Urinary Excretion of Acid Mucopolysaccharides by Patients with Rheumatoid Arthritis1

Abstract

Several methods have been described for the determination of urinary acid mucopolysaccharides (1-4). It has been found that in normal individuals the daily urinary excretion varies with age and sex (4,5). A few attempts have been made to correlate urinary excretion of acid mucopolysaccharides with different disease states. Craddock and Kerby (6) have reported that patients with impairment of renal function have a urinary excretion of acid mucopolysaccharides lower than that of normal individuals. They also found no significant differences between normal individuals and diabetic patients without renal involvement. In patients with rheumatoid arthritis Badin, Schubert, and Vouras (7) have demonstrated a high plasma concentration of acid mucopolysaccharides, but there have hitherto been no data available concerning their urinary excretion. This paper presents data on the urinary excretion of acid mucopolysaccharides by patients with rheumatoid arthritis and discusses the identity of the urinary acid mucopolysaccharides excreted in this disease. MATERIAL AND METHODThe study was performed on eight patients hospitalized for active rheumatoid arthritis. All of them showed a moderately elevated erythrocyte sedimentation rate, low-grade fever, involvement of several joints, and typical radiographic alterations. All patients were untreated when the urine collection was started. Two of them, however (M.G. and P.C.), discontinued treatment a few days before the urine collection was started. Urinary acid mucopolysaccharides were determined according to the method described by Di Ferrante and Rich (4), by which the urinary acid mucopolysaccharides are precipitated, from an aliquot of the 24-hour urine, with cetyl-trimethyl-ammonium bromide. After removal of the precipitant the glucuronic acid content of the precipitate is determined. The results in Table I In five patients (P.C., B.E., E.E., W.J., and G.A.) the urinary excretion of acid mucopolysaccharides was measured both before and during periods of oral treatment with sodium salicylate.In order to collect an amount of urinary acid mucopolysaccharides sufficient for purification and analysis, 20 liters of pooled urine from patients with rheumatoid arthritis were adjusted to pH 5 with 2 N HCl, and 8 Gm. of cetyl-trimethyl-ammonium bromide were added. After 24 hours at 00 C., the fine precipitate present was collected, by filtration under suction, on a thin layer of Hyflo super-cel. The cake of Hyflo super-cel was then washed in a 250-ml. centrifuge bottle with several 150-ml. aliquots of 95 per cent ethyl alcohol saturated in NaCl, until the supernatant obtained after centrifugation was colorless. The sediment was dried in a desiccator, under vacuum and in presence of paraffin chips, and then extracted three times with 30 ml. of distilled water. The aqueous extract was reprecipitated with three volumes of 95 per cent ethyl alcohol saturated in NaCl.After 24 hours at 00 C., the precipitate was collected by centrifugation, dissolved in 100 ml. of water and cleared of insolub...

Increased urinary excretion of acidic mucopolysaccharides in exophthalmos

“…DISCUSSION An increase in urinary excretion of AMPS has been described in studies of rheumatoid arthritis (20), lupus erythematosus (21), some types of cancer (22,23), Marfan's syndrome (24), and Hurler's syndrome (25,26). In patients with Hurler's syndrome only chondroitin sulfate B and heparitin sulfate are increased, while in Marfan's syndrome there is an increase in all mucopolysaccharides.…”

Slow turnover of manganese in active rheumatoid arthritis accelerated by prednisone

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“…The postulate that abnormal manganese metabolism might be present in human collagen disease rests on the following: (a) Rheumatoid arthritis displays abnormalities of mucoprotein and mucopolysaccharide metabolism (7)(8)(9)(10); (b) Another collagen disease, the hydralazine syndrome, appeared linked to manganese deficiency on the basis of animal studies (11,12) ; (c) Induction of the hydralazine syndrome seems to depend upon the genetic substratum (13); and (d) Genetic factors may interact with environmental ones in the development of manganese deficiency, as was proven by the manganese-dependent defects of the pallid strain of mice (14,15).…”

A Case of Sanfillippo’s Disease Correlating Clinical and Biochemical Findings

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