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Intestinal pH and propulsion: an explanation of diarrhoea in lactase deficiency and laxation by lactulose.

Subjects deficient in lactase may experience bloating, cramps and diarrhoea after ingesting milk, due to the unhydrolysed and poorly-absorbed lactose. The diarrhoea may result from an osmotic effect of the lactose itself or its poorly-absorbed acidic products of fermentation (Weijers, van de Kamer & others, 1961; Christopher & Bayless, 1971), possibly together with an alteration of sodium and water absorption due to the lowered colonic pH (Rousseau & Sladen, 1971). Laxation by lactulose (1-4-beta-galactosidofructose) may operate through an analogous mechanism. The drug is a synthetic dissaccharide which, in oral doses of 10-20 g, relieves chronic constipation (Wesselius-de Casparis, Braadbaart & others, 1968). It is neither hydrolysed by intestinal dissaccharidase (Dahlqvist & Gryboski, 1965) nor absorbed in the gut, but it is converted in the colon mainly to lactic and acetic acids by various bacteria including Lactobacillus acidophilus. Apart from the increased osmotic effect, the pH in the proximal colon falls markedly (Bown, Gibson & others, 1974), and larger doses may reduce stool pH. Weijers & others (1961) inferred that the acidic products formed from lactose in the colon stimulate propulsion, and K.S. Liem (Philips-Duphar) suggested to us that lactulose may relieve constipation partly by stimulation of propulsion due to the lowered pH. The experiments described below support this view.

Animals

Sucrase and lactase synthesis in suckling rat intestine in response to substrate administration.

The intestinal brush border disaccharidases separated by gel electrophoresis were studied after oral administration of a high sucrose or lactose diet to 11-day-old suckling rats during 3 days. Some modifications of the brush border protein and eyzyme patterns could be attributed to the effect of the basic diet: increase of glucoamylase, appearance of a weak sucrase activity and of a second molecular form of maltase. However, the specific action of a given disaccharide on the synthesis of the corresponding hydrolytic enzyme could be clearly demonstrated. Indeed, the electrophoretic pattern after sucrose or lactose feeding showed a marked increase of the protein bands corresponding to sucrase-isomaltase or lactase activities.

Administration, Oral

[Influence of dietary lactose on the development of lactase activity in the digestive tract of the pig].

Lactase activity has been measured in the pancreas, the small and large intestine of 79 pigs varying in age from 6-7 months. The endogenous enzyme level fluctuated along the small intestine but the activity did not vary according to the level of lactose fed in the diet either just after weaning or from 25 to 100 kg of live weight. Measurements performed in the content of the intestine showed that lactose could be digested by the enzymes of the microflora mostly active in the ileum, the caecum and the large intestine.

Animals

Variation in the lactase dehydrogenase activity of the esophagus.

Quantitative assay and electrophoretic study of lactate dehydrogenase (LDH) from various tissues of the opossum esophagus were performed. On the basis of expression of the LDH isozymes, we concluded that the smooth muscle of the body of the esophagus carry on more anaerobic glycolysis than the striated muscle. The smooth muscle of the gastroesophageal junction carry on both anaerobic as well aerobic glycolysis.

Animals

Regulation of the L-lactase dehydrogenase from Lactobacillus casei by fructose-1,6-diphosphate and metal ions.

The lactate dehydrogenase of Lactobacillus casei, like that of streptococci, requires fructose-1,6-diphosphate (FDP) for activity. The L. casei enzyme has a much more acidic pH optimum (pH 5.5) than the streptococcal lactate dehydrogenases. This is apparently due to a marked decrease in the affinity of the enzyme for the activator with increasing pH above 5.5; the concentration of FDP required for half-maximal velocity increase nearly 1,000-fold from 0.002 mM at pH 5.5 to 1.65 mM at 6.6. Manganous ions increase the pH range of activity particularly on the alkaline side of the optimum by increasing the affinity for FDP. This pH dependent metal ion activation is not specific for Mn2+. Other divalent metals, Co2+, Cu2+, Cd2+, Ni2+, Fe2+, Fe2+, and Zn2+ but not Mg2+, will effectively substitute for Mn2+, but the pH dependence of the activation differs with the metal ion used. The enzyme is inhibited by a number of commonly used buffering ions, particularly phosphate, citrate, and tris (hydroxymethyl) aminomethane-maleate buffers, even at low buffer concentrations (0.02 M). These buffers inhibit by affecting the binding of FDP.

Acetates

Number of mutations required to evolve a new lactase function in Escherichia coli.

The frequency of mutation of the ebgAo allele to ebgA+ was compared with the frequency of mutation of strA+ to strA-. The observation that both spontaneous and ethyl methane sulfonate-induced mutations to ebgA+ occurred more frequently than mutations to strA- suggests that ebgA+ mutants arise as the result of single-point mutations.

Alleles