Biochemical markers in the assessment of protein-calorie malnutrition in premature neonates

We studied 135 premature newborns of 26 to 36 weeks gestation, divided into three groups: the control group, 66 premature infants with uncomplicated course; 51 premature neonates with appropriate birth weight for gestational age (AGA), who suffered from clinical problems that delayed oral feeding; and 18 premature infants with small birth weight for gestational age (SGA). When neonates of the same postnatal age were compared, prealbumin concentrations were the lowest in the SGA group at the third and fourth postnatal week. Although the AGA group had the most infants with serious illnesses and the lowest protein-calorie intakes, their prealbumin concentrations did not differ significantly from those of the control group. But when the infants of each group were subdivided on the basis of intakes and weight gain regardless of postnatal age, those with greater intakes showed significantly higher prealbumin values; however, in all groups, the infants with higher intakes were also significantly older. Total proteins and albumin showed similar changes in all groups. Prealbumin concentrations showed great interindividual variability in infants of the same postnatal age. We conclude that prealbumin, albumin, and serum total proteins are not sufficiently sensitive biochemical markers to assess alterations of the nutritional status of premature infants.

Insulin stimulation of glucose metabolism in rat adipocytes: possible implication of protein kinase C

The hypothesis that insulin stimulation of glucose and lipid metabolism in rat adipocytes may involve the activation of protein kinase C was evaluated. 4 beta-Phorbol 12 beta-myristate, 13 alpha-acetate (PMA, 0.1-1000 ng/ml), a potent tumor promoter acting as a substitute for diacylglycerol to activate protein kinase C, stimulated 2-deoxyglucose transport in a time- and dose-dependent manner, without affecting passive glucose diffusion. PMA (0.1-1000 ng/ml) also elicited a dose-dependent activation of lipogenesis from [3-3H] glucose. Maximal PMA effects (100 ng/ml) on both processes were 60% of insulin maximal effects. In contrast, PMA (1-1000 ng/ml) failed to mimic the ability of insulin to stimulate lipogenesis from [3H]acetate. 4 beta-Phorbol 12,13 dibutyrate, mezerein, 1-oleyl-2-acetyl-glycerol, 1,2 diolein, known as protein kinase C activators, also markedly stimulated glucose metabolism whereas 4 alpha-phorbol 12,13 didecanoate and 4 beta-phorbol 13-monoacetate, shown not to activate protein kinase C, were ineffective. Mellitin, a cytotoxin-inhibiting protein kinase C, markedly decreased both PMA and insulin stimulation of glucose metabolism. PMA decreased insulin submaximal effects on 2-deoxyglucose transport without inhibiting insulin binding. Maximal PMA and insulin effects on 2-deoxyglucose transport and lipogenesis from [3-3H]glucose were not additive. Both PMA and insulin activated each metabolic process in a calcium-dependent manner. PMA, like insulin, no longer stimulated 2-deoxyglucose transport in fat cells treated with 2,4-dinitrophenol. These data show that PMA exhibited specific insulin-like properties on glucose metabolism in fat cells, without any effect on lipid synthesis from acetate. They indicate that PMA and insulin bioeffects may share a common step implicating a calcium- and energy-dependent process, distal to the initial insulin binding event. Our results suggest that protein kinase C may play a role in insulin regulation of glucose metabolism.

Effect of Glomus intraradices on infection by Fusarium oxysporum f.sp. radicis-lycopersici in tomatoes over a 12-week period

The interaction between Glomus intraradices Schenck & Smith, a vesicular–arbuscular mycorrhizal fungus, and Fusarium oxysporum Schlecht f.sp. radicis-lycopersici Jarvis & Shoemaker and its effect on tomato plants were investigated over a 12-week period. The root colonization by Glomus was not affected by the presence of Fusarium. The number of Fusarium propagules was consistently lower when the plants were inoculated with Glomus. The presence of Glomus decreased root necrosis caused by Fusarium in weeks 5, 11, and 12, but no significant effect was observed for the other 9 weeks. The results obtained at any observation time for the endomycorrhizal colonization and the Fusarium population, but not for the percent of root necrosis evaluation, were consistent throughout the 12-week experiment. It is concluded that the parameters used to study the interaction between a vesicular–arbuscular mycorrhizal fungus, a fungal root pathogen, and a host plant must be measured at different times after inoculation with the pathogen to make sure that observations are representative of the interaction under study.

Investigation on the occurrence of soluble lectins in mammalian nervous tissue extracts

Five brain or retina crude extracts obtained from adult mammalians and nine fractions of brain extracts prepared by chromatography were screened for their lectin activities. All crude extracts and several fractions contained agglutinins reacting with neuraminidase-treated rabbit red blood cells. Hemagglutination activity varied widely with the method of preparation of the extracts. Hemagglutination inhibition tests were carried out to look for possible differences in the specificities of the agglutinins. All were found to be D-galactosyl specific. Each crude extract was found to contain a second lectin activity, which was detected using ethanol-treated rabbit erythrocytes known to react with heparin-binding lectins. Hemagglutination and inhibition studies showed that they completely differ from the galactoside-binding lectins detected previously. The possible functions of these lectins are discussed.

Difference in blister fluid penetration after single and multiple doses of ceftriaxone

Plasma and suction skin blister fluid concentrations of ceftriaxone were studied in 12 subjects after intravenous administration of 1 g of ceftriaxone every 12 h (q12h) and 2 g every 24 h (q24h) after single and multiple doses. Ceftriaxone concentrations were determined by high-pressure liquid chromatography. Mean peak plasma concentrations (at the end of the 5-min infusion) were 254.0 and 374.8 micrograms/ml after administration of 1 g q12h after single and multiple doses, respectively. Similarly, with 2 g q24h, maximum levels were 409.6 and 443.5 micrograms/ml. Forty-eight hours after the last dose of ceftriaxone, plasma concentrations were still detectable: 1.2 micrograms/ml after 1 g q12h and 3.0 micrograms/ml after 2 g q24h. Higher ceftriaxone concentrations were observed in blister fluid after multiple doses than after a single dose. Peak concentrations almost doubled in the blister fluid after multiple doses: 36.0 versus 67.0 micrograms/ml and 38.6 versus 68.9 micrograms/ml for 1 g q12h and 2 g q24h, respectively. Elimination half-life of ceftriaxone in the blister (8.3 and 11.5 h) was longer than plasma half-life (6.3 h). With the area under the concentration-time curve ratio, a 113% increase in tissue penetration was observed after multiple doses for the 1 g q12h regimen. The free plasma and blister fluid ceftriaxone concentrations observed at the end of the dosing interval of the 2 g q24h regimen were higher than the MIC for 90% of the susceptible microorganisms and justified the once-a-day use of ceftriaxone.

[Quantitative measurement of lectin activities using an autoanalyser]

Today, an increasing number of lectins are available for a diagnostical purpose. Using an autoanalyser, it is possible to study and to measure the agglutination of red blood cells, one of their main properties.

Further evidence for the involvement of a membrane proteolytic step in insulin action

The hypothesis that insulin action involves a membrane proteolytic step was further explored, by using isolated rat adipocytes and liver plasma membranes. (1) The maximal insulin stimulation of 2-deoxyglucose transport and lipogenesis in fat-cells was selectively inhibited (73-88%) by N alpha-p-tosyl-L-lysine chloromethyl ketone (Tos-Lys-CH2Cl; active-site inhibitor of trypsin; 30-125 microM), p-nitrophenyl p'-guanidinobenzoate (active-site inhibitor of serine proteinases; 30-125 microM) and p-tosyl-L-arginine methyl ester (arginine ester substrate analogue of proteinases; 1-2 mM), under conditions where neither the basal rate of each metabolic process nor insulin binding nor cellular ATP content were affected. In contrast, N-acetyl-L-alanyl-L-alanyl-L-alanine methyl ester (alanine ester substrate analogue of proteinases; 1-2 mM) was ineffective. (2) Endoproteinase Arg-C (0.25-40 micrograms/ml) exerted dose-dependent insulin-like effects on both 2-deoxyglucose transport and lipogenesis in fat-cells, whereas endoproteinase Lys-C (5-100 micrograms/ml) was ineffective. The maximal activation by endoproteinase Arg-C of both processes (200 and 177% of control values respectively) was shown to occur under conditions where membrane integrity (assessed by measurement of lactate dehydrogenase leakage and passive glucose diffusion) was preserved. This effect was inhibited by Tos-Lys-CH2Cl (125 microM) and was not additive with the maximal insulin effect. (3) Insulin (1-100 ng/ml) produced a dose-dependent increase in the trichloroacetic acid-soluble 125I radioactivity released after a 30 min incubation at 37 degrees C of 125I-labelled liver plasma membranes, but was ineffective on 125I-labelled bovine serum albumin. Insulin effects on both radio-labelled proteins were reproduced by wheat-germ agglutinin (20 micrograms/ml), an insulin mimicker shown to act through the insulin receptor. These data provide further evidence for the hypothesis that insulin bioeffects involve the activation of a membrane serine proteinase with arginine specificity.

Single oral dose of ornidazole in women with vaginal trichomoniasis

Fifty-nine women with trichomonal vaginitis were randomly allocated to receive treatment with a single oral dose of either 0.5, 1.0, or 1.5 g of ornidazole. One week after treatment, a parasitologic cure was observed in 100% of patients treated with 1.5 g, in 95% of patients treated with 1.0 g, and in 65% of patients given 0.5 g. At the one-month follow-up visit, the cure rate remained at 100% for the 1.5-g dose group but dropped to 85 and 45% in the 1.0- and 0.5-g dose groups, respectively. The disappearance of symptomatic complaints was also dose related: the clinical cure was 100, 85, and 40% at the first follow-up visit and 89, 80, and 30% at the second follow-up visit. Adverse effects of mild or moderate severity were reported by 13 patients. These were encountered mostly in the 1.5- and the 1.0-g dose groups. The most frequent adverse effects were dizziness and gastrointestinal distress. Laboratory safety test did not reveal any significant toxicity. This study confirms that single-dose treatment of trichomoniasis with an oral dose of 1.5 or 1.0 g of ornidazole is effective and well tolerated.

Evidence for surface glycoprotein involvement in the intracellular bioactivity of insulin in rat adipocytes

Lectins specific for D-mannose (concanavalin A), N-acetyl-D-glucosamine (wheat-germ agglutinin) or D-galactose (Ricinus communis agglutinin I) inhibited insulin binding and activated glucose transport in rat adipocytes [Cherqui, Caron, Capeau & Picard (1982) Mol. Cell. Endocrinol. 28, 627-643]. In the present investigation, the intracellular activities of insulin and lectins on lipogenesis and protein synthesis were studied under conditions where neither agent had an effect on membrane transport processes. (1) When glucose transport was rate-limiting (0.5 mM-glucose), insulin (0.8 ng/ml) and lectins (20 micrograms/ml) increased lipogenesis by 2.4-3-fold. (2) When passive diffusion of glucose was amplified (10 mM-glucose), insulin (0.8 ng/ml) and lectins (20 micrograms/ml) increased lipogenesis by 1.6-1.8-fold even in the presence of 50 microM-cytochalasin B, which completely blocked glucose transport. (3) Insulin (6 ng/ml), concanavalin A and wheat-germ agglutinin (40 micrograms/ml) stimulated the incorporation of L-[U-14C]leucine into fat-cell protein 1.5-fold but did not modify alpha-aminoisobutyric acid uptake or 14C-labelled protein degradation. (4) Peanut and soya-bean agglutinins (specific for O-glycosidically-linked oligosaccharides), known not to alter insulin binding, were ineffective. (5) Lectin effects were dose-dependent and were markedly inhibited by specific monosaccharides (50 mM). (6) Insulin and lectin maximal effects were not additive and were completely abolished by neuraminidase treatment of fat-cells (0.05 unit/ml). These data indicate involvement of surface sialylated glycoproteins of the complex N-linked type in the insulin stimulation of glucose and amino acid intracellular metabolic processes. They suggest, together with our previous results, that the transmission of the insulin signal for both membrane and intracellular effects occurs via glycosylated effector entities of, or closely linked to, the insulin-receptor complex.

Further evidence for a role of carbohydrates in insulin binding: studies in lectin-purified receptors

Purification of liver membrane insulin receptors on concanavalin A- and ricin I-lectin columns gave a 15-fold enrichment in the insulin binding capacity per milligram of protein. Final receptor and protein recoveries were 53 and 3.8% respectively. Lectin-purification increased the receptor affinity for insulin, as indicated by a left-ward shift in the binding competition curve and a steeper slope in the Scatchard plot. Lectin-purification increased the receptor sensitivity towards the glycosidic probes. The maximal effects of beta-galactosidase, ricin I (galactose-binding lectin) and alpha-mannosidase were markedly amplified: 80, 90 and 60% inhibition, versus 45, 40 and 15% with particulate membranes. The limulus polyphemus (LPA) and wheat germ (WGA) agglutinins (sialic acid- and N-acetyl-glucosaminyl-binding lectins) became effective in modifying the insulin binding: 45 and 80% inhibition, respectively. The effects were dose-dependent, reversed by the monosaccharide competitors (lectin effects) and unrelated to the state of receptor occupancy. These findings indicate that, within the hormone recognition area, peptide chains containing galactose, mannose and N-acetyl-glucosamine are strictly required for insulin-receptor interaction and suggest that change in the receptor affinity is related to the role of carbohydrate in insulin binding.

Carbohydrate determinants involved in both the binding and action of insulin in rat adipocytes

The insulin receptor apparent affinity was markedly decreased in fat cells treated with lectins specific either for D-galactose (Ricinus communis agglutinin I, RCAI), D-mannose (concanavalin A, Con A, Lens culinaris agglutinin, LCA) or N-acetyl-D-glucosamine (wheat germ agglutinin, WGA), as indicated by a rightward shift of the binding competition curves and almost lineared Scatchard plots. Limulus polyphemus agglutinin (LPA), specific for sialic acid, was ineffective. All lectins enhanced 2-deoxy-D-glucose uptake with relative bioactivities (maximal lectin effect/maximal insulin effect) of 68-86%. Insulin and lectin stimulatory effects were antagonized by specific carbohydrates used as competitors and inhibited by cytochalasin B (70 microM). Maximal effects of insulin and lectins were not additive and were completely abolished in neuraminidase-treated fat cells. Lectins did not affect insulin degradation. These data show that sialylated glycosidic moieties containing D-galactose, D-mannose and N-acetyl-D-glucosamine units are involved in both processes of insulin 'high affinity' binding and activation of glucose transport but are not implicated in hormone degradation. They suggest that N-linked carbohydrate chains of the complex type may be essential for functional insulin receptor and post-receptor systems.

[Biological importance of the reactions between lectins and glycoconjugates in man]

Glucidic structures are now widely shown to be responsible of many recognition phenomenons. The biological efficiency of cellular membrane associated receptors depends on their stereospecific interactions with ligands. Glucidic structures are implicated in the interactions occurring between lectins and glycoconjugates. Although the knowledge about human lectins is still limited, such activities are now widely obvious for several cells: --erythrocytes: hemagglutin activity of glycophorin; --lymphocytes: Ts and NK cells; --platelets: plasma membrane and cell secreted lectins; --hepatic cells: lectins of hepatocytes and Kupffer cells; --muscular cells: galactose and heparin inhibitable lectins; --cells of human glomerular basement membrane: N-acetylosamines and N-acetyl neuraminic acid inhibitable lectins. To this list may be added the cytoagglutinating activity of fibronectin involved in cell-cell, cell-molecule or molecule-molecule interactions. The importance of lectinic agglutinins may be emphasized for several fundamental physiological mechanisms involved in molecular and cellular recognition: defenses against infection, coagulation, aging.

Ultraviolet difference spectroscopy study of peanut lectin binding to Mono- and disaccharides

Ultraviolet difference spectroscopy was used to study the interaction of peanut (Arachis hypogaea) lectin with complementary carbohydrates. A correlation was observed between variations of ultraviolet spectra during the binding of sugars to the lectin and the specificity and the strength of the binding. The association constant, free energy, enthalpy and entropy for peanut lectin-lactose interactions were calculated over the temperature range 10-30 degrees C. The binding constants for 10 mono- and disaccharides containing a D-galactopyranosyl or a D-talopyranosyl residue were calculated. Comparing their effectiveness to interact with peanut lectin, methyl alpha-D-galactopyranoside appeared to have a more marked affinity than lactose; D-galacturonic acid and methyl 7-deoxy-D-glycero-beta-D-galacto-heptopyranoside had no measurable affinity; the other sugars showed a lower affinity than lactose. The correlations between these differences and the conformations of the sugars obtained by X-ray analysis are discussed.

[Laser nephelometry for the quantitative determination of the interaction between peanut lectins and asialoglycoproteins]

The reaction of precipitation between peanut lectin and human serum desialylated glycoproteins was measured by means of laser nephelometry. Such a study can be used for the interactions with a purified asialoglycoprotein or with a whole serum. So, nephelometry allows investigations of abnormal or modified circulated molecules in a number of pathological situations.

Identification of liver cell membrane galactoglycoproteins involved in the process of insulin binding

The glycoproteinic nature of the insulin receptor was indicated using two different approaches: 1. [125I] insulin binding to soluble receptors from mouse liver was inhibited by digestion with beta-galactosidase or pretreatment with Ricinus communis I or concanavalin A. An other enzyme (neuraminidase) and lectins (wheat germ agglutinin, Dolichos biflorus) did not affect the binding reaction. These data confirmed that insulin directly interacts with the galactoglycoproteins of liver membranes. 2. The galactose oxidase-sodium boro[3H] hydride technique, previously used for labeling accessible membrane galactoglycoproteins, was again utilized to discern the components that interact with insulin. When liver membranes were equilibrated with 10-7 M insulin prior to labeling, the SDS gel radioactive profiles were specifically modified with two galactoglycoprotein of apparent molecular sizes 195 000 and 145 000, compatible with their participation in the insulin binding interaction. Membrane pretreatment with beta-galactosidase or Sophora japonica lectin reduced the labeling in most peaks, thus supporting the argument for labeling sensitivity. Preincubation of membranes with 10-7 M proinsulin slightly hindered labeling, while pretreatment with 10-7 M glucagon was ineffective, suggesting a specificity of the insulin effect. These data indicate that glycoprotein nature of the insulin receptor for two reasons: alteration of insulin binding after modification of the galactoglycoproteins, and alteration of galactoglycoprotein labeling after insulin binding. Two galactoglycoproteins, with apparent molecular weights 145 000 and 195 000, respectively, were identified and they are suggested to have insulin binding properties.

Further characterization of the insulin receptor glycosidic moiety in rat adipocytes

Simultaneous or sequential treatment of rat adipocytes with neuraminidase plus beta-galactosidase decreased insulin binding by 43%. No modification was observed with either enzyme individually. alpha-Mannosidase enhanced insulin binding (38%), whereas beta-N-acetylglucosaminidase and alpha-L-fucosidase were ineffective. Lectins that interact with galactose (Ricinus communis I, RCAI), mannose, Lens culinaris agglutinin (LCA), Concanavalin A (Con A) or N-acetylglucosamine (wheat-germ agglutinin, WGA) decreased insulin binding by 43, 57, 59 and 85% respectively. Lectin inhibition was dose-dependent, saturable and prevented by specific monosaccharides. RCAI, LCA, Con A and WGA decreased the insulin dissociation process by 45, 90, 78 and 84% respectively. Lectins specific for sialic acid, terminal galactose, N-acetylgalactosamine or fucose (Limulus polyphemus, peanut, soybean and Ulex I agglutinins) did not modify either insulin binding or dissociation. These results indicate involvement of penultimate D-galactose, internal N-acetyl-D-glucosamine and D-mannose residues in both processes. They suggest that, in rat adipocytes, a glycosidic moiety participates in the insulin-receptor interaction through N-linked oligosaccharides of the 'complex type'.

Comparative evaluation of carprofen and indomethacin in rheumatoid patients

Thirty-six patients with definite or classical rheumatoid arthritis were studied in a 6-week double-blind parallel trial. They were randomly divided into three groups and received either carprofen stepwise 150, 200, and 250 mg/day, carprofen 350, 400, and 450 mg/day or indomethacin 100 mg/day. Classical methods and parameters for evaluating the disease activity of rheumatoid arthritis were used. A large panel of laboratory tests were also involved in the assessment of toxicity. Although the incidence of adverse effects was similar for both drugs, cutaneous and gastrointestinal symptoms were more frequent with carprofen than with indomethacin, whereas central nervous system reactions were elicited more often with the latter drugs. For most of the efficacy variables studied, the carprofen high dosage regimen at weeks 5 and 6 was shown statistically superior or at least not different from the indomethacin group; both of these were superior to the carprofen low dosage regimen.