Levels of analysis for the study of environmental health disparities.

Reducing racial/ethnic and socioeconomic environmental health disparities requires a comprehensive multilevel conceptual and quantitative approach that recognizes the various levels through which environmental health disparities are produced and perpetuated. We propose a conceptual framework that incorporates the micro level, contained within the local level, which in turn is contained within the macro level. We discuss the utility of multilevel techniques to examine environmental level (both physical and social) and individual-level factors to appropriately quantify and improve our understanding of environmental health disparities. We discuss the reasoning and the methodological approach behind multilevel modeling, including differentiating between individual and contextual influences on individual outcomes. Next we address the questions and principles that guide the choice of levels or geographic units in multilevel studies. Finally, we address the ways in which different data sources can be combined to produce suitable data for multilevel analyses. We provide some examples of how such data sources can be linked to create multilevel data structures, and offer suggestions to facilitate the integration of multilevel techniques in environmental health disparities research and monitoring.

Phytohemagglutinin from red kidney bean (Phaseolus vulgaris) inhibits sodium and chloride absorption in the rabbit ileum.

Phytohemagglutinin (PHA), derived from red kidney bean (Phaseolus vulgaris), can induce malabsorption and diarrhea when fed to rats. In this study, we determined the effect of PHA on ion transport in the rabbit ileum in vitro. Compared with control tissues, PHA (1 mg/ml) added to the mucosal solution increased short-circuit current (1.1 +/- 0.2 microEq/cm2 X h, p less than 0.001), decreased net Na (-1.0 +/- 0.5 microEq/cm2 X h, p less than 0.02) and Cl (-1.2 +/- 0.6 microEq/cm2 X h, p less than 0.025) absorption, and decreased tissue conductance (-1.8 +/- 0.5 mS/cm2, p less than 0.001). Serosal addition of PHA had no effect on the short-circuit current or tissue conductance. Mucosal PHA did not increase mucosal levels of cyclic adenosine monophosphate or cyclic guanosine monophosphate. Removal of serosal calcium did not affect the increase in short-circuit current induced by mucosal PHA. Utilizing fluorescent microscopy, rhodamine-labeled PHA was found to bind to the luminal border of villus cells, but not to crypt cells, in the ileum. In the descending rabbit colon, PHA did not affect either the short-circuit current or conductance, and rhodaminated PHA did not bind to the epithelial surface. Using the increase in short-circuit current as an indicator of absorption, PHA did not affect Na-coupled glucose or amino acid absorption in the ileum. This study suggests that dietary lectins may play a role in regulating intestinal fluid and electrolyte transport.

Role of opiate receptors in regulation of enkephalin stimulation of active sodium and chloride absorption.

The mechanism of opioid peptide stimulation of active Na and Cl absorption in rabbit ileum is not known. Since vasoactive intestinal peptide (VIP) modulation of electrolyte transport is mediated by specific membrane receptors, these experiments sought to determine whether membrane receptors for opioid peptides are present on rabbit ileal enterocytes. Although we found specific binding both of radiolabeled opioid peptides to homogenates of cerebrum and ileal myenteric plexi and of 125I-VIP to ileal enterocytes, specific binding of radiolabeled opioid peptides to either ileal enterocytes or their homogenates was not identified. In parallel studies, tetrodotoxin, an inhibitor of neurotransmission, did not alter VIP-stimulation of Cl secretion but inhibited D-Ala2-methionine-enkephalinamide-induced electrolyte absorption. These studies suggest that opioid peptide stimulation of active Na and Cl absorption is mediated by an unidentified intermediary agonist.

Adenosine and adenosine analogues stimulate adenosine cyclic 3', 5'-monophosphate-dependent chloride secretion in the mammalian ileum.

Adenosine receptors that modulate adenylate cyclase activity have been identified recently in a number of tissues. The purpose of these investigations was to determine the effect of adenosine on ion transport in rabbit ileum in vitro. Adenosine and some of its analogues were found to increase the short circuit current (Isc) and the order of potency was N-ethylcarboxamide-adenosine greater than or equal to 2-chloroadenosine greater than phenylisopropyladenosine greater than adenosine. Purine-intact adenosine analogues had no effect on Isc. The effect of adenosine on Isc was enhanced by deoxycoformycin, an adenosine deaminase inhibitor, and by dipyridamole, an adenosine uptake inhibitor. The increase in Isc induced by 2-chloroadenosine was partially reversed in a dose-dependent manner by 8-phenyltheophylline but not by theophylline or isobutylmethylxanthine. 2-Chloroadenosine increased cyclic AMP content, and stimulated net Cl secretion; these effects were partially blocked by 8-phenyltheophylline. These results suggest that there is an adenosine receptor on rabbit ileal mucosal cells that stimulates adenylate cyclase, which results in secondary active Cl secretion.