide. This is not a reflection of the precision of the methods used, but may be due to the fact that we sampled a fairly large cross-section of the population, with varying dietary habits. The low potassium range need further investigation. It must, however, be mentioned that many of our patients have a plasma potassium value at the lower limits of the European and North American reference ranges without any apparent symptoms of hypokalaemia. The explanation for the low plasma potassium value may be dietary deficiency, as the traditional Barbadian diet in the lower socio-economic group is low in fresh fruits and vegetables (AU)

Serum protein fractionation and quantitation by cellulose acetate electrophoresis on normal Jamaicans

Quantitation of serum proteins by cellulose acetate done on 319 voluntary blood donors in Jamaica showed significant increases in both y and b-globulins of the order of 0.5 gm and 0.35 gm/dl respectively. These studies re-emphasize the importance of relating laboratory results to local normal values as well as the employment of methods or techniques that are fairly well universally standardized and accurate. Further studies as to the precise reasons for these increases would probably best be done by Immunological Assays, particularly of the Immunoglobulins Ig G, A and M (AU)

Plasma protein response in children with trichuris dysentry syndrome - abstract

In Trichuris Dysentry Syndrome (TDS), we have elsewhere shown an IgE-mediated mucosal mast cell inflammatory response and infiltration of the colonic lamina propria by macrophages with evidence of the cellular production to TNF O. There is an increased concentration of this cytokine in the systemic circulation: both this and the correlation of finger-clubbing with worm load are evidence of an inflammatory response which is systemic as well as local to the intestine. We therefore assayed the plasmas of 53 TDS children, 16 "disease control" (DC) and 20 "normal control" (NC) children for plasma protein changes. DC children were Trichuris negative patients who had clinical indications for colonoscopy, mainly chronic diarrhoea; NC were trichuris-negative asymptomatic children of similar background to the TDS patients who were subjected to venepuncture and non-invasive tests of intestinal permeability and intestinal protein clearance (normal). There was a significant increase (p<0.05) in the means of C-Reactive protein (CRP) and antitrypsin in the TDS compared with the NC group. The mean increase in the DC group was significantly differernt from the NC. The reduction in the mean albumin concentration in TDS compared with NC children was not quite significant (p=0.05). Caeruloplasmin showed a significant difference only between the DC and NC children (p < 0.05). The other plasma proteins assayed, transferrin and fibrinogen, showed no significant difference in their means among the three groups. These changes in plasma protein concentrations are indicative of a generalized sytemic response to Trichuris trichuria and correspond to a continuous, mile "acute phase response" to this chronic infection (AU)

Absorption of iron from maize (zea mays L.) and soya beans (Glycine hispida Max.) in Jamaican infants

The absorption of iron from 59Fe-labelled maize and soya-bean preparation was measured by whole-body counting in forty-two apparently healthy Jamaican infants and compared with the absorption of ferrous ascorbate. The mean absorption of Fe from maize was 4.3 percent and from soya bean baked at 300§, 9.4 percent, compared with 28.5 percent for ferrous ascorbate. In a group of children given boiled soya beans the mean absorption of Fe was 2.8 percent, and of ferrous ascorbate 16.7 percent. There was much variability between replicate tests made on the same child at intervals of 1-2 weeks. The absorption of food Fe was not increased in children who were considered to be anaemic (haemoglobin less than 100 g/l) or Fe-deficient (serum Fe less than 500 æg/l and saturation of total Fe-binding capacity less than 15 percent). The poor availability of Fe in maize meal, which is a staple food of children in Jamaica, is probably an important cause of the high prevalence of Fe-deficiency anaemia (AU)

Serum lipids and lipoprotein patterns in adults in a rural area of Jamaica - abstract

In a cardivascular-diabetes survey we examined 77 percent of a defined population of 695 rural Jamaican aged 25-64. Fastings and 1-hour post glucose load blood samples were drawn. Serum cholesterol, triglycerides and blood glucose were measured in the fasting and glucose in the 1-hour samples using Auto Analyzer techniques. Lipoprotein pater electrophoresis was run on the fasting serum within 48 hours of collection. A 12-lead electrocardiogram, blood pressure and a chest X-ray were taken and an effort pain questionnaire completed. Cholesterol values ranged from 98-545 Mg percent with a mean and standard deviation for males of 204.6, and 41.3 mg percent respectively and for females 226.3 and 37.5 mg percent respectively. Triglycerides ranged from 24-400 mg percent with a mean and standard deviation for males of 80.1 and 43.5mg percent respectively and for females 79.7 and 44.3mg percent respectively. The triglyceride distributions were markedly skewed. Cutting points to distinguish high from normal levels of lipids were determined statistically at the 95 percent points of the distributions for each sex and each of four age groups. Respondents were typed according to the method of Fredrickson et al. by refeference both to the electrophoretic strip and the lipid levels. Overall, 7.3 percent of males and 7.9 percent of females had both abnormal trips and lipids, with predominace of pattern types II and IV. The typeIV abnormality (high triglycerides) was associated with obesity and glucose intolerance type II (high cholesterol) only with glucose intolerance in women. Neither blood pressure nor cardiothoracic ratio was higher nor ECG ischaemia and angina more common among the abnormals than normals. Although high lipids levels are frequently found in Lawrence Tavern they are not apparently associated with manifestations of ischaemic heart disease or high blood pressure (AU)

A survey of blood glucose and serum lipoprotein in adults in a rural area of Jamaica - abstract

A community survey in Lawrence Tavern was started in October, 1969 in which all 544 perons aged 25-54 living in a particular area were requested to participate. Measurements taken included fasting and 1 hour blood glucose and insulin, serum cholesterol and triglycerides, lipoprotein electrophoresis, heamoglobin concentration, packed cell volume and haemoglobin type as well as blood pressure and anthropometric data. A chest X-ray and ECG were also taken. The aim of the study is to investigate the single joint distributions of the measurements and the relationships existing between glucose tolerance and cardiovascular parameters. Mean fasting blood glucose levels of the first 379 respondents show no trend with age in males and little evidence of any trend in females. However mean 1-hour post-Glucola levels show a striking trend with age. Of the 30 persons qualifying for the diagnosis of diabetes based on a 1-hour blood level of 180 mgm percent or greater, 6 were known diabetics, 13 were confirmed as newly discovered diabetics and 5 confirmed as non-diabetics by a full glucose tolerance test 6 refused the full test. Confirmed diabetic were more common among females than males aged 35-44 (6/92 as against 1/50) but no difference was found in the decade 45-54 (5/65 as against 7/65). Only one case (unconfirmed) eas found below age 35. Results for the other measurements made on blood constituents are not yet available (AU)

Dietary fat and serum triglycerides

Fasting serum triglyceride levels from children in our ward who have recovered from malnutrition are about 30 percent of the values reported by others for normal children or similarly recovered patients. Our patients have been treated for malnutrition with a diet containing 60-70 percent of total calories as fat. We have investigated the effects of the dietary fat intake on the fasting level of serum triglycerides by feeding these children a diet containing 30 percent of the calories as fat. Two to 4 days after changing the diet, fasting serum triglycerides rose 200 to 700 percent; thereafter the values stabilized within the normal values usually found in the literature. The rise was accounted for mainly by the d<1.019 lipoprotein triglycerides. Advantage was taken of the wide range of values obtained to study the composition of the d<1.019 lipoprotein. The data obtained support the hypothesis that the components of this lipoprotein fraction are in a constant proportion, thus it would constitute a definite chemical entity. The high sensitivity of infants to changes in the dietary fat intake and the rapidity of this response are being considered in the studies concerning the pathogenic mechanism of the fatty infiltration of the liver produced by protein malnutrition (AU)

Protein turnover in skeletal muscle. I. The effect of starvation and a protein-free diet on the synthesis and catabolism of skeletal muscle proteins in comparison to liver

Rates of synthesis and catabolism of liver and muscle sarcoplasmic and myofibrillar protein have been measured in young control, starved and protein (deprived) rats using [14C]Na2CO3 to label protein. Half-lives for synthesis of 1.35, 2.8 and 7.2 days for liver, sarcoplasmic and myofibrillar proteins, respectively were obtained, whilst half-lives for catabolism were 1.55, 3.6 and 15.6 days in each case in the control animals. The protein free diet for 3 days caused a small decrease in the rate of synthesis of liver and muscle proteins. The catabolic rate of liver protein was increased by 20 percent whilst there was a smaller increase in the catabolic rate of myofibrillar proteins. Starvation for 3 days caused a 20 percent reduction in the rate of liver protein synthesis whilst there were greater reductions in muscle protein synthesis. The catabolic rate of liver protein was only slightly increased whereas there was a 75 percent increase in the rate of myofibrillar protein breakdown. The total amount of protein synthesis and catabolism in liver and the 2 muscle protein fractions over the first 3 days of the 3 regimes were calculated. Muscle protein turnover, in particular myofibrillar, was shown to be very sensitive to dietary protein and/or calorie deficiency. These results are discussed in terms of the mobility and therefore importance of muscle protein metabolism in the economy of the whole animal. (AU)

The turnover of [75 Se] selenomethionine in infants and rats measured in a whole body counter

The gamma-emitting amino acid [75Se]selenomethionine was given to rats and to human infants, and the rate and route of excertion of 75Se was followed for several weeks by daily measurements in a 4 pi whole body counter. These data were used to calculate the turnover rate of total body protein, and the results were checked against other, technically more difficult, methods.(AU)

Symptoms and clinical and laboratory findings in 123 cases of Schistosomiasis mansoni in St. Lucia

The presenting symptomatology and clinical and laboratory findings in 123 patients, referred to a clinic for the treatment of schistosomiasis mansoni, are reported and discussed. Thirty-three patients (26.8 per cent) had no complaint when seen initially. The complaints of the others, in order of frequency, were abdominal pain, weakness, diarrhoea (with or without blood in faeces), giddiness, anorexia, dyspnoea and fever. The mean faecal egg load of patients with bloody diarrhoea was not significantly higher than that of patients with diarrhoea alone. Eighteen patients had clinical enlargement of the liver (14 or 11.4 percent) and of the spleen (4 or 3.2 percent) which could be ascribed to schistosomiasis. Hepatosplenomegaly in three other patients as ascribed to other conditions. The mean faecal egg concentration was significantly higher in patients with hepatosplenomegaly than in those with hepatomegaly alone. Ranges and mean values of haemoglobin and eosinophilia are given by age group. Alteration in plasma proteins was found in patients who had spleen and/or liver enlargement, the latter group having a reversed albumen/globulin ratio which, in the two instances in which electroporesis could be carried out, was found to be the result of a tremendous increase in the gamma globulin fraction.(Summary)

Demyelinating disease in a woman from tropical South America with features of multiple sclerosis and neuromyelitis opticaz: clinical, protein chemistry and pathological findings

The ocurrence of demyelinating disease with many of multiple sclerosis and of neuromyelitis optica in a patient born and brought up in Guyana in tropical South America is so exceptional as to merit an individual case report. The similarities and differences between the findings in this patient and those accepted as typical of these diseases, as they are commonly known, are discussed in detail. (AU)

The measurement of total lysine turnover in the rat by intravenous infusion of L-[U-14C] lysine

Rats were infused intravenously for periods up to 7 hr with L-[U-14C]lysine. After about 4 hr the specific activity of free lysine in the blood reached a plateau. From the value of the plateau specific activity it is possible to calculate the total lysine flux into or out of the blood stream. In normal rats the flux is equivalent to a total protein turnover of 25-30 g kg-1 day-1. In male, but not in female rats the total flux decreased significantly with increasing body weight or age. Six weeks of protein depletion caused a decrease of 30 percent in the flux. Alloxan diabetes in a small number of rats caused no significant change. After the first « hr of the infusion the specific activity of the mixed serum proteins increased almost linearly. From the rate of increase and the specific activity of the free lysine at plateau, an approximate estimate can be made of the renewal rate of the serum proteins. This estimate must be too low, because the specific activity of the free amino acid at the site of synthesis, e.g. in the liver cell, must always be lower than in serum. The validity of the continuous infusion method is discussed in relation to other methods of measuring total amino acid or protein turnover.(AU)