[Our experience in the treatment of psoriatic rheumatism with D-penicillamine].
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Biomedical subjects
Publications and source records attributed to D Maestracci.
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Using a double labeling method based on the method of Thomas (Thomas, L. 1973). Isolation of N-ethylmaleimide-labeled phloridzin-sensitive D-glucose binding protein of brush border membrane from rat kidney cortex. Biochim. Biophys. Acta, 291, 454--464), with radioactive N-ethylmaleimide ([3H]NEM and [14C]NEM) in the presence and absence of D-glucose, a protein band which is periodic acid--Schiff staining insensitive and which has a relative mobility (Rm) of 0.55 (corresponding to a molecular weight of 51 000 daltons) as determined by sodium dodecyl sulfate (SDS) electrophoresis was labeled preferentially. When radioactive p-hydroxymercuriphenylsulfonate ([203Hg]PCMBS) is used in the presence and absence of D-glucose, as described by Smith et al. (Smith, M. W., Ferguson, D. R., and Burton, K. A. 1975. Glucose- and phloridzin-protected thiol groups in pig intestinal brush border membranes. Biochem. J. 147, 617--619.), a protein band which has a relative mobility of 0.62 and a corresponding molecular weight of 42 000 daltons was labeled. Control experiments have shown that increasing concentrations of nonradioactive NEM (0.1--5.0 mM) do not substantially modify the electrophoretic pattern of SDS-solubilized brush border membrane. Nonradioactive PCMBS (0.1--10 mM), on the other hand, modifies the electrophoretic pattern and especially causes a change in relative mobility of the 0.55 protein band which migrates after 1 mM PCMBS treatment with a Rm of 0.62. The effect of 1 mM PCMBS can be reversed by adding L-cysteine or dithiothreitol. Actin extracted from rabbit muscle migrates with the same Rm as the 0.55 protein band in our electrophoretic conditions.
HLA groups including the characteristics of 25 antigens were determined in 108 patients suffering from psoriatic arthritis. These included 18 patients with central forms (pelvospondylitis), and 90 patients with peripheral forms (polyarthritis with or without sacroiliitis). Analysis of the results leads to the following conclusions: central psoriatic arthrisis is strongly associated with B27 and BW38, less closely with B13 and slightly with BW17. Peripheral psoriatic arthritis has the same relationship with the HLA system as has psoriasis without arthropathy.
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The releases of proteins, maltase, lactase, sucrase, trehalase, alkaline phosphatase, gamma-glutamyltransferase and leucylnaphthylamide-hydrolyzing activity from human intestinal brush bborder membrane vesicles by various enzymes (especially pancreatic proteases) have been studied. The brush border membrane enzymes are not solubilized by digestion with trypsin and chymotrypsin but are largely released after treatment with papain or elastase. Most of the enzymes are fully active after the proteolytic treatment. All proteins released by papain and elastase have been identified by electrophoresis to already known intestinal hydrolases. Electron microscopy of brush border membrane vesicles demonstrates "knob-like" structures (particles) attached to the external side of the membrane. During papain treatment, enzyme removal runs parallel with the disappearance of the particles. During elastase treatment it is not possible to correlate the release of the enzymic activities with the removal of the particles. The results indicate that most of the intestinal hydrolases are surface components attached to the external side of the membrane. They are in accord with the concept that the brush border membrane enzymes are organized within the membrane in a mosaic-like pattern.
Rats eating a diet containing casein hydrolysate (10% wt/wt)(diet 3) instead of whole casein (diet 1) exhibited increased tolerance to nine consecutive daily injections of 15 mg/kg of 5-fluorouracil (5-FU). The relative nutritional efficiency of diet 3 was significantly higher during 5-FU treatment. Serum albumin levels measured after 5-FU treatment dropped by only 2.7% in diet 3 groups and by 13.5% in diet 1 groups. Serum albumin values for rats on the control diet (Purina lab chow) were comparable to those on diet 1. No 5-FU-related mortality was observed in any of the groups. Intestinal brush border enzymes were determined in a group of rats on diet 1. At the end of 5-FU treatment statistically significant changes were observed: sucrase dropped to 30% of control and leucylnaphthylamide-hydrolyzing activity dropped to 19% of control. The activity of gamma-glutamyltransferase did not change significantly. It is postulated that under these circumstances a mixture with a prevalence of free amino acids (casein hydrolysate) could be more readily absorbed than a corresponding mixture containing a larger proportion of oligopeptides.
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The postition of a number of human intestine brush border membrane enzyme activities in polyacrylamide gels after electrophoresis has been determined. These activities are, in order from the origin, maltase/glucoamylase, lactase/phlorizin hydrolase, maltase/sucrase/isomaltase, enteropeptidase, trehalase and gamma-glutamyl-transferase. Leucylnaphthylamide hydrolyzing activity was inactivated by sodium dodecylsulfate and its position was not determined. The positions of the activities have been correlated with the positions of protein bands previously determined. One such band situated between enteropeptidase and alkaline phosphatase has not been identified.
A sensitive method for the estimation of trypsin and enteropeptidase is described. The use of alpha-N-benzoyl-DL-arginine-p-nitroanilide as substrate in combination with the Bratton-Marshall reaction increased the sensitivity of an established method to a degree which permits the determination of enteropeptidase at considerably lower activity levels than heretofore such as those expected in brush border membrane preparations from peroral biopsies of human small intestine.
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The authors explored a group of patients suffering from rheumatic pelvispondylitis from the point of view of muscular lesions: clinical muscular examination, anatomo-pathological investigation of the muscle (optical microscopy, histochemistry), electromyographic investigation, and determination of certain serum and muscle enzymes. Some muscular anomalies were observed, which were predominant in the muscles of the lumbar grooves, although there were some lesions of the quadriceps muscle, with a myogenous appearance, but without inflammation. The clearest anomalies were neurogenic and were present particularly in the muscles of the lumbar grooves.
In a study on 43 patients suffering from Paget's disease the authors grouped them within the HL-A histo-compatibility system. Twenty-nine antigens in this system were investigated. Comparison with the distribution in the population of France did not show a significant difference. Nevertheless, there appeared to be a greater frequency of the HL-A 5 and perhaps of W 22 antigens in patients suffering from generalized Paget's disease.
An immunological investigation was carried out on 33 rheumatoid polyarthritis patients. The phenomena of antierythrocytes immunization were investigated by standard tests : irregular agglutinins, haemolysins, and auto-antibodies which all proved negative. The lymphocyte immunological phenomena were also studied. Cold (4 degrees C) lymphocytotoxins were shown in 8 patients, 5 of whom had anti-lymphocyte auto-antibodies. The proportions of "sheep rosettes" were significantly reduced. The sera did not show notable anti-complementary activity. Studies on the human antiglobulins and on species antiglobulins were not very conclusive. Cryoglobulins were never detected. No clear correlation was found between these different tests and those of standard rheumatism serology.
Long-term trial of sulindac (in general practice): 2,040 patients with osteoarthritis of the hip or of the knee been treated, 86,5% of them have been following the treatment for one year. This trial let us pointing out the non-improverishment of effectiveness of sulindac and the keepint of its good tolerance for long term. Some epidemiological data have been collected, among which: the importance of ponderal overload in patients studied and the prevalence of the right joints diseases on the left one's.
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