NBT-PABA test to assess efficiency and kinetics of substituted proteolytic enzyme action in pancreatic duct ligated minipigs.

The NBT-PABA test is an established method for diagnosis of pancreatic exocrine insufficiency. In the present study the NBT-PABA test was used to test and compare the efficacy of two multienzyme preparations (product A and B) differing in galenic preparation in minipigs in which pancreatic exocrine insufficiency (PEI) was induced by pancreatic duct ligation. Without enzyme substitution no distinct increase in PABA was found in blood after oral administration of NBT-PABA. Administration of both enzyme preparations led to a clear dose dependent rise in PABA-concentrations in blood. Interestingly, the two preparations showed different time curves of serum PABA concentration, indicating differences in the kinetic of proteolytic enzyme action. It is concluded that the NBT-PABA test can be a very useful test for indirectly evaluating proteolytic enzyme efficacy in vivo, and also gives information about the kinetics of enzyme action, not only the end-result of enzyme action (like digestibility trials which were used traditionally). A single test is performed in a few hours and there is no need for fistulated animals.

p-Aminobenzoic acid transport by normal and Plasmodium falciparum-infected erythrocytes.

De novo folate biosynthesis is required for the growth of malarial parasites and is inhibited by several important antimalarial agents. We show here that exogenous p-aminobenzoic acid (pABA) can be utilized by malaria parasites to synthesize folates. The transport of pABA into parasite infected red cells was therefore characterized. Normal red cells transport pABA in a saturable and energy-dependent manner, with a dissociation constant of 83 nM. pABA transport in parasite-infected red cells may use the same mechanism, as demonstrated by similarities in time course, concentration-response, and dissociation constant (111 nM). The transport capacity of red cells is temperature-, energy- and pH-dependent. It is inhibited by the proton ionophore, carbonylcyanide m-chlorophenylhydrazone (CCCP), but not by the sodium ionophores nigericin and monensin. p-Aminosalicylic acid (PAS) inhibits pABA transport competitively, with a inhibition constant of 378 nM. Phloritin, flufanamic acid, and 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid (DITS), which are inhibitors of the anion transporter (band 3), and oxalic acid, a substrate of this transporter, partially inhibit pABA transport into both normal and infected red cells. Interestingly, in both normal and infected red cells, the inhibitory effects of PAS and the anion transport inhibitors are additive, suggesting the involvement of 2 independent mechanisms.

Glycine conjugation of para-aminobenzoic acid (PABA): a quantitative test of liver function.

OBJECTIVE: To evaluate glycine conjugation of para-aminobenzoic acid (PABA) to the hippurated metabolites, para-aminohippuric acid (PAHA), and para-acetamidohippuric acid (PAAHA) as a quantitative liver function test in patients with liver disease. DESIGN AND METHODS: Serum concentrations of PABA and metabolites were measured by high pressure liquid chromatography in 24 controls and 50 patients with hepatobiliary disease. RESULTS: Hippurate formation was significantly decreased in all patient groups with chronic liver disease versus controls. The hippurate ratio (% hippurated metabolites formed) correlated with severity of disease, serum albumin, and factor VII concentrations. PAHA concentration was a better prognostic indicator than factor VII concentrations in patients with acute liver disease; concentrations of zero correctly predicted a poor outcome in patients with fulminant liver failure. CONCLUSIONS: Glycine conjugation of PABA may be useful as a quantitative liver function test in patients with hepatobiliary disease and as a prognostic index in patients with fulminant liver failure.

Influence of gastric emptying on the PABA test.

Serum and urine PABA curves monitored in 13 healthy volunteers were analysed and compared with curves from 11 healthy volunteers after administration of the gastrokinetic agent domperidone. Both in serum and in urine less variation in the PABA curves was observed after domperidone. Results without domperidone were subdivided in a group with normal gastric emptying (I) and a group with slow gastric emptying (II), based upon the time at which the serum PABA peak was found. Maximal serum PABA concentration, serum PABA at t = 60 min, lagphase and t1/2 for urinary excretion, and % PABA excretion from 0-3 h, 3-6 h and 0-6 h differed significantly between the two groups. Instead, no differences were found between subgroup I and volunteers after concomitant domperidone administration. In summary, PABA test results in serum and urine are influenced by variations in gastric emptying. Domperidone corrects for delayed gastric emptying and thereby narrows the range of normal PABA excretion values.

Simultaneous determination of p-aminobenzoic acid, acetyl-p-aminobenzoic acid and p-aminohippuric acid in serum and urine by capillary gas chromatography with use of a nitrogen-phosphorus detector.

In various studies during recent years, the use of p-aminobenzoic acid has been described in screening tests for exocrine pancreatic function. A synthetic three-unit compound N-benzoyl-L-tyrosyl-p-aminobenzoic acid has been administered orally and hydrolysed in the small intestine in the presence of chymotrypsin to N-benzoyl-L-tyrosine and p-aminobenzoic acid. This study describes a convenient procedure in which, after a selective extraction and derivatization with diazomethane, capillary gas chromatography is used combined with nitrogen-sensitive detection. With the proposed procedure, p-aminobenzoic acid and its major metabolites, acetyl-p-aminobenzoic acid and p-aminohippuric acid, can be monitored in serum and in urine samples.

Lipoamidase activity in human serum is due to biotinidase.

Lipoamidase, as determined by lipoyl-p-aminobenzoic acid (L-pABA) hydrolyzing activity, and biotinidase in human serum have similar pH profiles, molecular weights, thermostabilities, and are similarly inhibited by p-hydroxymercuribenzoate and not inhibited by phenylmethylsulfonylfluoride. A monospecific polyclonal antibody prepared against biotinidase immunoprecipitated greater than 95% of serum L-pABA hydrolyzing activity and an identical proportion of biotinidase activity. In addition, children with profound biotinidase deficiency (less than 10% normal serum activity) have greatly reduced levels of L-pABA hydrolyzing activity in serum (less than 15% of mean normal activity) and obligate heterozygotes have activities intermediate between that of normal and profoundly deficient individuals. These results indicate that most, if not all, of the L-pABA hydrolyzing activity in human serum is due to biotinidase. Moreover, since the Km of L-pABA hydrolysis by serum is high, it is unlikely that lipoic acid is recycled in the serum by biotinidase.

Simultaneous determination of mepivacaine, tetracaine, and p-butylaminobenzoic acid by high-performance liquid chromatography.

INTRODUCTION: The purpose of the present study was to develop a simple method for the simultaneous determination of mepivacaine, tetracaine, and p-butylaminobenzoic acid (BABA) in human plasma using high-performance liquid chromatography (HPLC) with a multiwavelength detector. METHODS: Human blood samples containing heparin, as an anticoagulant, and physostigmine (100 microg/ml), as an anticholinesterase, or human plasma containing physostigmine were spiked with various concentrations of mepivacaine, tetracaine and, in some cases, BABA. Blood samples were centrifuged and plasma was deproteinized with trifluoroacetic acid (TFA; 7%). After centrifugation, the pH was adjusted to 4.5 and an aliquot of 20, 50 or 100 microl was injected into the HPLC apparatus. The detection was done simultaneously at wavelengths of 214 and 300 nm. Analytical chromatography was done on a Waters microBondapak C(18) reverse-phase column (3.9 x 300 mm; particle size 10 microm) with a 30-min increasing linear gradient of 20-40% acetonitrile+0.05% TFA in H(2)O+0.05% TFA at a flow rate of 1 ml/min. The Waters HPLC system included two pumps, an automatic injector, a column oven, and a M490 multiwavelength detector. Quantification was done using integration of peak areas with peaks of authentic mepivacaine, tetracaine, and BABA standards. RESULTS: Calibration curves for standards of mepivacaine, tetracaine, and BABA were linear in the concentration ranges from 0.1 to 100 microg/ml, and the correlation coefficients exceeded.99 for all compounds. The lower limits of detection were 100 ng/ml for mepivacaine and 50 ng/ml for tetracaine and BABA. The yields for mepivacaine, tetracaine, and BABA were 91+/-2.1%, 82+/-3.3%, and 88+/-2.0% (mean+/-S.E.M., n=6), respectively. Degradation of tetracaine by human plasma at 37 degrees C was inhibited by physostigmine. DISCUSSION: The method is sensitive enough to allow blood concentration determinations of mepivacaine and tetracaine or its metabolite, BABA, following local anesthesia induced by these two drugs, especially when their toxic effect may be present. This method also may be useful in forensic medicine for determination of the cause of death after local anesthesia with mepivacaine and/or tetracaine.

A new multiple-unit oral floating dosage system. II: In vivo evaluation of floating and sustained-release characteristics with p-aminobenzoic acid and isosorbide dinitrate as model drugs.

In a previous study, we developed a multiple-unit type of oral floating dosage system, which is a new type of floating pill composed of both an effervescent layer and a swellable membrane layer coated on sustained-release pills. The system was shown to have excellent floating ability and sustained-release characteristics in vitro, irrespective of the pH and viscosity of the medium. In the present study, the floating ability and the sustained-release characteristics of the system in the gastrointestinal tract have been evaluated in vivo. In beagle dogs and humans in the fed state, most of the new type of pills containing barium sulfate were floating in the stomach at 10 min, and they kept floating for at least 3 h after administration (observed by periodic X-ray photographs), while some control pills without the effervescent layers were already transited into the small intestine by 3 h. Moreover, in order to evaluate the sustained-release characteristics of the drug from the new type of floating pills, p-aminobenzoic acid (PABA), with a limited absorption site, and isosorbide dinitrate (ISDN), with wide absorption sites in the gastrointestinal tract, were employed as model drugs. Floating pills of the new type, with the same sustained-release rate as that of non-floating pills (control pills) were prepared. In beagle dogs in the fed state, the new type of floating pills containing PABA showed higher plasma PABA levels at 5 and 6 h after dosing and 1.61 times greater AUC than the control pills.(ABSTRACT TRUNCATED AT 250 WORDS)

A qualitative assessment of biotinidase deficiency.

Screening programs for late-onset, biotin-responsive, multiple carboxylase deficiency (LMCD) detect colormetrically the presence of biotinidase activity in dried samples of whole-blood spotted on filter-papers as used in the neonatal screening of phenylketonuria. A sensitive and stable qualitative technique is described using 10 microliter of serum that avoids problems associated with poor sample collection, improper drying of blood-spots and transient color development. The modified assay is timely and suitable for the clinical laboratory not involved in mass screening programs.

Blood concentrations of tetracaine and its metabolite following spinal anesthesia.

Blood concentrations of tetracaine and its metabolite, p-butylaminobenzoic acid, were measured after spinal anesthesia with tetracaine which had been administered to patients under going orthopedic surgery. Tetracaine, an ester anesthetic, was given to 10 patients, the dose was 8-14mg, and blood samples were collected 1, 2 and 6h after the injection of tetracaine. We used gas chromatography/mass spectrometry for purposes of analysis. Tetracaine was not detected in any blood sample, but the metabolite was detected in each sample with the mean concentrations of 126.5, 97.9 and 43.3ng/ml at 1, 2 and 6h, respectively. This data will be useful in determination of the cause of death after spinal anesthesia with tetracaine.

Determination of ester-type local anesthetic drugs (procaine, tetracaine, and T-caine) in human serum by wide-bore capillary gas chromatography with nitrogen-phosphorus detection.

A sensitive method for simultaneous determination of ester-type local anesthetic drugs (procaine, tetracaine, and T-caine) has been developed using wide-bore capillary gas chromatography with nitrogen-phosphorus detection (GC-NPD). The extraction procedure, the experimental conditions for heptafluorobutyryl (HFB) derivative formation, and the percentage of the ester-type local anesthetic drugs from the human serum are described. The HFB derivatives of ester-type local anesthetic drugs showed sensitivity of approximately 2-3 fold higher than that without derivatization. The detection limits of HFB derivatives of the ester-type local anesthetic drugs were approximately 60-70 pg on column. Recoveries from the human serum were 85-94%. This method could be used to determine concentrations as low as 24-28 ng/mliters of the ester-type local anesthetic drugs.

Evaluation of two forms of N-benzoyl-L-tyrosyl p-aminobenzoic acid in pancreatic function testing of dogs.

Plasma para-aminobenzoic acid (PABA) concentrations were compared in 12 dogs after oral administration of either a powdered suspension or a solution of N-benzoyl-L-tyrosyl-PABA. Peak PABA plasma concentrations were significantly higher at 30, 60 and 90 minutes after administration of the solution (P less than 0.05). As the solution may now be used as a clinical test, interpretation of the results by comparison with normal absorption curves obtained after administration of the suspension could contribute to a failure to diagnose canine exocrine pancreatic insufficiency.

Pancreatic function following partial pancreatectomy and anastomosis of the pancreatic duct to the stomach or duodenum in dogs.

The effects of pancreatic duct anastomosis to stomach (stomach group) or duodenum (duodenal group) on pancreatic function were examined in dogs following two thirds pancreatectomy. Normal fasting blood glucose concentrations were maintained in both groups despite significant reductions in glucose tolerance in the stomach group, and reductions in fasting insulin and insulin peak response in both groups. Pancreatic exocrine function was significantly decreased in both groups, though plasma p-aminobenzoic acid (PABA) concentrations were generally higher in the duodenal group. A correlation was found between plasma trypsin-like immunoreactivity (TLI) and pancreatic weight. These results indicate that anastomosis of the pancreas to bowel can be undertaken with minimal postoperative complications and that the site of the anastomosis influences pancreatic function. They suggest that preservation of more than one third of the pancreas is required for optimal function. The complementary information provided by the PABA and TLI tests suggests their dual application will be clinically useful for the detection and characterisation of naturally occurring pancreatic diseases.

Diagnostic value of plasma PABA level in pancreatic diseases.

NBT-PABA test was performed in 72 subjects with simultaneous determination of the plasma PABA time-concentration curve. The curve in 25 controls after oral administration of N-benzoyl-L-tyrosyl-P-aminobenzoic acid (NBT-PABA) peaked (3.88 +/- 0.78 micrograms/ml, M +/- SD) at the third hour. In patients with chronic pancreatitis (24) and pancreatic carcinoma (6), the curves were flattened, and peaked at the fifth hour (2.7 +/- 1.4 micrograms/ml, M +/- SD), and fourth hour (3.14 +/- 2.26 micrograms/ml, M +/- SD), respectively. The discrimination between the controls and patients with chronic pancreatitis was most significant in the third-hour plasma PABA concentration (P less than 0.0001). This study shows that determination of the third-hour plasma PABA concentration is better in sensitivity and specificity than the 6-hour urinary excretion of PABA, suggesting that the third-hour plasma PABA concentration after oral administration of NBT-PABA might be a sensitive index of exocrine pancreatic function test.

Effects of dietary proteins on absorption and gastrointestinal movement of p-aminobenzoic acid in conscious rats.

We monitored the absorption and movement of dietary soluble components along the gastrointestinal tract of rats by using p-aminobenzoic acid (PABA) as a marker after feeding 8 and 16% casein or soybean protein isolate (SPI) diets containing 1% PABA. The portal concentration of PABA, as an index of absorption, increased rapidly and reached the same high level 10 min after the feeding of all four diets, and the increased level of portal PABA was maintained for 30-80 min in each group. The increased levels of the SPI-fed groups continued longer than those of the casein-fed groups. In contrast, the gastric emptying rate slowed after 20 min in all the groups, and the gastric emptying of PABA for the initial 60 min in the 8% casein group was significantly faster than that in the 8% SPI group. The PABA content of the first small intestinal segment, which may be influenced by small intestinal transit, was higher in the casein group. These results indicate that the absorptive rate of PABA is determined not only by gastric emptying but also by small intestinal transit. The gastric emptying and the content of PABA in the first segment of the small intestine was not correlated in 8% protein groups. This suggests that the effect of SPI on gastrointestinal movement is different from that of casein.

Bentiromide:xylose test in healthy cats.

The N-benzoyl-L-tyrosyl-p-aminobenzoic acid (bentiromide):xylose test for simultaneous evaluation of pancreatic exocrine function and intestinal absorptive function was studied in 8 clinically healthy cats. Plasma p-aminobenzoic acid (PABA) and xylose concentrations were determined before, and at 30, 60, 90, 120, 150, and 180 minutes after, a solution of bentiromide (1 g/100 ml) and D-xylose (10 g/100 ml) was given orally at a dosage of 5 ml/kg of body weight. The peak plasma concentrations for PABA occurred between 60 and 120 minutes, with highest mean value at 90 minutes (7.5 +/- 3.2 micrograms/ml), and for xylose between 30 and 120 minutes, with the highest mean value at 60 minutes (42.6 +/- 17.8 mg/dl). Large SD in plasma PABA and xylose concentrations indicated marked individual variation between healthy cats. It was concluded that (i) large variations between clinically healthy cats may limit the diagnostic usefulness of the bentiromide:xylose test in the cat, and (ii) guidelines for interpretation of plasma PABA and xylose concentrations reported previously for clinically healthy dogs could not be applied to cats because values were lower in cats.

Clinical and pathologic changes in experimentally induced acute pancreatitis in cats.

Acute pancreatitis was induced in 6 cats by infusion of oleic acid into the pancreatic duct. Clinical changes included fever, tachycardia, and variable degrees of abdominal pain; vomiting occurred rarely, and diarrhea was not noted. Serum lipase activities were significantly increased through the 4th day after the surgical operation, although amylase activities were significantly decreased during most of the acute phase. Serum calcium and phosphate concentrations were decreased significantly on the 4th day after surgical operation. Hematologic alterations included normocytic, normochromic, responsive anemias, but changes in WBC values were not statistically significant. Evidence of exocrine pancreatic insufficiency after induction of acute pancreatitis was not demonstrated in any cats during the study. The results of this study indicate that increases in serum lipase activity are the most consistent and earliest indicators of acute pancreatitis in cats, but that more sensitive methods of laboratory evaluation should be sought.

Pancreatic adenocarcinoma in a dog with a maldigestion syndrome.

Maldigestion caused by a pancreatic enzyme insufficiency was diagnosed in a 10-year-old Scottish Terrier on the basis of clinical signs and gastrointestinal function test results. The histologic diagnosis was pancreatic adenocarcinoma. Maldigestion is an unusual manifestation of this malignancy, particularly in the absence of other clinical signs. However, pancreatic neoplasia should be considered in aged dogs that develop exocrine insufficiency.

Evaluation of 60-minute blood p-aminobenzoic acid concentration in pancreatic function testing of dogs.

For evaluation of pancreatic function testing, a peptide that releases p-aminobenzoic acid (PABA) on digestion by chymotrypsin was given to clinically normal dogs and to dogs with unexplained diarrhea. Blood concentration of PABA and percentage of PABA excretion in the urine at 6 hours after oral administration were determined. One-hour blood values did not reflect pancreatic exocrine secretion as well as did the 6-hour urinary excretion values.

Sensitivity and specificity of radioimmunoassay of serum trypsin-like immunoreactivity for the diagnosis of canine exocrine pancreatic insufficiency.

Concentrations of serum trypsin-like immunoreactivity (TLI) measured by radioimmunoassay were low (less than 1.9 micrograms/L) in 25 dogs with exocrine pancreatic insufficiency (EPI), compared with 100 clinically normal (control) dogs (5.2 to 34.0 micrograms/L; P less than 0.001; sensitivity, 100%). Serum TLI concentrations (5.5 to 35.0 micrograms/L) in a group of 50 dogs with small intestinal disease (SID) were not significantly different from those of control dogs, values being greater than the lower limit of the control range in all cases (specificity, 100%). Results of bentiromide (N-benzoyl-L-tyrosyl-p-aminobenzoic acid [BT-PABA]) tests and fecal proteolytic activity (determined by use of an azocasein substrate) were abnormal in 21 of 22 dogs with EPI (sensitivity, 95%). Bentiromide test results were subnormal in 13 of 35 dogs with SID (specificity, 63%), whereas fecal proteolytic activity was subnormal in 7 of 34 dogs with SID (specificity, 79%). It was concluded that assay of serum TLI is a highly sensitive and specific test for the identification of dogs with EPI.