No abstract

No abstract

Since the decline of the widespread supplementation of the diet with vitamin D, the demands of the physiological growth spurt for extra vitamin D in adolescents already on a borderline intake may be responsible for the great increase in "biochemical" rickets. Once the growth spurt is over the condition subsides but the results ofimpaired growth or permanent pelvic deformity will not necessarily be eradicated.

SUMMARY The 'missing peptidase' hypothesis to explain the aetiology of coeliac disease has never been satisfactorily resolved and recent reports suggest that coeliac brush borders may have depressed levels of specific peptidase enzymes. It has been inferred from these studies that the subsequent brush border digestion of gliadin peptides may therefore be defective. In this present study a sensitive fluorometric assay was used to measure the hydrolysis of a peptic-tryptic digest of gliadin by both normal and coeliac brush borders. The coeliac brush borders were as efficient as the normals in hydrolysing gliadin peptides and showed no depression of any specific peptidase activity. It is now recognised that it is the brush border which is the major site of mucosal protein digestion and is known to contain numerous peptidase enzymes. 14-7 Given also that the brush border represents the interface between the intracellular milieu and the toxic gliadin peptides then this membrane becomes the most logical site for any enzyme defect. Supporting such an idea is the fact that other brush border membrane enzyme defects are well documented, including enterokinase deficiency'8 and sucrase-isomaltase deficiency. '9 This present study represents the first detailed study of the enzymology and digestive capacity toward gliadin of the isolated coeliac brush border membrane. The ability to study the coeliac brush border hydrolysis of gliadin peptides has been made possible by the development of a sensitive microassay2( designed specifically to measure this digestion. Methods BIOPSIESJejunal biopsies were obtained using a steerable biopsy capsule (Meditech) under fluoroscopic screening. The subjects for the control group were patients being biopsies for routine diagnostic purposes. The coeliac group were patients in remission, who had been on a gluten free diet for at least a year, and who were being checked for the maintenance of their response to the diet. Biopsies on 11 May 2018 by guest. Protected by copyright.

SummaryCalciferol therapy for 12 months in white, Asian, and West Indian schoolchildren resulted in a highly significant increase in height and weight when compared with schoolchildren not so treated. The rate of fall of serum alkaline phosphatase was similar in both the treated and untreated schoolchildren and in other children treated in hospital for rickets. Dietary studies on 9% of the total survey by weighed inventory methods showed a low average intake of vitamin D, while random estimates of 25-hydroxycalciferol levels on 6% of the children were less than 3 8 ng/ml in 40% of those studied (principally Asian). It was concluded that there was a significant problem of vitamin D deficiency among Asian and West Indian teenagers and that white children were also affected to a less degree.