Carbonic anhydrase (CA), a zinc metalloenzyme existing in several isoenzymic forms, is involved in CO2 transport at the cellular and pulmonary levels. Previously we reported (N. Engl. J. Med. 277:1t57, 1967) that infants with respiratory distress syndrome (RDS) had lower cord blood CA activity than infants without RDS. The present study includes a larger number of premature infants (104) to distinguish between the low CA due to immaturity or to RDS. Cord red blood cell CA activity increased with gestational age but at all stages of maturity infants with RDS had lower CA activity than similar infants without RDS (p ~ 0.05 for all gestational age groups). CA isoenzymes B and C (CA-B and CA-C) increased with maturation but were lower in infants with than without RDS (p ~ 0.05). Specific activities (enzyme activity/enzyme protein) of CA-B and CA-C were the same for infants with RDS, normal infants, and adults indicating that the low CA activity in infants with RDS is not due to CA inhibitors or abnormal types of CA but to diminished enzyme protein. Total red blood cell zinc was the same for all newborn infants but the ratio, red blood cell zinc/CA protein, was higher for infants with RDS (p ~ 0.05) than any others. This could be due to either: (a) inability to incorporate zinc into CA molecule, (b) an abnormal zinc metalloprotein, or (c) a defect in CA protein synthesis after zinc incorporation into CA precursor. COValENT. Carbonic anhydrase activity was measured using the carbon dioxide hydration reaction; isoenzymes of carbonic anhydrase were identified by immunochemical techniques. Carbonic anhydrase activity is not inhibited by elevated Pco~ or by acidosis. The relationship between carbonic anhydrase activity and the age of the red cell is unknown. As a group, newborn infants with R D S who died had lower carbonic anhydrase activity than infants who survived. However, deaths were more frequent in infants of shorter gestational age, who were the infants who also had lower carbonic anhydrase activity. Within given gestational age periods the number of infants who died was too small to permit statistical comparison. In older children with elevation of Pco2, decreased carbonic anhydrase activity has not been demonstrated.
Read full abstract