Elevated pancreatic oncofetal antigen levels measured by enzyme immunoassay in pure pancreatic juice of patients with pancreatic cancer

Pancreatic oncofetal antigen (POA) was measured by enzyme immunoassay in pancreatic juice from patients with pancreatic cancer, chronic pancreatitis, or other diseases. POA levels in pancreatic cancer were significantly higher than in other disorders, and POA was seen by immunofluorescence to be in the cancerous tissues of pancreatic cancer. Assay of POA in the pancreatic juice may be more reliable than serum POA, and could contribute to the diagnosis of pancreatic cancer.

Simple, rapid determination of serum guanase activity with the Hitachi 736 automated discrete analyzer

In this new method for determining serum guanase activity by use of the Hitachi 736-40 automated analyzer, serum is incubated with a mixture of xanthine oxidase, superoxide dismutase, and catalase; a reagent containing KCN, guanine, nitrotetrazolium blue, and Triton X-100 is added; and the increase in absorbance at 570 and 660 nm is measured for 2.4 min. Only 20 microL of sample is required, and results are linearly related to the activity concentration of guanase up to 30 U/L. Within-run and day-to-day precision (CV) was respectively 2.6 to 4.2% and 3.5 to 5.5% over 0-30 U of guanase activity per liter. The normal reference interval, as calculated from data on 40 healthy persons, is 0.1 to 2.2 U/L. Results correlate well (r = 0.997) with those by a kinetic method (Clin Chem 27: 560, 1981). The guanase activity of 150 samples can be measured within 1 h by this method.

Analysis of guanase by agarose gel electrophoresis and activity staining

A method was developed to separate guanase by agarose gel electrophoresis and to detect its activity by staining of the bands with a mixture of the enzymes xanthine oxidase, catalase, and aldehyde dehydrogenase, the coenzyme NADP+, and a substrate of guanine, ethanol, phenazine methosulfate, nitrotetrazolium blue, and KCN in Tris-(hydroxymethyl)methylamine buffer (pH 8.0). Serum samples showed bands 1 (faster moving) and 2 corresponding to the positions of albumin and alpha 2-globulin, respectively, found by serum protein staining. The same bands were detected with guanase from human liver and kidney, although band 2 from the latter samples was not as distinct as that from the liver samples.

Simple, rapid determination of serum guanase activity with the Hitachi 736 automated discrete analyzer

In this new method for determining serum guanase activity by use of the Hitachi 736-40 automated analyzer, serum is incubated with a mixture of xanthine oxidase, superoxide dismutase, and catalase; a reagent containing KCN, guanine, nitrotetrazolium blue, and Triton X-100 is added; and the increase in absorbance at 570 and 660 nm is measured for 2.4 min. Only 20 microL of sample is required, and results are linearly related to the activity concentration of guanase up to 30 U/L. Within-run and day-to-day precision (CV) was respectively 2.6 to 4.2% and 3.5 to 5.5% over 0-30 U of guanase activity per liter. The normal reference interval, as calculated from data on 40 healthy persons, is 0.1 to 2.2 U/L. Results correlate well (r = 0.997) with those by a kinetic method (Clin Chem 27: 560, 1981). The guanase activity of 150 samples can be measured within 1 h by this method.

Carbohydrate antigenic determinant (CA 19-9) and other tumor markers in gastrointestinal malignancies

The serum carbohydrate antigenic determinant (CA 19-9) was assayed in patients with various diseases, and it provides excellent sensitivity for adenocarcinoma of the pancreas (25/27, 93%), while only 4% (2/54) of the patients with benign diseases and none of the 40 healthy subjects showed elevated CA 19-9 concentrations over 37 units/ml as upper normal value. Increased serum carcinoembryonic antigen (CEA) levels over 2.5 ng/ml were observed in patients with pancreatic cancer (18/22, 82%), compared to 22% (12/54) of the patients with benign diseases and 10% (4/40) of the healthy subjects. 12 of the 19, 6 of the 19 and none of the 22 patients with pancreatic cancer exhibited high serum ferritin, beta 2-microglobulin, or alpha-fetoprotein levels, respectively. A significant difference in CA 19-9 was found between patients with pancreatic cancer and gastric cancer, other gastrointestinal (GI) malignancies, other non-GI malignancies, benign digestive diseases or normal populations.

Clinical evaluation of serum guanase activity in liver diseases

We measured serum guanase (EC 3.5.4.3) activity in patients with various diseases and in healthy controls, and evaluated the clinical usefulness of this enzyme in liver diseases. The reference range, which showed no significant difference between sexes and ages over the range studied, was 0 to 1.8 U/L. The mean guanase activities for patients with various liver diseases, including acute hepatitis, chronic hepatitis, liver cirrhosis, hepatoma and metastatic carcinoma, were above the upper limit of the reference range. In acute hepatitis and metastatic carcinoma of the liver, the activities were especially high. Validity (sensitivity + specificity) of guanase, which in all tests was above 1.66, was compared to that of AST and ALT in liver diseases. With guanase, the highest validity (1.98) was found in acute hepatitis and metastatic carcinoma. Specificity of guanase was 0.98, whereas sensitivity of AST was 1.00 in all diseases. Sensitivity and specificity of ALT were 0.85 to 0.97 in all diseases. As guanase was specific, including this enzyme with other liver function tests, such as AST and ALT, may decrease false-positive results and may be effective for prediction of liver disease.

Combined effects of lead and EDTA on Na+,K+-ATPase activity of erythrocyte membranes

Erythrocyte Na+,K+-ATPase activity increased significantly in lead workers of a lead refining factory when measured with EDTA and compared to the controls without EDTA. The enzyme activity measured with EDTA increased in the following order: controls less than office workers in a lead refining factory less than lead workers. A positive correlation existed between blood lead and enzyme activity with EDTA (r = 0.380, p less than 0.10), and the activity without EDTA (r = 0.398, p less than 0.05). A negative correlation was found between sodium in erythrocytes and enzyme activity with EDTA (r = -0.437, p less than 0.05), and the activity without EDTA (r = -0.416). But no relationship was observed between enzyme activities and potassium in erythrocytes. A positive correlation between enzyme activity with EDTA and that without EDTA was observed (r = 0.452, p less than 0.05). With addition of lead to fragments of erythrocyte membranes, a significant decrease occurred in the activity of the enzyme without EDTA, whereas no change was observed with EDTA. No significant change occurred in the enzyme activity with and without EDTA upon addition of lead to blood. The maximum level of lead in membrane fragments (lead combined with membranes) of workers exposed to lead was 0.60 microgram/mg protein, and that in the experiment of addition to blood was 7.0 micrograms/mg protein.

Guanine deaminase in serum as an indicator of survival probability in severe shock patients

To find ways of predicting survival or death in cases of severe shock, arterial blood pH and gases, vital signs, and the half-life of activity in the enzymes guanine deaminase, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), were studied in 24 patients. The mean arterial blood pH (+/- SD) in survivors was 7.325 +/- 0.092 while that in non-survivors was 7.108 +/- 0.251 (p less than 0.05). The mean half-life of guanine deaminase in survivors was 19.8 +/- 3.3 hours, while that in non-survivors was 58.6 +/- 11.8 hours (p less than 0.001). When the screening values were set at 7.190 for the arterial blood pH and 36 hours for the half-life of guanine deaminase activity, the 'validity' (sensitivity plus specificity) for the combination of the two tests was 1.88. The values may be useful for the prognosis of survival in severe shock patients.

Effect of lead on erythrocyte membranes

The effect of blood lead on erythrocyte membrane proteins was studied in 28 workers from a scrap lead refining factory and in 18 controls working in railway construction. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of the polypeptides in the erythrocyte membrane showed that bands 3 and 4.1 had significantly decreased while bands 2.3, 6, and 7 had significantly increased in the lead workers compared with the controls. For the lead workers, the correlation coefficients between blood lead and bands 2.3 and 3 were r = 0.545 (p less than 0.01) and r = -0.51 (p less than 0.01) respectively. These results suggest that the decrease in erythrocyte membrane permeability results from a decrease in the membrane transfer protein responsible for band 3.

Erythrocyte arginase activity as an indicator of lead exposure

ABSTRACT A semi-automated method has been developed for the determination of the arginase activity of erythrocytes using dried blood spots, which are easy to prepare on site in a factory for later laboratory analysis. The mean arginase activity of erythrocytes in 49 men occupationally exposed to lead was 62·9 IU/g·Hb (SD, 14·4 IU/g·Hb); in 45 men not exposed to lead the mean was 44·6 IU/g·Hb (SD, 11·6 IU/g·Hb). A significantly higher mean arginase activity was found in the specimens from lead-exposed workers (p < 0·001). The correlation coefficient between blood lead and erythrocyte arginase was r = 0·67 (p < 0·001). The degree of correlation between blood lead and lead indicators including arginase was r = 0·75 for urine δ-aminolaevulinic acid, r = 0·67 for erythrocyte arginase, r = 0·66 for urine lead, and r = 0·63 for coproporphyrin. Erythrocyte arginase showed no significant correlation in the liver function tests, GOT, GPT, and albumin in serum. When 40 μg/100 g of blood lead concentration was fixed as the basic value and 56·2 IU/g·Hb of erythrocyte arginase activity was set as the screening value in lead-exposed workers, the sensitivity and specificity of the arginase test were 0·96 and 0·65, respectively. Thus the validity of the test was calculated to be 1·61. These results show that the arginase level of erythrocytes can be considered to be one of the significant indicators of occupational exposure to lead because it reflects well the dose-response relationship of lead in the human body. Our method allows rapid analysis of erythrocyte arginase and thus should be useful in screening for lead exposure.

[Effects of lead on the protein of erythrocyte membranes]

In order to study the effects of lead in the circulating peripheral blood on the erythrocyte membrane, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of protein in the erythrocyte membrane was performed in 28 men exposed to lead in a scrap lead refining factory and 18 men working in railway construction as the controls. Furthermore, in order to corroborate the effects in vitro experiments by SDS-PAGE of protein in the mixture of human erythrocyte membranes with added lead were performed. 1) In the lead workers compared with the controls, SDS-PAGE of protein in the erythrocyte membrane showed that relative concentrations of bands 1, 2, 3 and 4.1 were significantly decreased while those of bands 2.3, 6 and 7 were significantly increased. 2) SDS-PAGE of protein in the in vitro experiment showed that the relative concentrations of bands 1, 2, 3, 4.1 and 4.2 were decreased while those of bands 2.3, 4.5, 5, 6 and 7 were increased. Therefore, these results show the same trends as those of the in vivo experiments. 3) For the lead workers, the correlation coefficients between blood lead and bands 2, 2.3 and 3 were r = -0.414 (p less than 0.05), r = 0.545 (p less than 0.01) and r = -0.509 (p less than 0.01), respectively. Also a higher coefficient of correlation (r = -0.777, p less than 0.001) was found between bands 2 and 2.3. 4) As the molecular weight of substances showing bands 2 and 2.3 were 220700 and 133800, respectively, according to PAGE using molecular weight markers, band 2.3 is considered to be due to a cleavage product from that of band 2. From these results, we summarized as follows. Lead combined with erythrocyte membrane decreases the band 3 penetrating lipid bilayer, and that causes the decrease of membrane transportation. On the other hand, the variation of band 2 and 4.1 influences the spectrin-actin network. This is considered to be one of the reasons that MCV is decreased.

Effect of lead in vitro on water metabolism and osmotic fragility of human erythrocytes

The addition of lead to normal human blood was previously found to cause a decrease in erythrocyte osmotic fragility in vitro. The mechanism of the decreased osmotic fragility caused by lead has not been completely clarified, but the following hypothesis has been proposed. Lead causes a leakage of water from erythrocytes, thus more water can enter the cell before haemolysis occurs. There has been no report, however, of the direct measurement of the intracellular water content of erythrocytes treated with lead. This study has tried to clarify the relation between intracellular water and the osmotic fragility of lead-treated erythrocytes in vitro. The results showed that 0.05 microM/ml of lead decreased the osmotic fragility, the intracellular water content, and intracellular potassium and mean corpuscular volume, increased the plasma water content and trapped water content, and contracted the erythrocyte shape. These changes corresponded well with each other, and close coincidence of the osmotic fragility and the intracellular water content was also observed.

An increase in the Na+/K+-ATPase activity of erythrocyte membranes in workers employed in a lead refining factory

To clarify the relationship between erythrocyte Na+/K+-ATPase activity and haematological findings, several clinical laboratory examinations were performed on 31 male workers employed in a scrap lead refining factory and, as controls, 50 male workers employed in railway construction. The results were: (1) Values for erythrocyte Na+/K+-ATPase activity, blood and urine lead, urine delta-aminolaevulinic acid, and urine coproporphyrin of lead workers were significantly higher than those of the controls (p less than 0.01). (2) A strongly positive relationship between blood lead and erythrocyte Na/K-ATPase activity was observed in lead workers (r = 0.473, p less than 0.01). (3) A strongly negative relationship between Na+/K+-ATPase activity and intracellular sodium was observed in both groups (lead workers; r = -0.601, p less than 0.01: controls; r = 0.595, p less than 0.01).

Mechanism of increased osmotic resistance of red cells in workers exposed to lead

In order to clarify the mechanism of the increased osmotic resistance of red blood cells in lead workers 19 men employed in a lead refining factory and 18 control male workers employed in railway construction were examined for red cell count, haematocrit, MCV, blood and urine lead concentrations, urine coproporphyrin and delta-aminolevulinic acid, osmotic resistance of red cells, lecithin-cholesterol acyltransferase (LCAT) activity in serum, and cholesterol content and cholesterol-to-phospholipid ratio of the red cell membrane. The results were: (1) The osmotic resistance of the red cells (p less than 0.05), cholesterol content of the red cell membrane, blood and urine lead, urine coproporphyrin, and urine delta-ALA concentrations (p less than 0.01) were higher in the lead workers than in the controls. (2) In the lead workers close relationships were observed between the osmotic resistance and the blood lead concentration (r = -0.515, p less than 0.05), osmotic resistance and LCAT activity (r = 0.596, p less than 0.01), and osmotic resistance and cholesterol of the red cell membrane (r = -0.492, p less than 0.05).