Plasma Proteins and the Gastrointestinal Tract

Jeffries, Graham H.; Holman, Halsted R.; Sleisenger, Marvin H.

doi:10.1056/nejm196203292661307

Cited by 101 publications

(32 citation statements)

References 38 publications

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“…Another important internal source of nitrogenous material is the digestive enzymes; in adults, these enzymes have been estimated to supply approximately 35 g protein/24 hr (protein content of digestive fluids, in grams per 24 hours: salivary, 4.5; gastric, 9.3; biliary, 1.0; pancreatic, 10.5; intestinal, 9.9) [26]. Under physiologic conditions, a significant amount of plasma protein leaks out into the gastrointestinal tract, is rapidly digested into constituent amino acids and largely reabsorbed [13]. Microorganisms, too, contribute to the amino acid content of the intestine.…”

Section: Discussionmentioning

confidence: 99%

Endogenous Amino Acid Loss and Its Significance in Infantile Diarrhea

1973

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ExtractSignificant amino acid loss through the stool, analogous to impeded reabsorption of water, fat, and electrolytes, was suspected in infantile diarrhea. The stools of six patients, who had acute diarrhea and received no protein by mouth, were collected and analyzed for amino acids, nitrogen, and protein. Similar determinations were made on five normal controls. In addition, stool collections were made from one patient during a severe protracted diarrhea which necessitated parenteral alimentation, during a subsequent isolated acute episode of diarrhea, and after complete recovery. The results of the analyses showed that free amino acids in the stool are elevated up to 10-fold during diarrhea, as compared with periods of remission and with normal controls. Protein and total nitrogen excretion is also elevated in diarrhea, although to a lesser degree (4-and 2.5-fold, respectively). It is postulated that protracted diarrhea is associated with impaired reabsorption of endogenous nitrogen, which results in a vicious cycle of protein depletion that ultimately leads to an intractable stage. The validity of this assumption is confirmed by the success achieved by parenteral amino acid therapy for protracted diarrhea.

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Section: Discussionmentioning

confidence: 99%

Endogenous Amino Acid Loss and Its Significance in Infantile Diarrhea

1973

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“…Thus, some of the patients showed evidence of impaired gut transport of Cu64, although their serum ceruloplasmin concentrations were normal. This impairment was evidenced by alterations in shapes of oral absorption curves with delays in the appearance of the initial peak of radioactivity (Table II) We did not investigate whether loss of the copper protein via the feces might contribute to lowering of ceruloplasmin concentrations analogous to the loss of albumin noted in a few patients with sprue (17). Such a mechanism might be considered, since virtually all plasma proteins, including ceruloplasmin, have been found in gastric and intestinal juices (18) and such physiologic losses may be exaggerated in patients with various forms of intestinal pathology.…”

Section: Discussionmentioning

confidence: 99%

Absorption of Copper in Malabsorption Syndromes*

Sternlieb¹,

Janowitz²

1964

J. Clin. Invest.

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“…Minor loss of protein into the gastrointestinal tract occurs in normal subjects and appears to be a factor in the normal catabolism of the serum proteins (26). Excessive enteric protein loss has been shown to be of significance in the hypoalbuminemia associated with a variety of disorders, including Whipple's intestinal lipodystrophy (27), gastric rugal hypertrophy (28), gastric carcinoma (29), sprue (30), regional enteritis, ulcerative colitis (31), constrictive pericarditis (32), and intestinal lymphangiectasia (6, 23).…”

Section: Discussionmentioning

confidence: 99%