ABSTRACT
1. Daily fecal loss and daily clearance of alpha-1-antitrypsin were determined in 30 infants without intestinal disorders and in 21 with persistent diarrhea. 2. Stools were collected during a 48-h period and a randomly obtained single sample was also collected. Blood samples were also collected from the infants, and alpha-1-antitrypsin was measured by radial immunodiffusion in both stool and serum. 3. No difference in daily fecal loss (mg/d) of alpha-1-antitrypsin was detected between the control group and the group with persistent diarrhea (11 +/- 9.3 vs 18.5 +/- 20 mg/d). No difference in daily alpha-1-antitrypsin clearance (ml/d) was detected between the control group and the group with persistent diarrhea (4.3 +/- 3.6 vs 5.2 +/- 4.8 ml/d). 4. There was a strong correlation between daily fecal loss and daily clearance of alpha-1-antitrypsin (N = 50). There was a weak correlation between the concentrations of alpha-1-antitrypsin in randomly obtained single samples and daily fecal loss of the antiprotease (N = 25; r = -0.183; P < 0.01). 5. We conclude that: a) there is no increased fecal loss of alpha-1-antitrypsin persistent in diarrhea; b) fecal alpha-1-antitrypsin clearance is not necessary to estimate the enteric loss of the antiprotease; c) the determination of alpha-1-antitrypsin in random samples of feces is not a reliable method.
Subject(s)
Humans , Infant, Newborn , Infant , alpha 1-Antitrypsin , Diarrhea, Infantile , Feces , Diarrhea, Infantile , Protein-Losing Enteropathies/metabolism , Immunodiffusion , Time FactorsABSTRACT
Plasma proteins leak into the gastrointestinal tract under physiological conditions. This may assume enormous proportions in certain pathological conditions associated with the stomach, intestines, intestinal lymphatics and capillaries, resulting in severe hypoproteinemia. Quantitation of this leakage has been achieved by using plasma proteins or non-protein foreign colloids and macromolecules labelled with radioactive isotopes. The requirements of an ideal label have been listed and the advantages/disadvantages of different tracer labels have been reviewed. No label presently available fulfils all the requirements of an ideal tracer. In spite of this, a wealth of information has been acquired by gastroenterologists to unravel the mystery of hypoproteinemia of unknown cause.
Subject(s)
Digestive System/metabolism , Humans , Protein-Losing Enteropathies/metabolismABSTRACT
El clearance fecal de alfa-1-antitripsina fue realizado en 47 pacientes de edad pediátrica que presentaron diversas enfermedades digestivas: 6 con colitis ulcerosa, 5 con enfermedad celíaca, 6 con intolerancia a la proteína de la leche de vaca, 1 con linfagiectasia intestinal, 1 con giardiasis, 1 con colitis inespecífica, 1 con resección del íleon terminal, y 1 con talasemia mayor y dolor abdominal. Quince pacientes presentaron diarrea crónica inespecífica. Diez niños sin enfermedad digestiva fueron incorporados como grupo control. El 1er. grupo de niños presentó valores significativamente mayores (p < 0.05) del clearance fecal de alfa-1-antitripsina con respecto a los pacientes con diarrea crónica inespecífica y del grupo control. Solo un niño con intolerancia a la proteína de la leche de vaca tuvo un valor inferior a la media + 2 Desvío estandar. Todos los niños con diarrea crónica inespecífica presentaron valores similares a los del grupo control, con excepción de 1 que tuvo un resultado ligeramente aumentado, no hallándose diferencia significativa. El paciente con talasemia mayor y dolor abdominal presentó un valor muy elevado, desconociéndose el motivo de este hallazgo. El clearance fecal de alfa-1-antripsina es un método útil, simple, menos costoso y no invansivo que las técnicas tradicionales para el diagnóstico de enteropatía perdedora de proteínas en la infancia