In vitro uptake of labeled amino acids by red blood cells of children with protein-calorie malnutrition.

The in vitro uptake of 14C-glycine, 14C-leucine and 35S-methionine by red blood cells as well as the red blood cells and plasma amino acid patterns were studied in 20 children with protein-calorie malnutrition. Blood samples were obtained from each patient on admission, following clinical recovery and, when possible, several months later. Amino acid uptake as well as levels of red blood cells and plasma amino acids are quantitatively changed in protein-calorie malnutrition. Significantly increased uptake of 14C-glycine but decreased uptake of 14C-leucine and 35S-methionine were observed in patients on admission. Following clinical recovery the uptake values of all three amino acids were markedly reduced to levels significantly below normal. Several months later values for glycine and leucine uptake were found to be normal. No significant correlation, however, was found between glycine, leucine, or methionine uptake values and concentrations of these amino groups in RBCs or plasma of patients. It is concluded that the elevations observed in red blood cell amino acids of protein-calorie malnutrition patients are not purely a result of increased amino acid uptake of RBCs and that normalization of both amino acid uptake values and their concentrations in RBCs require longer than the treatment period.

Cutaneous cryptococcosis in a diabetic renal transplant recipient.

A diabetic renal transplant recipient with cellulitis caused by Cryptococcus neoformans, serotype A, is described. The diagnosis was based on the demonstration of capsulated, budding yeast cells in the aspirated material and tissue from the cellulitic lesion and isolation of the aetiological agent in culture. The isolate formed well-developed capsules in the brain tissue of experimentally infected mice and produced cherry-brown colonies on niger seed medium. The patient's serum was positive for cryptococcal antigen (titre 1 : 4) with no other evidence of systemic infection. He was successfully treated with AmBisome, followed by fluconazole, resulting in the complete resolution of cellulitis and disappearance of the cryptococcal antigen. This report underscores the fact that patients with cutaneous cryptococcosis should be thoroughly evaluated, as it may be the first manifestation of a systemic disease. Prompt diagnosis and treatment are important to improve survival.

The relationship between serum carnitine levels and the nutritional status of patients with schistosomiasis.

Serum carnitine levels were investigated in a group of normal adults and two groups of patients with active schistosomiasis who also showed signs of malnutrition and vitamin deficiency. The first group consisted of 16 patients with Schistosoma mansoni and/or Schistosoma haematobium infection. They received an adequate diet supplemented with vitamin and iron therapy and received no treatment for their parasitic infection till their hemoglobin levels were restored to normal. The second group consisted of 12 patients with schistosomiasis as well as intestinal polyposis. They received the same diet as the first group but because of their poor condition were immediately treated for parasitic infection. Results showed that both groups of patients had subnormal levels of serum carnitine with the polyps patients (Group II) having a significantly lower level than patients with simple schistosomiasis (Group I). After nutritional repletion a significant increase was observed in the carnitine levels of most patients in group I indicating a relationship between the nutritional status of the patients and their serum carnitine levels. The patients with polyps also showed considerably increased carnitine levels after treatment and dietary repletion. The usefulness of serum carnitine measurement as an index of protein malnutrition in man is discussed.

Effect of hashish on brain gamma aminobutyric acid system, blood fibrinolytic activity and glucose and some serum enzymes in the rat.

Adult male rats were exposed to Hashish smoke for 15 min. Certain biochemical parameters were determined. This treatment did not change the brain glutamic acid level, whereas it significantly decreased brain gamma aminobutyric acid level. There was a significant increase in the activity of the brain enzyme forming gamma aminobutyric acid, namely glutamate decarboxylase, as well as in that enzyme metabolizing gamma aminobutyric acid, namely aminobutyrate aminotransferase. However, the increase was much more marked in the case of aminobutyrate aminotransferase, a finding that might explain the decrease observed in brain gamma aminobutyric acid upon exposure to Hashish. Blood glucose and fibrinolytic activity were significantly increased. It was concluded that these changes might be due to an adrenaline releasing effect of Hashish smoke inhalation. Serum lactate dehydrogenase and serum glutamate oxalacetate transaminase activities were significantly increased, whereas serum glutamate pyruvate transaminase activity was unaffected. From these data it was suggested that the source of leakage of these enzyme activities into the blood is probably the skeletal muscles rather than the liver.

Effect of hashish smoke on some blood and serum parameters in rabbits.

Exposure of rabbits to hashish smoke every other day for a period of one month resulted in a marked increase in blood ammonia. This increase is not probably due to any hepatic damage since there was no concomitant increase in the number of serum enzymes known to be elevated during hepatic damage. It might be related to the inhibitory effect of hashish on incorporation of amino acids into proteins resulting in an increased availability of amino acids to the catabolic pathways coupled with an increase in the glutamate dehydrogenase activity. These factors could also account for the increased blood urea concentrations in these animals.

Effect of chronic exposure to tobacco smoke on some blood lipids and coagulation parameters in the rat.

Adult male rats were exposed to tobacco smoke from filter-tipped cigarettes twice daily for a period of four months. Some blood lipids and coagulation parameters were studied. This treatment did not change the serum cholesterol, whereas it significantly increased serum triglycerides and plasma free fatty acids; these were possibly secondary to nicotine-induced catecholamine release. Blood thromboplastic activity as well as platelet aggregation were significantly increased. On the other hand blood fibrinolytic and prothrombin activities were unaffected. These results were discussed.

Some genetic, clinical and immunologic interrelations in schistosomiasis mansoni.

The aim of the present work was to study the possible association of some class I, II MHC gene products with variations in the clinico-pathological outcome of human schistosomiasis mansoni as well as with the variability in immune responsiveness. The study was carried out on 47 patients with schistosomiasis mansoni and 20 healthy volunteers served as control group for the immunological parameters and 200 subjects for the genetic studies. The following were determined: class I, II HLA typing, serum IgG, IgM, C3c, immediate intradermal test and passive haemagglutination using S mansoni worm antigen, T lymphocyte subsets, delayed intradermal test and leukocyte migration inhibition using phytohaemagglutinin (PHA) and soluble egg antigen (SEA) of S mansoni. A statistically significant association was found between HLA-B5 and DR3 and with the occurrence of hepatosplenic disease; this phenotype also correlated with changes in T lymphocyte subsets and high immune reactivity, both humoral and cell mediated. HLA-DQI was also associated with failure to develop hepatosplenic disease. The present study consolidates also the view of the important role of host immune reactivity in the clinical outcome of schistosomiasis mansoni and demonstrates the contribution of the genetic impact on both clinical and immunological heterogeneity of the disease.

HLA-A, -B and -C specificities in insulin dependent diabetes mellitus in the Egyptian population.

The diversity of HLA antigens frequencies associated with Insulin Dependent Diabetes Mellitus (IDDM) reported in different populations raised the importance of determining HLA-A, -B and -C specificities in patients with IDDM in the Egyptian population. The study has been carried out on thirty patients with IDDM and thirty healthy control subjects matched for age and sex as patients included in the study. The results of the present work showed that patients with IDDM showed a significant increase in frequency of HLA-A2, HLA-B8 and HLA-B15. These findings are in accordance with the genetic heterogeneity of IDDM which is in turn in harmony with the modern concept on the complex aetiology of the disease. On the other hand, HLA-A3, HLA-B5 and HLA-B7 have been found significantly decreased in patients with IDDM, thus suggesting that these alleles may confer a protective effect from acquiring the disease. When HLA specificities have been studied in relation to the age of onset of the disease, HLA-A29 have been found in higher frequency in the age group after 15 years, while HLA-B15 in that before 15 years. This variability may be related to variation in the viral agents responsible for the infectious mechanism.

The interaction of zinc and vitamin A in human schistosomiasis.

Levels of vitamin A and components of its transport protein complex, retinol binding protein and prealbumin, as well as zinc and its major binding proteins albumin and alpha 2-macroglobulin were measured in plasma of ninety-one male Egyptian patients with active schistosomal infection and thirty-two healthy adult males. Patients were divided into four groups: Group I had active schistosomiasis without associated complications; Group II had schistosomiasis complicated by colonic polyposis; Group III had advanced schistosomiasis, hepatosplenomegaly and/or ascites; and Group IV had chronic salmonella septicaemia in addition to schistosomiasis. Results showed that all patient groups had subnormal levels of plasma vitamin A, retinol binding protein, prealbumin, zinc and albumin (P less than 0.005 for all parameters) but elevated alpha 2-macroglobulin (P less than 0.001) when compared to the control group. Alterations in the vitamin A transport proteins increased with schistosomal complications and were closely correlated to changes in vitamin A (P less than 0.005), but alterations of albumin and alpha 2-macroglobulin were less consistent and did not correlate with changes in zinc levels. There was a highly significant correlation, however, between plasma zinc concentrations and those of vitamin A, retinol binding protein and prealbumin (P less than 0.001 for all correlations) in all groups of patients as well as the control group. These findings indicate that the binding and transport proteins of both zinc and vitamin A were adversely affected by schistosomiasis and its various complications. Deficiencies of both zinc and vitamin A seem to be interrelated in this disease and the vitamin A transport system may be largely dependent on zinc status.

Complications of human schistosomiasis and their effect on levels of plasma copper, zinc and serum vitamin A.

Plasma copper, zinc, serum vitamin A and carotenoids were serially determined in three groups of patients: a group with active Schistosoma mansoni infection, a group with S. mansoni complicated by colonic polyposis and a group with S. mansoni associated with chronic salmonellosis. Results indicated a significant elevation in copper and significant depressions in zinc, vitamin A and carotenoids, the degree of which correlate with the associated complications of this disease. There was a positive correlation between zinc and vitamin A levels in all patients on admission suggesting a relationship between these two nutrients in schistosomal infection. Nutritional repletion of some patients of the first group resulted in significantly improved levels of copper, zinc, vitamin A and carotenoids before drug therapy was introduced indicating that alterations of these parameters are at least partially related to anaemia and poor nutritional status. At clinical recovery, levels of the four parameters were significantly improved in all patients from pre-treatment values but were within the normal range only in patients of the first group. This indicates that complications associated with schistosomiasis may delay normalization of copper, zinc and vitamin A levels beyond the clinical cure stage.

Effect of zinc supplementation on S. mansoni-infected hamsters.

Golden hamsters were used to determine whether intraperitoneal Zn supplementation can improve the outcome of infection with Schistosoma mansoni. The animals were divided into two groups; one received an initial intraperitoneal dose of Zn chloride (0.75 mg 100 g body wt.-1) followed by booster doses (0.25 mg 100 g body wt.-1) twice weekly for four weeks, the other group received no Zn supplement. After one week, when the initial and one booster doses were given, half of the animals in each group were exposed to S. mansoni cercariae for two hours using body immersion technique. After five weeks (one week after the final Zn supplement) the animals were killed, their worm burdens determined and their livers, kidneys, spleens, hearts and sera examined. There was a significant reduction in total worm counts in the Zn supplemented group (P less than 0.05). Also, Zn supplementation of infected animals protected them against the hepatomegaly which is very often associated with schistosomiasis. Spleen weight and Zn uptake were highest in the infected Zn supplemented group, indicating that this organ requires larger amounts of Zn to perform its various Zn-dependent immunological functions. The data suggest that Zn may enhance the ability of the body organs to resist some of the harmful effects of schistosomal infection.