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Biomedical subjects

J Murison

Publications and source records attributed to J Murison.

At least 19 recordsLinked to original sources

RIP4 is an ankyrin repeat-containing kinase essential for keratinocyte differentiation.

The epidermis is a stratified, continually renewing epithelium dependent on a balance among cell proliferation, differentiation, and death for homeostasis. In normal epidermis, a mitotically active basal layer gives rise to terminally differentiating keratinocytes that migrate outward and are ultimately sloughed from the skin surface as enucleated squames. Although many proteins are known to function in maintaining epidermal homeostasis, the molecular coordination of these events is poorly understood. RIP4 is a novel RIP (receptor-interacting protein) family kinase with ankyrin repeats cloned from a keratinocyte cDNA library. RIP4 deficiency in mice results in perinatal lethality associated with abnormal epidermal differentiation. The phenotype of RIP4(-/-) mice in part resembles that of mice lacking IKKalpha, a component of a complex that regulates NF-kappaB. Despite the similar keratinocyte defects in RIP4- and IKKalpha-deficient mice, these kinases function in distinct pathways. RIP4 functions cell autonomously within the keratinocyte lineage. Unlike IKKalpha, RIP4-deficient skin fails to fully differentiate when grafted onto a normal host. Instead, abnormal hair follicle development and epidermal dysplasia, indicative of progression into a more pathologic state, are observed. Thus, RIP4 is a critical component of a novel pathway that controls keratinocyte differentiation.

Animals↗

Fluctuations of serum bile acid concentrations during the menstrual cycle.

Fasting primary bile acid conjugates were measured in 44 women by radioimmunoassay methods. Bile acid values were significantly greater in the 21 women who were in the first half of the menstrual cycle than in the 23 women in whom blood was sampled during the second half of the cycle. Similar measurements were made at weekly intervals after menstruation in five subjects; increased values were observed in the first week. It is concluded that serum bile acid values fluctuate during the menstrual cycle.

Adult↗

Ursodeoxycholic acid therapy and biliary lipids--a dose-response study.

The effects of four different doses of ursodeoxycholic acid (250, 500, 750, and 1000 mg daily) on biliary lipids were studied in 24 patients with radiolucent gallbladder stones. There was a significant increase in the proportion of ursodeoxycholic acid in bile after all doses, being greatest with 750 and 1000 mg daily. Unsulphated lithocholic acid was also increased in the bile after therapy, while the other major bile acids were reduced. The cholesterol content of bile was reduced by all doses, and this change was most marked after 1000 mg (from 10.9 +/- 1.4 to 5.6 +/- 0.5 mol%, P < 0.01). Biliary cholesterol saturation improved significantly only after 750 and 1000 mg daily.

Adolescent↗

Radioimmunoassay of primary bile salts in serum.

Rapid, sensitive radioimmunoassays have been developed for the conjugated primary bile salts, cholate and chenodeoxycholate, using immunogens prepared by the mixed anhydride procedure. Antibodies produced showed equal specificity for glycine and taurine conjugates. Cross-reactivities were comparable with those from other published radioimmunoassays. The assays were routinely performed on unextracted sera and the concentrations correlated well with concentrations determined by gas-liquid chromatography. Accuracy, determined by the addition of bile salt to charcoal-extracted serum, and percision, determined by replicate analysis of a normal sample, were both less than +/- 10%. These figures are comparable with those obtained by both gas-liquid chromatography and other radioimmunoassays for bile salts. Normal sera were found to contain 0.49-1.32 mumol/l of cholate and 0.55-2.02 mumol/l of chenodeoxycholate. Serum concentrations in patients with liver disease were higher than this normal range. Three patients with mild liver distrubance were found to have one bile salt in the upper limit of normal, but in each case the other primary bile salt was outwith the normal range.

Adult↗

Measurement of serum primary bile acid ratio by gas liquid chromatography and radioimmunoassay.

The application of a sensitive gas liquid chromatography (GLC) assay has enabled patients in different diagnostic groups to be differentiated on the basis of the ratio of the primary bile acids, cholic: chenodeoxycholic acid. Because this method is unsuitable for a routine clinical laboratory, the primary bile acid ratio (PBR) is determined by radioimmunoassay techniques (RIA), and the results were compared with GLC analysis. RIA provided comparable results in control subjects and patients with large-duct obstruction, but significantly higher PBR values were found in cirrhotic subjects.

Animals↗

Comparison of fixed doses of chenodeoxycholic acid for gallstone dissolution.

96 patients with gallstones have been treated for up to four years with chenodeoxycholic acid in daily doses of 500, 750, or 1000 mg. None of the patients started on 500 mg daily showed complete gallstone dissolution. 8 out of 41 patients on 750 mg daily had complete dissolution of their radiolucent gallbladder stones after six or more months, and a further 4 showed partial dissolution. 5 out of 28 patients on 1000 mg daily had complete dissolution of their radiolucent gallbladder stones after at least six months, and a further 9 showed partial gallstone dissolution. The mean duration of therapy was greater on 750 mg than on 1000 mg/day (1.27 vs. 0.58 years), and when results were analysed after the first six months' therapy the total response-rate was significantly greater for the 1000 mg dose (12 out of 28) than for the 750 mg dose (9 out of 41). The individual response of radiolucent gallabladder stones to therapy could not be predicted from stone size, weight of patient, dosage/kg, orchange in biliary lipids. Treatment of radiolucent gallstones with chenodeoxycholic acid should start at 1000 mg daily.

Bile↗

Reversal of clofibrate-induced cholesterol oversaturation of bile with chenodeoxycholic acid.

Giving clofibrate 2 g daily to seven patients significantly increased the biliary cholesterol concentration while the proportion of bile acids fell. Five patients on established clofibrate treatment were given 750 mg of chenodeoxycholic acid (CDCA) daily for one month. Biliary lipid analysis after the CDCA treatment showed a significant fall in the proportion of cholesterol and a rise in that of bile acids. The serum lipid concentrations, which had already been reduced by diet and clofibrate, showed a further significant reduction after the introduction of CDCA. This study suggests that CDCA may be usefully combined with clofibrate to reverse the tendency towards cholesterol saturation of bile and enhance the effect of lowering serum lipid concentrations.

Adult↗

Effect of prolonged feeding with chenodeoxycholic acid on bile in patients with and without gallstones.

Nineteen patients who received chenodeoxycholic acid 750 mg/day for six months had duodenal bile aspirated before and after treatment. In five patients with hypertriglyceridaemia but no gallstones cholesterol saturation was reversed in every case, the mean cholesterol saturation index (SI +/- standard deviation) changing from 1-38 +/- 0-31 to 0-68 +/- 0-06 (P less than 0-005). In 14 patients with gallstones there was also an improvement in bile cholesterol content, but this was not sufficient to produce mean unsaturation, saturation index changing from 1-55 +/- 0-52 to 1-13 +/- 0-43 (P less than 0-05). Only seven of 14 patients with gallstone achieved cholesterol unsaturation. In four patients with hypertriglyceridaemia and gallstones, mean unsaturation was produced and the saturation index changed from 1-70 +/- 0-45 to 0-86 +/- 0-47 (P less than 0-05). When all nine patients with hypertriglyceridaemia were grouped, the mean saturation index fell from 1-52 +/- 0-40 to 0-76 +/- 0-30 after therapy (P less than 0-001). In contrast the 10 patients without hypertriglyceridaemia showed no significant fall in saturation index which was 1-50 +/- 0-54 before and 1-24 +/- 0-40 after therapy. The ability of chenodeoxycholic acid feeding to improve bile saturation with cholesterol correlated with the presence of hypertriglyceridaemia whether or not gallstones were present. It did not correlate with gallstone dissolution or body weight.

Adult↗

The estimation of phospholipids in bile.

Total and lipid phosphorus were measured in the duodenal aspirate of 24 fasting subjects following an injection of cholecystokinin. The lipid phosphorus values were lower than the total phosphorus, a difference most pronounced in dilute samples. Storage at -20 degrees C over 4 weeks resulted in a loss of over 50% lipid phosphorus. Such alterations in the lipid phosphorus affected the calculation of biliary phospholipid and hence the saturation index of cholesterol in bile causing it to be erroneously elevated. It is concluded that analysis of bile samples should be undertaken on freshly obtained samples and include a preliminary step for the extraction of lipids.

Bile↗

Generation of ammonia from non-urea sources in a faecal incubation system.

1. A 25% faecal suspension in sodium chloride solution, incubated anaerobically at 37 degrees C for 48 h, showed excellent survival of all the main groups of faecal bacteria. 2. All faecal incubation systems studied generated large amounts of ammonia, particularly those in which bacterial counts fell during incubation. As normal faeces contain negligible amounts of urea this ammonia must have been generated from sources other than urea. 3. Ammonia was also generated by faeces delivered by sodium chloride enema, and by ileostomy fluid, indicating that the phenomenon is not confined to distal colonic contents. 4. Ammonia generation by incubated faeces was inhibited by prior autoclaving of the sample, but not by sterilization with gamma-irradiation. 5. Generation of ammonia by incubated stool was accompanied by release of large amounts of organic anion and a fall in pH. 6. These observations are interpreted as evidence that ammonia generated within the colon in situ is not derived exclusively from urea, but also from bacterial deamination of amino acids, peptides and proteins. Simultaneously bacterial activity generates large amounts of organacid. The presence of living bacteria is not essential for ammonia generation, provided that bacterial enzymes are present. 7. Bacterial generation of organic solute in faeces which have left the body is sufficiently rapid to cast serious doubts on the validity of faecal centrifugation, or other time-consuming techniques involving lengthy handling of faeces, as methods of obtaining extracellular faecal fluid for measurements of organic constituents or ammonia.

Adult↗

Acute pancreatitis and diabetic ketoacidosis in accidental hypothermia and hypothermic myxoedema.

Serial serum amylase and blood glucose levels were measured in 68 hypothermic (rectal temperature 35 degrees C or less) patients, including 15 who had hypothermic myxoedema (serum protein bound iodine 3.5 mug/100 ml or less). Raised amylase levels were found in 34 patients and probably reflected a mild acute pancreatitis. The high amylase levels correlated with low arterial PO(2) levels and significantly with high arterial PCO(2) levels and the base deficit but not with the severity or duration of the hypothermia. The acute pancreatitis does not explain why hypothermic patients with myxoedema have a poorer prognosis than those who are euthyroid. The pancreatitis occasionally contributed to the development, sometimes delayed, of diabetic ketoacidosis, blood glucose levels of over 120 mg/100 ml being found in 20 patients. There was a significant correlation between the raised serum amylase levels and the hyperglycaemia. Hypoglycaemia, sometimes profound, was found in 12 patients.

Acute Disease↗