Letter: Immunoglobulin characterization.
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Biomedical subjects
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The protein composition of normal human pancreatic juice and pancreatic juice of men with chronic calcifying pancreatitis (CCP) were compared using immuno-diffusion techniques. An additional protein was found in pathological pancreatic juice and this protein has been identified as lactoferrin. Its concentration has been determined. The indirect immunofluorescence method was used to detect and localize lactoferrin in 9 samples of human pancreas from 3 patients with CCP and 6 patients without CCP. The fluorescence was found in all samples. Lactoferrin staining was localized in lumen acinar and in the cytoplasm of the acinar cells. The fluorescence was stronger in the apical zone of acinar cells. When lactoferrin antiserum was incubated with lactoferrin insolubilized by glutaraldehyde, no fluorescence staining was detected. The differences between our results obtained by immunodiffusion and immunofluorescence techniques are explained by the different sensitivity of the two techniques and these results indicate that lactoferrin is a protein of pancreatic secretion.
The two human anionic trypsinogens 1 and 2 were purified from human pancreatic juice by gel filtration on Sephadex G-100 and by chromatography on DEAE-cellulose. After activation of their respective zymogens by porcine enterokinase, human trypsins 1 and 2 were studied for their reaction with a wide variety of proteinase inhibitors. Kunitz pancreatic trypsin inhibitor and human pancreatic secretory trypsin inhibitor completely inhibited both human trypsins at a stoichiometric inhibitor-to-enzyme ratio of one to one. In contrast, bovine pancreatic secretory trypsin inhibitor (Kazal's inhibitor) failed to inhibit either human trypsin. The inhibition of both human trypsins by porcine pancreatic secretory trypsin inhibitor was demonstrated. The reactions of the trypsins with chicken ovomucoid, Ascaris lumbricoides (type suis), human sperm and blood plasma trypsin inhibitors were studied. The most striking difference between the two human trypsins was the reaction with soybean trypsin inhibitor (Kunitz). Trypsin 2 was completely inhibited in a one-to-one molar ratio while trypsin 1 was poorly inhibited. The presence of a prekallikrein in human pancreatic juice is discussed.
The two chymotrypsinogens present in human pancreatic juice have been purified and characterized. The zymogens are two immunologically and electrophoretically different proteins. Chymotrypsinogen A, the major chymotryptic component (90% of the total potential N-acetyl-L-tyrosine ethylester activity) is stable in acidic medium. By its molecular weight (approx. 24 000), specific activity (530) and amino acid composition, human chymotrypsinogen A resembles chymotrypsinogens A and B form bovine and porcine pancreas. Chymotrypsinogen B is a minor chymotryptic component (7% of the total potential N-acetyl-L-tyrosine ethylester activity) unstable in acidic medium with a molecular weight slightly higher (approx. 27 000) and a specific activity slightly lower (300) than chymotrypsinogen A. The last 3% of the total potential N-acetyl-L-tyrosine ethylester activity corresponds to a proelastase that we have partially characterized.
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We have shown the presence of lactoferrin in the pancreatic juice of patients with chronic calcifying pancreatitis (CCP) and its absence in controls. In this work, lactoferrin has been found in saliva, but neither in gastric juice nor in bile. Therefore, a technique for collecting the human duodenal juice with a rubber tube and preventing its contamination with saliva is described. In the duodenal juice of 15 patients with CCP, 52 controls without evident pancreatic diseases, and 9 cases of pancreatic diseases other than CCP, lactoferrin has been searched for by immunological methods before and after an intravenous injection of CCK-PZ (3 U CHR) + secretin ( C U). The lactoferrin test in positive in 5, inconclusive in 6, and negative in 41 cases, and in the 9 cases of non-CCP pancreatic diseases it is negative. The use of this test in the diagnosis of CCP is proposed.
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For a better understanding of the molecular mechanism leading to intraductal precipitation of proteins in primary chronic calcifying pancreatitis in man, we studied the composition of normal and pathological human pancreatic juice by immunotechniques. We found an increased level of serum proteins in pathological juices: 12.47% of total proteins compared to 1.8% in normal ones; albumin is 8.16% of the total proteins, IgG 2.84%, IgA 0.83% and IgM 0.91%. Transferrin and alpha 2-macroglobulin are present, but were not estimated. The albumin/IgA and albumin/IgG ratios favour the hypothesis of a local synthesis of these immunoglobulins as was shown in normal juice. The cross adsorption of antisera against pancreatic juice showed the presence in the pathological juice of a normal molecule in much higher concentration. The role of these proteins in precipitation is discussed.
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Acute ethanol intoxication was studied in 38 Wistar rats, 18 on a balanced diet and 20 on a high fat diet, fed by gavage on 47% ethanol in a dosage of from 3 to 12 g/kg body weight daily for periods ranging from three to 16 days. No macroscopic changes in pancreas or liver were found in any of these animals. Histological changes (venous congestion of the pancreas, the liver, and the kidneys) were found in rats given 4 g or more per kilogram. The only difference between the findings in rats given a balanced diet and those given a high fat diet was the development of fatty livers in the latter group. Chronic ethanol intoxication was studied in 45 Wistar rats, on a balanced diet, which were given 20% ethanol freely for 20 to 30 months. More than half the animals developed pancreatic lesions very similar to those of human chronic pancreatitis. The pathological changes, in foci surrounded by normal pancreatic tissue, were a reduction in acini, duct multiplication (probably by neogenesis), protein plugs, sometimes calcified in the ducts and sclerosis. Samples of pancreatic juice from four animals exposed to ethanol contained significantly higher protein concentrations than samples taken from two control animals. Protein precipitates appeared spontaneously in the pancreatic juice of the animals exposed to ethanol, but not in that of the controls. These findings are very similar to those in alcoholic pancreatitis in man, which has thus been reproduced for the first time in experimental animals. Beta-cell adenomata of the islets of Langerhans were observed in four of the rats exposed to ethanol.
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