Diarrhea and short-chain fatty acids in disaccharide malabsorption; regulation of colonic fermentation.
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Synthetic glycoproteins can be prepared by reductive amination of proteins and reducing carbohydrates in the presence of sodium cyanoborohydride. The reaction proceeds readily in aqueous solution at pH 6--9 to give high degrees of substitution. The degree of substitution can be determined by amino acid analysis, as the 2 degrees amine linkage formed with the epsilon-amino groups of lysine is stable to acid-catalyzed protein hydrolysis conditions. Antisera have been obtained to bovine serum albumin conjugates containing reductively aminated cellobiose, lactose, and maltose. Preliminary experiments demonstrate that antiserum to the cellobiose-BSA conjugate is hapten-specific, and the structural features of the hapten recognized by the antibodies were established by hapten inhibition experiments. These studies demonstrate that antibodies recognize both the terminal beta-glucosyl and acyclic reduced glucosyl residues.
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A seroepidemiological surveillance of a contact population was started in 1984 in French Polynesia. The ELISA test was used to measure IgM anti-ND-O-BSA in the sera. Specific antibody levels were higher in healthy Polynesians than in normal individuals living in a nonendemic country. The positive threshold of the reaction was fixed according to this background activity in healthy Polynesians. Under these conditions, 100% of the multibacillary patients were detected as seropositive as compared to 5% of the paucibacillary group. In the population of 724 household contacts tested and observed for 2 years: 93 (12.8%) were seropositive, with 8 (1.1%) showing activity equivalent to multibacillary patients (1 of these 8 individuals developed a lepromatous form of leprosy); 631 (87%) were seronegative and 3 developed a paucibacillary form of the disease (2 BT, 1 I) without any antibody increase. Among those four contacts who developed leprosy, three were related to a multibacillary index case. These data suggest that this test may be useful for the prediction of multibacillary leprosy. A long-term surveillance of this high-risk population will be able to evaluate the diagnostic and prognostic value of the serological assay.
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