Presence of an Olive Oil Splitting Lipase in the Blood of Patients With Multiple Sclerosis.

Abstract

Recently Brickner has reported that the blood of patients with multiple sclerosis causes a myelinolysis of the spinal cords of rats in vitro; he has also found that serum from these patients becomes less alkaline on standing than does serum from normal individuals; this difference is accentuated by the presence of lecithin. These changes he ascribes to the presence of increased amounts of a lipolytic substance in the blood of patients with multiple sclerosis. He believes that this substance may be an etiological agent. We have made studies of the serum lipases of 19 patients with multiple sclerosis, using as substrates olive oil and ethyl butyrate according to the technique previously described by us. This is a titration method, employing N/20 NaOH and phenolphthalein. The error is such that we only consider values above 0.2 cc. as positive. In the cases studied we have found values of 0.3 cc. or above, using olive oil as a substrate, in 12 or 63%. Sera from 146 dispensary patients have been used as controls. Of these sera 140 showed no trace of olive oil lipase, 6 gave values of 0.3 cc. or above. On these 6 false positives the clinical diagnoses were astigmatism, cataract, hypertension, arthritis, cerebellar medulloblastoma, and traumatic psychosis. Thus 95.9% of the controls gave negative results for olive oil lipase. In view of the finding of an olive oil splitting lipase in the blood of animals with experimental liver or pancreatic injury a special study was made of cases with a clinical diagnosis of liver or pancreatic involvement. Eleven such cases were studied. Seven, or 63% of them, showed the presence of an olive oil splitting lipase in the blood serum. The diagnoses on the cases showing positive results were: carcinoma of the biliary tract, carcinoma of head of pancreas (2 cases), stone in common duct, and cirrhosis (3 cases).