[Methods for the study of proteinuria. Interpretation].
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Biomedical subjects
Publications and source records attributed to J C Fruchart.
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Plasma lipids, lipoproteins and apolipoproteins A1 and B were determined in a reference population and in 273 patients who underwent coronary arteriography for evaluation of chest pain. The patients were divided into 3 groups according to arteriographic findings. The 102 patients in group A had normal coronary arteries; the 30 patients in group B had small vascular abnormalities but no significant narrowing; the 141 patients in group C had significant vascular lesions with greater than or equal to 50% narrowing. Total cholesterol and triglycerides were quantified using enzymatic methods. HDL cholesterol and phospholipids were enzymatically analyzed after phosphotungstate precipitation. Plasma lipoproteins were evaluated by quantitative electrophoresis based on densitometric scanning of the lipoprotein bands after separation and visualization by polyanion precipitation. Apoproteins A1 and B were measured by electroimmuno-diffusion assay using ready-for-use plates. Statistical evaluation of the data showed that group C patients had higher betalipoprotein and apo B levels and lower alphalipoprotein and apo A1 levels than subjects with normal coronary arteries. The predictive value of these results was established in relation to clinical findings. Plasma lipid measurements proved inadequate to separate the 3 groups. In contrast, the betalipoprotein/alphalipoprotein ratio and, still better, the apo A1/apo B ratio provided good discrimination. The results suggest that measurement of plasma apo A1 and apo B levels is the best means of assessing the risk of coronary artery disease.
Adipose tissue lipoprotein lipase activity (LPL) falls dramatically during experimental infection of mice by Plasmodium chabaudi. The decrease in this activity accounts for the seric accumulation of triacyl-glyceride-rich lipoproteins (chylomicrons mainly and Very Low Density Lipoproteins (VLDL) partly). This loss of tissue LPL enzyme activity is moreover enhanced, in capillary vessels, by a simultaneous decrease in the activatory power of serum towards the enzyme. This phenomenon is mainly related to the presence of Very Low Density Lipoproteins. In the mouse VLDL apoprotein composition is supposed to be modified. On the contrary, in fatal infection of mice by P. vinckei the adipose tissue lipoprotein lipase (LPL) activity is normal or even increased.
We describe a simplified electroimmunoassay for quantification of human apolipoproteins A-I and B on prepared plates. A solution of agarose at 55 degrees C, containing hydroxyethylcellulose and antibodies, is poured onto a plastic film and allowed to gel. Wells are punched in the gels and the plates are dried for storage. Before use, they are rehydrated and buffered. We use succinylated Sudan Black to prestain lipoprotein fractions of plasma. After electrophoresing samples of plasma or standards for 3 h at 4 degrees C at 12.5 V/cm, we measure the peak heights and read the results from a standard curve prepared by using calibrated sera of known apolipoprotein B and A-I content as secondary standard. The within- and between-assay coefficients of variation were less than 4% in all cases. Results correlated well with those obtained by classic electroimmunodiffusion. Subjects with confirmed atherosclerotic lesions had significantly (p less than 10(-9)) lower ratios of apolipoprotein A-I to apolipoprotein B, compared with ratios in controls.
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The kinetic study of the seric free fatty acids, total lipids and hepatic triacyglycerides had led us to conclude that the biosynthesis of T.A.G.-rich lipoproteins increases during malaria. It seems that the parasite induces a lipolysis of adipose tissue in order to meet its own needs for fatty acids and that the excess of the latter taken by the liver involves an increased synthesis of the V.L.D.L. The cis-vaccenic acid has also been analysed during the evolution of parasitaemia; these variations by themselves cannot explain the extra parasitic hemolysis.
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An accurate, quick, and reproducible method to assay serum lipase activity allowed a parallel study of lipase and amylase in 147 patients. Lipase appeared very specific of pancreatic distress. In acute pancreatitis its increase was constant, frank, quick and lasting. It brought a diagnostic argument superior to the dosages of amylase activities in serum and/or urine. But its value as an evolutive and pronostic test was as much limited. Its interest as a negative argument for differential diagnosis was not superior either. In chronic pancreatic diseases, it gave evidence of massive spread or complications.
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The aim of the present study was to determine, in the rat, changes in the plasma lipids and lipoprotein levels after single or iterative administration of triton WR 1339 in order to elicit the inverse relation between triglyceride and high density lipoprotein levels in man and animal. 24 hours after the acute intravenous injection of triton WR 1339 increases of cholesterol and glyceride were observed while HDL decreased. These effects are potentiated by iterative intravenous administration of triton. According to Nikkila these variations could be explained by the fact that a part of HDL proceeds from the catabulism of lipoproteins rich in glycerides. At the time of the recovery of epuration process, the HDL regeneration from VLDL that are abondant in the plasma should represent the changes observed. The effects found after iterative intravenous administration of triton, confirm that infusion of the detergent induces in the blood a decrease of the catabolism of lipoproteins rich in triglycerides and at the same time the disappearing of blood HDL.
The hypertriglyceridaemia of patients with haemodialysis-treated chronic renal insufficiency was characterized in respect of the apolipoproteins C of VLDL. Using Kane's method, particular attention was paid to the CII/CIII ratio of VLDL isolated by ultracentrifugation in eleven hemodialyzed patients with hypertriglyceridaemia. There was a significant decrease of this ratio compared to twenty three patients with essential hypertriglyceridaemia. A removal defect is suggested as fundamental to the pathogenesis of the hypertriglyceridaemia of renal failure since apoprotein CII acts as a specific activator of lipoprotein lipase.
We describe a procedure for the convenient separation of proteins by sodium dodecyl sulfate/polyacrylamide gel electrophoresis of urine from cases of renal disease. A precipitation method that requires no special apparatus was used to concentrate the urinary proteins; for electrophoretic separation we used a commercially supplied polyacrylamide/cellulose gel slab. This method seems to be valuable for investigation of proteinuria; we recommend it for routine use.
The Hyland laser nephelometer PDQ system for the assay of apolipoprotein B (apo-B) in human serum is described. Within and between-batch precision, accuracy and reliability are discussed. This instrument represents an important development in the immunochemical assay of apo-B, and the speed, precision, and convenience of the methodology make such a system attractive. Quantitation of apo-B was assessed in normal and hyperlipaemic subjects. Comparisons were made with two other specific and sensitive immunological methods for quantifying apo-B: enzymeimmunoassay (EIA) and rocket immunoelectrophoresis (RIE). Results obtained by the three methods correlated very well.
A four and a half year old boy was hospitalised with acute respiratory failure due to the inhalation during two hours of the smoke from an overheated frier. Oxygen, corticosteroids and furosemide led to clinical stabilisation but after 24 hours asphyxia developed. The trachea was found to be obstructed by a firm elastic substance which prevented intubation or bronchoscopy. Autopsy revealed massive cellular desquamation of the bronchial lining. The lumen was occupied by miscellaneous debris. There were multiple pulmonary infarcts. This is the second case of acute intoxication by acroleine. In the light of these two cases, treatment should consist of corticosteroids, antibiotherapy, inhalation therapy, and repeated bronchial aspiration.
We describe a modified lipoprotein electrophoresis on acrylamide gel. The lipoproteins, prestained with Sudan Black, are separated by running on acrylamide-agarose gels, with two different concentrations of acrylamide and a constant concentration of agarose. The sera are deposited in the first gel (2% acrylamide). Chylomicrons remain at origin and other lipoproteins run through the first gel to the second one (3% acrylamide gel). VLDL stays at the junction of both gels, LDL and HDL are separated in the 3% acrylamide gel. By this technique, we were able to detect an increase of Lp(a) and to identify the different types of hyperlipoproteinemia. After running, the plates can be treated for storage.
Diagnosis of type III hyperlipoproteinemia requires preparative ultracentrifugation in order to measure the cholesterol/triglyceride molar ratio into isolated d less than 1.006 lipoproteins. The authors describe an ultracentrifugation micromethod which needs 600 microliter of serum and can be completed within three hours (Airfuge Beckman instruments). An original tube-slicer allows the separation of the d less than 1.006 lipoproteins located into top fractions. This simple micromethod might confirm diagnosis of type III in patients and would be useful for clinical laboratories.
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The effects of different types of phospholipids on the lipoprotein lipase (LPL) and on the hepatic triglyceride lipase (TGLH) were studied by comparative in vitro incubation. Substrates were prepared by homogenization in glycerol of 3H-labelled triolein plus phosphatidylcholine (either dipalmitoyl PC, or ovolecithin or highly unsaturated PC, EPL Nattermann). Enzymes were obtained from rat adipose tissue, myocardium, lungs and liver and human adipose tissue and post-heparin plasma, respectively. The enzyme activities as determined in mmol/ml medium showed differences of highly statistical significance (p less than 0.001). In any tissue investigated the enzyme activities of LPL or TGLH followed the sequence: highly unsaturated PC (EPL) greater than ovo-lecithin greater than dipalmitoyl-lecithin. This was true for the enzymes of rat and human origin as well. It was concluded that the observed LPL and TGLH activation may account for the beneficial therapeutic effects of highly unsaturated phosphatidylcholine (EPL) in human hyperglyceridemias.