Increased Protein Loss Research Articles

Влияние нутритивного статуса на течение и исходы острых респираторных заболеваний у детей, протекающих с поражением нижних отделов респираторного тракта

The article discusses the effects of nutrition in children on the course and outcomes of acute respiratory infections (ARIs) affecting the lower respiratory tract. The clinical pathogenic aspects of the severe course of respiratory infections (including community-acquired pneumonia) in infants younger than 1 year of age with protein-energy malnutrition based on the recent foreign published data are addressed. The data on the association between nutrition prior to the onset of ARI and the course of bronchiolitis are uncovered. It was demonstrated that a child’s organism experiences protein deficiency during the acute fever resulting from reduced nutritional intake, increased protein loss, and the changes in protein metabolism. This leads to immune dysfunction. The authors report that all children older than 1 year of age who were admitted to hospitals with ARIs are underweight. Considering this, the development of diet correction algorithms using sipine products in children older than 1 year of age with the acute stage of respiratory infections is a relevant and littleknown issue. In addition to the correction of protein, fat, and carbohydrate composition of nutrition, a complex approach using vitamin mineral complexes, probiotics, and prebiotics is required. KEYWORDS: nutritional status, acute respiratory infections, community-acquired pneumonia, children older than 1 year of age, proteinenergy malnutrition. FOR CITATION: Kremplevskaya S.P., Muzyka A.D., Melekhina E.V. et al. Effect of nutritional status on the course and outcomes of acute respiratory infections in children affecting the lower respiratory tract. Russian Medical Inquiry. 2020;4(11):691–697. DOI: 10.32364/2587-6821-2020-4-11-691-697.

A potent liver-mediated mechanism for loss of muscle mass during androgen deprivation therapy.

ContextAndrogen deprivation therapy (ADT) in prostate cancer results in muscular atrophy, due to loss of the anabolic actions of testosterone. Recently, we discovered that testosterone acts on the hepatic urea cycle to reduce amino acid nitrogen elimination. We now hypothesize that ADT enhances protein oxidative losses by increasing hepatic urea production, resulting in muscle catabolism. We also investigated whether progressive resistance training (PRT) can offset ADT-induced changes in protein metabolism.ObjectiveTo investigate the effect of ADT on whole-body protein metabolism and hepatic urea production with and without a home-based PRT program.DesignA randomized controlled trial.Patients and interventionTwenty-four prostate cancer patients were studied before and after 6 weeks of ADT. Patients were randomized into either usual care (UC) (n = 11) or PRT (n = 13) starting immediately after ADT.Main outcome measuresThe rate of hepatic urea production was measured by the urea turnover technique using 15N2-urea. Whole-body leucine turnover was measured, and leucine rate of appearance (LRa), an index of protein breakdown and leucine oxidation (Lox), a measure of irreversible protein loss, was calculated.ResultsADT resulted in a significant mean increase in hepatic urea production (from 427.6 ± 18.8 to 486.5 ± 21.3; P < 0.01) regardless of the exercise intervention. Net protein loss, as measured by Lox/Lra, increased by 12.6 ± 4.9% (P < 0.05). PRT preserved lean body mass without affecting hepatic urea production.ConclusionAs early as 6 weeks after initiation of ADT, the suppression of testosterone increases protein loss through elevated hepatic urea production. Short-term PRT was unable to offset changes in protein metabolism during a state of profound testosterone deficiency.

MODERN VISION OF DEVELOPMENT FACTORS OF PROTEIN-ENERGY MALNUTRITION SYNDROME IN PATIENTS, RECEIVING PERITONEAL DIALYSIS

Patients who have end-stage chronic kidney disease (СKD) and who receive substitutive peritoneal dialysis (PD) therapy, often have complication such as protein-energy malnutrition syndrome (PEMS). Important prognostic value is given to nutritional disorders as they increase prior disease development, complicate its correction, influence survival rate of patients of this category.&#x0D; Purpose: to explore prevalence of protein-energy malnutrition syndrome in PD patients and define factors of its development.&#x0D; Materials and methods: 67 PD patients were examined. Evaluation of nutritional status in patients under investigation was made using development of complex methodology that includes 5 specifications – body mass index (BMI), triceps skinfold, arm circumference – biceps, floating albumin and seraalbumin, absolute number of lymphocyte.&#x0D; Results. PEMS was found in 35,8% of patients, 29,8% had mild case and 6% had moderate case with mixed form domination. 26,8% of PD patients had average high or high transport characteristics of abdominal membrane that provided increased protein loss through abdominal membrane on PD. It was determined that with the growth of С-reactive protein (CRP) level nutritional disorders increased. In our research chronic inflammation syndrome was found in 16,3% of cases. Besides, protein loss was growing fast after another dialysis peritonitis. Expressed deficit of daily consumption of protein was registered in 29,2% of patients.&#x0D; Conclusion. Our researches analysis allowed us to define that risk factors of formation of protein metabolism disorders in PD patients are low protein consumption, connection with nutritional deficiency syndrome, system inflammatory reaction, protein loss with dialysis fluid having high transport characteristics of abdominal membrane and repeated dialysis peritonitis.

Nutrition in inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic pathology that has an outbreaks course that in recent years have seen an increase in incidence, especially at younger ages. Malnutrition is frequently associated with this condition, therefore, it is very important to ensure a right nutritional intervention, especially in pediatric patients, to ensure an optimal growth and also an improvement in the clinic. Our goal will be updated the role of nutrition in this disease and in its treatment based on the published evidence. Malnutrition in these patients is frequent and is influenced by various factors such as, decreased food intake, increased nutrient requirements, increased protein loss and malabsorption of nutrients. Therefore there should be a nutritional monitoring of all of them, in which anthropometric measurements, laboratory tests and densitometry were made to establish the needs and sufficient caloric intake tailored to each patient. The use of enteral nutrition as a treatment in Crohn’s disease with mild to moderate outbreak in child population, is amply demonstrated, has even shown to be superior to the use of corticosteroids. Therefore we can conclude by stressing that nutritional intervention is a mainstay in the management of patients with IBD, which aims to prevent and / or control disease-related malnutrition to decrease morbidity and mortality and improve quality of life.

Protein loss in human hair from combination straightening and coloring treatments.

Hair chemical treatments, such as dyeing and straightening products, are known to cause damage that can be assessed by protein loss. The aim of this study was to evaluate the hair protein loss caused by combined chemical treatments (dye and relaxer) using the validated bicinchoninic acid (BCA) method. Three kinds of straighteners, based on ammonium thioglycolate, guanidine hydroxide and sodium hydroxide, were evaluated and the least harmful combination indicated. Caucasian virgin dark brown hair tresses were treated with developed natural brown color oxidative hair dyeing and/or straightening commercial products based on ammonium thioglycolate, sodium hydroxide, or guanidine hydroxide. Protein loss quantification was assessed by the validated BCA method which has several advantages for quantifying protein loss in chemically treated hair. When both treatments (straightening and dyeing) were combined, a higher negative effect was observed, particularly for dyed hair treated with sodium hydroxide. In this case, a 356% increase in protein loss relative to virgin hair was observed and 208% in relation to only dyed hair. The combination of dying and relaxers based on ammonium thioglycolate or guanidine hydroxide caused a small increase in protein loss, suggesting that these straightening products could be the best alternatives for individuals wishing to combine both treatments. These results indicated that when application of both types of products is desired, ammonium thioglycolate or guanidine hydroxide should be chosen for the straightening process.

Nutritional Status of Patients with Brain Disorder during the First Six Months

1Yonsei University Graduate School of Medicine Objective: Patients with brain disorder manifest hypermetabolism, increased energy expenditure, and increased protein loss. Nutritional support can prevent loss of immunocompetence, and can decrease morbidity and mortality associated with brain disorder. Thus, we aimed to determine the nutritional status by measuring body mass index (BMI) in patients with brain disorder during the first 6 months and identify factors related to malnutrition in this study. Method: We enrolled 244 patients from January 2008 to December 2009. The patients were classified into two groups: BMI under 18.5 were categorized as malnourished, while BMI over 18.5 as not malnourished. Extracted data includes demographic characteristics, type of brain disorder, functional independence measure (FIM) and Korea mini-mental status exam (K-MMSE) scores, history of diabetes mellitus (DM), and laboratory data. Feeding method was classified into oral and enteral tube feeding. Results: The prevalence of malnourished patients was 13.1% (32 out of 244 patients). There was significant difference of total lymphocyte count (TLC) between the two groups. And there was no significant difference of correlation in other parameters. Analysis of feeding method showed that 11.4% of oral feeding patients were malnourished, compared to 17.4% of tube feeding patients who were categorized as malnourished. The tube feeding group tends to be more malnourished. Conclusion: The results of this study can be a guide for active rehabilitation of patients with brain disorder, and further studies regarding functional outcome and complications related to early nutritional status is needed. (Brain & NeuroRehabilitation 2015; 8: 53-58)

Bioactive hydrogels with enhanced initial and sustained cell interactions.

The highly tunable properties of poly(ethylene glycol) (PEG)-based hydrogel systems permit their use in a wide array of regenerative medicine and drug delivery applications. One of the most valuable properties of PEG hydrogels is their intrinsic resistance to protein adsorption and cell adhesion, as it allows for a controlled introduction of desired bioactive factors including proteins, peptides, and drugs. Acrylate-PEG-N-hydroxysuccinimide (Acr-PEG-NHS) is widely utilized as a PEG linker to functionalize bioactive factors with photo-cross-linkable groups. This enables their facile incorporation into PEG hydrogel networks or the use of PEGylation strategies for drug delivery. However, PEG linkers can sterically block integrin binding sites on functionalized proteins and reduce cell-material interactions. In this study we demonstrate that reducing the density of PEG linkers on protein backbones during functionalization results in significantly improved cell adhesion and spreading to bioactive hydrogels. However, this reduction in functionalization density also increases protein loss from the matrix over time due to ester hydrolysis of the Acr-PEG-NHS linkers. To address this, a novel PEG linker, acrylamide-PEG-isocyanate (Aam-PEG-I), with enhanced hydrolytic stability was synthesized. It was found that decreasing functionalization density with Aam-PEG-I resulted in comparable increases in cell adhesion and spreading to Acr-PEG-NHS systems while maintaining protein and bioactivity levels within the hydrogel network over a significantly longer time frame. Thus, Aam-PEG-I provides a new option for protein functionalization for use in a wide range of applications that improves initial and sustained cell-material interactions to enhance control of bioactivity.

Synthesis and Characterization of a Matrix-Metalloproteinase Responsive Silk–Elastinlike Protein Polymer

Silk-elastinlike protein polymers (SELPs) are recombinant polymers consisting of tandem repeats of silk (GAGAGS) and elastin (GVGVP) units. By modification of the length and composition of these repeats, the properties of SELP hydrogels can be controlled for specific applications including nucleic acid and virus delivery and tissue engineering. Here, the structure of SELPs is further modified to include a sequence that is sensitive to matrix-metalloproteinases (MMPs). MMPs are a ubiquitous family of extracellular matrix-modifying enzymes that are commonly associated with numerous vital processes. Increased levels of MMPs are found at high levels locally in many types of solid tumors. By modifying the SELP backbone with MMP-sensitive peptide sequences, a hydrogel that is degradable by MMPs was produced. The MMP-sensitivity of the polymer was examined by incubation with MMP-2 and MMP-9, which yielded complete cleavage of all full-length polymers by 36 hours and 48 hours, respectively, with no observable effect on unmodified SELP. Hydrogel sensitivity was tested by exposure to MMP-2 or MMP-9 for 2 weeks, during which samples were taken to analyze protein loss from the hydrogel and release of 100 nm fluorescent beads. Following the incubation period, hydrogels were tested in mechanical compression to examine the loss of hydrogel stiffness due to degradation. It was found that MMP-2 and MMP-9 caused 63% and 44% increased protein loss and 65% and 95% increased release from MMP-sensitive hydrogels, while the compressive modulus decreased by 41% and 29%. These results suggest the potential of MMP-responsive SELPs for localized delivery of bioactive agents where MMPs are overexpressed.

Influence of somatic cell count and total bacterial counts of raw milk in cheese yield using small-scale methodology

The objectives of this study were to evaluate the influence of SCC and TBC of raw milk in cheese yield, using a reduced scale method, and to evaluate theoretical prediction of cheese yield. 270 samples of raw milk were split into three SCC levels (below 200,000; 200,000-750,000; above 750,000 SC/mL) and three TBC levels (below 100,000; 100,000-750,000; above 750,000 CFU/mL). Raw milk samples were submitted to compositional analysis (fat, protein, lactose, total solids and SNF content), SCC, TBC, freezing point and pH. The production of the small-scale cheese was conducted according to the method developed at Cornell University (Melilli et al., 2002). Cheese whey samples were submitted to compositional analysis (fat, total protein, true protein, lactose, total solids and SNF content) and SCC. The increase in the SCC of raw milk resulted in increased protein loss in cheese whey. High SCC (above 200,000 SC/mL) in milk samples was correlated to reduced dry matter yield. There was no effect of TBC in cheese yield in the experimental conditions used. There was a high correlation between the theoretical yield values and the yield values predicted by the small-scale method, indicating that this method is appropriate for cheese yield prediction.

Corticosteroids Increase Protein Breakdown and Loss in Newly Diagnosed Pediatric Crohn Disease

Children with Crohn disease have altered growth and body composition. Previous studies have demonstrated decreased protein breakdown after either corticosteroid or anti-TNF-α therapy. The aim of this study was to evaluate whole body protein metabolism during corticosteroid therapy in children with newly diagnosed Crohn disease. Children with suspected Crohn disease and children with abdominal symptoms not consistent with Crohn disease underwent outpatient metabolic assessment. Patients diagnosed with Crohn disease and prescribed corticosteroid therapy returned in 2 wk for repeat metabolic assessment. Using the stable isotopes [d5] phenylalanine, [1-(13)C] leucine, and [(15)N(2)] urea, protein kinetics were determined in the fasting state. Thirty-one children (18 controls and 13 newly diagnosed with Crohn disease) completed the study. There were no significant differences in protein breakdown or loss between patients with Crohn disease at diagnosis and controls. After corticosteroid therapy in patients with Crohn disease, the rates of appearance of phenylalanine (32%) and leucine (26%) increased significantly, reflecting increased protein breakdown, and the rate of appearance of urea also increased significantly (273%), reflecting increased protein loss. Whole body protein breakdown and loss increased significantly after 2 wk of corticosteroid therapy in children with newly diagnosed Crohn disease, which may have profound effects on body composition.

Outcome and Risk Factors for Mortality in Pediatric Peritoneal Dialysis

The mortality rate among children requiring renal replacement therapy is higher than in children without end-stage renal disease (ESRD). Some factors, such as hypoalbuminemia, high peritoneal transport rate, age, malnutrition, cardiovascular disease, and recurrent peritonitis, appear to be associated with lower survival in adult peritoneal dialysis patients. Data regarding risk factors of mortality in children with continuous ambulatory peritoneal dialysis (CAPD) are limited. The aims of this study were to analyze the clinical characteristics of patients and investigate if routinely used laboratory and clinical variables are independent risk factors for mortality in children on CAPD. We performed a retrospective chart analysis of pediatric ESRD patients on CAPD between January 1997 and September 2008. 29 patients undergoing CAPD for more than 3 months were enrolled. An analysis was performed on clinical and biochemical variables for survivors and nonsurvivors to identify potential risk factors for mortality. Mean age was 12.18 +/- 4.57 years. During the follow-up period, 8 patients transferred to hemodialysis and 13 patients received deceased donor renal transplantation. By the end of the study, 5 patients had died. Actuarial survival rate at 2 and 5 years was 96.55% and 91.19% respectively. The major complication during therapy was peritonitis (1 episode/57.79 patient-months). In the univariate analysis, younger age at initiation of dialysis, presence of comorbid disease, higher peritoneal transport rate, increased protein losses through peritoneal dialysis, high total daily protein loss, hypoalbuminemia, and hypophosphatemia were variables associated with mortality in pediatric CAPD patients. However, in the multivariate analysis, only low serum albumin (b = -2.089, p = 0.006; hazard ratio 8.06, 95% confidence interval 0.028 - 0.546) was independently associated with mortality. Mortality was low in our pediatric patients receiving CAPD. Hypoalbuminemia showed a significant association with death in CAPD patients.

Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Malnutrition is common in patients with end-stage liver failure and hepatic encephalopathy, and is considered a significant prognostic factor affecting quality of life, outcome, and survival. The liver plays a crucial role in the regulation of nutrition by trafficking the metabolism of nutrients, their distribution and appropriate use by the body. Nutritional consequences with the potential to cause nervous system dysfunction occur in liver failure, and many factors contribute to malnutrition in hepatic failure. Among them are inadequate dietary intake, malabsorption, increased protein losses, hypermetabolism, insulin resistance, gastrointestinal bleeding, ascites, inflammation/infection, and hyponatremia. Patients at risk of malnutrition are relatively difficult to identify since liver disease may interfere with biomarkers of malnutrition. The supplementation of the diet with amino acids, antioxidants, vitamins as well as probiotics in addition to meeting energy and protein requirements may improve nutritional status, liver function, and hepatic encephalopathy in patients with end-stage liver failure.

Fecal alpha-1 antitrypsin concentration in protein-losing enteropathies caused by Rotavirus and enteropathogenic bacteria infection

Background An increase in protein loss through the intestinallumen is commonly found in children with intestinal inflammation. Measurement of fecal alpha-1 antitrypsin (FAA T) concentration has been used to detect the loss of protein through the digestive system. FAAT concentration increases in diarrhea patients due to Rotavirus, Adenovirus, Shigella, Enterotoxigenic E. coli (ETEC), and Salmonella infection.Objective To determine the relationship between types ofpathogen, acute diarrhea, and alpha-1 antitrypsin concentrationin children with acute diarrhea caused by Rotavirus andenteropathogenic infection.Methods Descriptive statistics and proportion difference betweenthe two non-related groups were used to assess the proportion ofprotein-losing enteropathy (PLE) in children with acute diarrheaand was analyzed using chi square test.Results In this study, PLE group comprised 25% (24/95) subjectswithout unknown cause of diarrhea, 50% (4 7 /95) had one typeof pathogen, and in 23% (22/95) subjects had 2 or more types of pathogens. The most common pathogen found in PLE group was Rotavirus, found in67 (53%) subjects and E. coli in 41 (33%) subjects. In non-PLE group, we also found similar pathogen pattern. The mean alpha-1 antitrypsin (AAT) concentration in acute diarrhea group due to Rotavirus infection was significantly higher (P= 0.003) compared to acute diarrhea groups caused by non-Rotavirus infection. The mean AAT concentration in acute diarrhea group due to E. coli infection did not differ significantly (P= 0.735) compared to acute diarrhea group caused by non-E. coli infection.Conclusion Rotavirus was a more significant cause of PLEcompared to E.coli.

Effects of Growth Hormone on Glucose, Lipid, and Protein Metabolism in Human Subjects

In evolutionary terms, GH and intracellular STAT 5 signaling is a very old regulatory system. Whereas insulin dominates periprandially, GH may be viewed as the primary anabolic hormone during stress and fasting. GH exerts anabolic effects directly and through stimulation of IGF-I, insulin, and free fatty acids (FFA). When subjects are well nourished, the GH-induced stimulation of IGF-I and insulin is important for anabolic storage and growth of lean body mass (LBM), adipose tissue, and glycogen reserves. During fasting and other catabolic states, GH predominantly stimulates the release and oxidation of FFA, which leads to decreased glucose and protein oxidation and preservation of LBM and glycogen stores. The most prominent metabolic effect of GH is a marked increase in lipolysis and FFA levels. In the basal state, the effects of GH on protein metabolism are modest and include increased protein synthesis and decreased breakdown at the whole body level and in muscle together with decreased amino acid degradation/oxidation and decreased hepatic urea formation. During fasting and stress, the effects of GH on protein metabolism become more pronounced; lack of GH during fasting increases protein loss and urea production rates by approximately 50%, with a similar increase in muscle protein breakdown. GH is a counterregulatory hormone that antagonizes the hepatic and peripheral effects of insulin on glucose metabolism via mechanisms involving the concomitant increase in FFA flux and uptake. This ability of GH to induce insulin resistance is significant for the defense against hypoglycemia, for the development of "stress" diabetes during fasting and inflammatory illness, and perhaps for the "Dawn" phenomenon (the increase in insulin requirements in the early morning hours). Adult patients with GH deficiency are insulin resistant-probably related to increased adiposity, reduced LBM, and impaired physical performance-which temporarily worsens when GH treatment is initiated. Conversely, despite increased LBM and decreased fat mass, patients with acromegaly are consistently insulin resistant and become more sensitive after appropriate treatment.

Plasma cholinesterase activity in patients during peritoneal dialysis

Literature data suggest that the release of nitric oxide (NO) by endothelial NO synthase contributes to functional alterations of the peritoneal membrane induced by acute peritonitis. Experimental animal studies show that induced peritonitis was characterized by structural changes in the peritoneal membrane and increased permeability for urea and glucose, as well as increased protein loss in dialysate [1]. Plasma cholinesterase (PChE, 3.1.1.8) is an enzyme synthesized in the liver, molecular mass from 345,000 to 371,000 Da. The aim of this study was to evaluate the functional characteristics of the peritoneum, determining PChE transfer from blood to dialysis fluid in peritonitis-free patients and in patients with peritonitis.

Hair color changes and protein damage caused by ultraviolet radiation

Ultraviolet and visible radiations are known to damage hair. However, quantitative data relating damage to hair type, proteins and color to the radiation wavelength are missing. We studied the effect of UV plus visible, UVA plus visible, visible mercury-vapor lamp radiation and sunlight on (blended) virgin dark-brown, blond and red hair and (one head) virgin black and curly dark-brown hair. All hair types showed a substantial increase in protein loss in water after lamp and sun irradiation. The damaging effect of UVB was about 2–5 times higher than that of UVA plus visible radiation, depending on the hair type. Significant color changes were also observed in every hair type, after lamp and sun irradiation, being more pronounced for the light colored hairs. The luminosity difference parameter was the major contributor to the hair color changes, but significant changes in the red–green and yellow–blue parameters of every hair were observed. In this case, the damaging effect is ascribable mainly to UVA radiation. No significant changes in the mechanical properties or topography were observed in any case. We discuss these results in terms of hair type and composition and melanin types.

Hair color changes and protein damage caused by ultraviolet radiation

Ultraviolet and visible radiations are known to damage hair. However, quantitative data relating damage to hair type, proteins and color to the radiation wavelength are missing. We studied the effect of UV plus visible, UVA plus visible, visible mercury-vapor lamp radiation and sunlight on (blended) virgin dark-brown, blond and red hair and (one head) virgin black and curly dark-brown hair. All hair types showed a substantial increase in protein loss in water after lamp and sun irradiation. The damaging effect of UVB was about 2–5 times higher than that of UVA plus visible radiation, depending on the hair type. Significant color changes were also observed in every hair type, after lamp and sun irradiation, being more pronounced for the light colored hairs. The luminosity difference parameter was the major contributor to the hair color changes, but significant changes in the red–green and yellow–blue parameters of every hair were observed. In this case, the damaging effect is ascribable mainly to UVA radiation. No significant changes in the mechanical properties or topography were observed in any case. We discuss these results in terms of hair type and composition and melanin types.

Mice that lack endothelial nitric oxide synthase are protected against functional and structural modifications induced by acute peritonitis.

Pharmacologic studies suggest that the release of nitric oxide (NO) by endothelial NO synthase (eNOS) contributes to functional alterations of the peritoneal membrane (PM) induced by acute peritonitis. In this study, peritoneal permeability parameters in a mouse model of peritoneal dialysis were characterized, and the effects of eNOS deletion on the PM structure and permeability at baseline and after catheter-induced bacterial peritonitis were examined. Exposure of C57BL/6 mice to standard dialysate yielded a transport of urea and glucose, a sodium sieving, and a net ultrafiltration that were remarkably similar to the values obtained in rats. In comparison with controls, mice with catheter-induced peritonitis were characterized by structural changes in the PM (mononuclear cells infiltrate, vascular proliferation), upregulation of endothelial and inducible NOS, increased permeability for urea and glucose, decreased ultrafiltration, and increased protein loss in the dialysate. Comparison of eNOS wild-type and knockout mice revealed that the permeability modifications and structural changes induced by acute peritonitis were significantly reversed in eNOS knockout mice, resulting in a net increase in ultrafiltration. In contrast, the deletion of eNOS in mouse peritoneum was not reflected by permeability modifications or structural changes at baseline. These results are the first to take advantage of a knockout mouse model to demonstrate directly the crucial importance of eNOS in the permeability and structural modifications caused by acute peritonitis. The characterization of this mouse model suggests that genetically modified mice represent useful tools to investigate the molecular bases of the peritoneal changes during peritoneal dialysis.

Anorexia and food utilization in nematode infected lambs on pasture

AbstractThe influence of naturally acquired nematode infections on food intake and utilization was investigated in grazing lambs. It was first demonstrated in a pilot study with penned lambs that the application of chrome-oxide in a ruminal bolus could be used for comparison of food intake in infected and uninfected lambs on grass. In a field trial, repeated in two consecutive seasons, 48 lambs grazed on clover grass in six groups. Three stocking rate groups were grazed on contaminated pastures (I-low, I-medium and I-high) and three groups on clean pastures (U-low, U-medium and U-high). Faecal dry-matter (DM) output of individual lambs was estimated in August each year by the chrome-method. DM intake and food conversion efficiency were calculated based on hand-picked herbage samples and in vitro assessment of digestibility. Substantial worm burdens, increasing from year 1 to year 2, were observed and some lambs had clinical symptoms in the 2nd year. In year 2, lambs on contaminated pastures had significantly lower DM intake (proportionately 009 lower), higher faecal protein losses and lower food conversion efficiency compared with the uninfected lambs on clean pastures. The effect of infection on food intakes was eliminated if corrected for body weight. The study showed that if exposure to nematode infections is large enough, increased protein losses in faeces and anorexia may contribute to reduced performance in lambs in late season.

Markers of inflammation in the feces of infants with cow's milk allergy.

Growing evidence exists that exposure to cow's milk elicits inflammation in the gut of infants with cow's milk allergy, irrespective of symptoms. To demonstrate inflammation and increased protein leakage from the gut during a cow's milk elimination-challenge test in fecal samples of infants presenting with different symptoms suggestive of cow's milk allergy, we measured the concentrations of alpha1-antitrypsin (AT), eosinophil cationic protein (ECP), immunoglobulin (Ig) A, and cow's milk-specific IgA antibodies, in fecal samples of 208 infants with a mean age of 7 months. Prechallenge samples were collected after a mean 3-week elimination period, and post-challenge samples were obtained 4 days after starting the challenge. Fecal levels of prechallenge total IgA (p = 0.02) and post-challenge AT (p = 0.001) were higher in infants with a positive challenge. Of these infants, pre- and post-challenge levels of ECP were higher in those reacting after 24 h than in those reacting within 1 h (p = 0.006 and p = 0.045). Prechallenge levels of ECP were higher in those showing intestinal symptoms (p = 0.008), and both pre- and post-challenge levels of total IgA were higher in those with an IgE-mediated reaction to cow's milk (p = 0.04 and p = 0.008). Regardless of the challenge result, total IgA increased during the challenge (p < 0.001 for both challenge-positive and -negative infants) and was higher in those breast-fed until the challenge than in those fed formula only (p < 0.01). Hence, in infants reacting to the cow's milk challenge, higher prechallenge levels of fecal IgA indicate increased antigenic stimuli in the gut, and higher post-challenge levels of AT reflect increased protein loss as a result of intestinal inflammation. In infants with slowly evolving gastrointestinal symptoms, increased fecal ECP may help in distinguishing patients from those who tolerate cow's milk. Individual serial follow-up of fecal IgA and ECP can be used to estimate the degree of inflammation in the gut and an appropriate time for a challenge test, but are not diagnostic tools for cow's milk allergy.