Pancreatic and salivary amylase activity in undernourished Colombian children

The ontogeny of saliva secretion in infants and esophagoprotection

BACKGROUND

Several studies have reported that severe reflux esophagitis is rare in infants despite the well known high occurrence of regurgitation in early infancy. There is evidence of the importance of saliva for the pre-epithelial protection of the esophageal mucosa.

RESULTS

A longitudinal study conducted on healthy infants indicated that the stimulated capacity of saliva secretion (saliva output per kg of body weight) was significantly higher during their first year of age compared to older children and adults. In addition, this secretion pattern was also observed in low weight newborns during the first weeks of life and persisted in infants with severe protein-calorie malnutrition (marasmus).

CONCLUSION

The greater ability to secrete saliva is an important physiological condition that may protect the infant from acid/pepsin aggression to the esophagus during early stages of development.

Stratification of pancreatic tissue samples for molecular studies: RNA-based cellular annotation procedure

BACKGROUND/OBJECTIVES

Meaningful profiling of pancreatic cancer samples is particularly challenging due to their complex cellular composition. Beyond tumor cells, surgical biopsies contain desmoplastic stroma with infiltrating inflammatory cells, adjacent normal parenchyma, and "non-pancreatic tissues". The risk of misinterpretation rises when the heterogeneous cancer tissues are sub-divided into smaller fragments for multiple analytic procedures. Pre-analytic histological evaluation is the best option to characterize pancreatic tissue samples. Our aim was to develop a complement or alternative procedure to determine the cellular composition of pancreatic cancerous biopsies, basing on intra-analytic molecular annotation. A standard process for sample stratification at a molecular level does not yet exist. Particularly in the case of retrospective or data depository-based studies, when hematoxylin-eosin stained sections are not available, it supports the correct interpretation of expression profiles.

METHODS

A five-gene transcriptional signature (RNACellStrat) was defined that allows cell type-specific stratification of pancreatic tissues. Testing biopsy material from biobanks with this procedure demonstrated high correspondence of molecular (qRT-PCR and microarray) and histologic (hematoxylin-eosin stain) evaluations.

RESULTS

Notably, about a quarter of randomly selected samples (tissue fragments) were exposed as inappropriate for subsequent clinico-pathological interpretation.

CONCLUSIONS

Via immediate intra-analytical procedure, our RNA-based stratification RNACellStrat increases the accuracy and reliability of the conclusions drawn from diagnostic and prognostic molecular information.

Safety of rapid intravenous rehydration and comparative efficacy of 3 oral rehydration solutions in the treatment of severely malnourished children with dehydrating cholera

OBJECTIVES

Assess the safety of rapid intravenous rehydration of severely malnourished children and compare the efficacy of 3 formulations of oral rehydration salts solutions.

PATIENTS AND METHODS

A group of 175 severely malnourished children of either sex (weight/length <70% of National Center for Health Statistics median), ages 6 to 36 months with cholera, were randomly assigned to receive 1 of 3 oral rehydration solutions (ORSs): glucose-ORS (n=58), glucose-ORS plus 50 g/L of amylase-resistant starch (n=59), or rice-ORS (n=58). Severely dehydrated children at enrollment were administered 100 mL/kg of an intravenous solution for 4 to 6 hours before randomisation, and those with some dehydration were randomised on enrollment. The electrolytes of the 3 ORSs were identical. In acute and convalescence phases, treatment was similar other than the nature of the ORSs.

RESULTS

Intravenous fluid (mean) administered to 149 study children was 103 mL/kg (95% confidence interval [CI] 96-109), and all were rehydrated within 6 hours. None of them developed overhydration or heart failure. During the first 24 hours, stool output (31%; 95% CI 14%-42%; P=0.004) and the ORS intake (26%; 95% CI 12%-37%; P=0.002) of children receiving rice-ORS were significantly less compared with children receiving glucose-ORS. The mean duration of diarrhoea in all children (66 hours; 95% CI 62-71), and time to attain 80% of median weight/length (7.15+/-2.81 days) were not different.

CONCLUSIONS

Dehydration in severely malnourished children can safely be corrected within 6 hours. All study ORSs were equally efficient in correcting dehydration. Rice-ORS significantly reduced the stool output and ORS intake, confirming previous reports.

Maldigestion and malabsorption of dietary lipid during severe childhood malnutrition

BACKGROUND

Diets rich in lipid are used to provide energy density in treating children with severe malnutrition, but the extent to which their digestion and absorption can cope with the load effectively is uncertain.

AIM

To determine the extent of impaired digestion or absorption, in three groups of eight malnourished children (aged 5-23 months) using isotopic probes of the predominant fatty acids in coconut and corn oil used to fortify the diet.

METHODS

Each child received oral doses of one of three (13)C labelled triglycerides (trilaurin, triolein, or trilinolein). The recovery of (13)C label in stool either as triglyceride (TAG) or fatty acid (FA), was used to assess digestion and absorption. In a separate test, the recovery of label in stool following an oral dose of [(13)C]-glycocholate was measured to assess bile salt malabsorption.

RESULTS

The median recovery of label in stool was 9% (range 1-29%) of administered dose. Following treatment there was a reduction in stool (13)C excretion for the labelled TAG (<1%). In half the subjects, label was recovered as TAG in stool (median 0.6%, range 0-44%). Most label in stool was recovered as FA (median 30%, range 0-100%). Following [(13)C]-glycocholate, label was recovered in excess in about one third of studies.

CONCLUSION

Abnormalities in the gastrointestinal handling of lipid were observed in over 50% of children with severe malnutrition, reflecting problems in absorption, although impaired solubilisation or hydrolysis could also be contributory factors. The underlying lesion improves as treatment progresses, leading to concomitant improvement in function.

Effect of a long-term change from a mixed to a lactovegetarian diet on human saliva

The effects of this long-term dietary change on secretion rate, buffer capacity, concentration of sodium and potassium and amylase activity of stimulated parotid and whole saliva was studied in 20 healthy, normal-weight, non-smoking omnivores. Salivary counts of mutans streptococci and lactobacilli were also made. Dietary surveys were carried out and saliva samples collected before (baseline) and 3, 6 and 12 months after the dietary change as well as 3 yr after the end of the lactovegetarian diet period. The dietary data showed an increase in the consumption of fruits, vegetables and dairy products and a decrease in meat, fish, eggs, sweets and biscuits. These changes led to an increased intake of carbohydrates, fibre and water. After 12 months on the vegetarian diet, the secretion rate, buffer capacity and sodium concentration of whole saliva and the secretion rate of parotid saliva had increased significantly. At the 3-yr follow-up, the buffer capacity and sodium concentration were still elevated, while the secretion rate had almost returned to the baseline values. The potassium content of whole saliva showed a tendency to increase during the vegetarian diet period, but had decreased again at the 3-yr follow-up.

Saliva composition in Indian children with chronic protein-energy malnutrition

The composition of paraffin-stimulated and unstimulated whole saliva was compared between two groups of 8-12-year-old Indian children-one group with severe to moderate chronic protein-energy malnutrition (PEM group) and an age- and sex-matched control group with normal protein status or mild PEM. The classification of PEM was based on anthropometric measurements compared with Indian standards. Stimulated saliva was analyzed for the following variables: electrolytes (Na+, K+, Ca2+, Cl-, and PO4(3-)), total protein, hexosamines, fucose, sialic acid, and amylase. Unstimulated saliva samples were analyzed for total protein, salivary and myeloperoxidase, thiocyanate, lactoferrin, lysozyme, a bacteria-agglutinating protein (BAGP), total IgG, total IgA, and specific anti-S. mutans IgA. The results show that the PEM group had a reduced secretion rate of stimulated but not unstimulated saliva. Further, the Ca2+ and Cl- concentrations in stimulated saliva were significantly lower in the PEM group compared with the control group, but the other electrolyte levels were similar. No differences were found in total protein concentration or glycoprotein bound carbohydrates in stimulated saliva between the two groups, but the quantity of total protein secreted per min was reduced by 20% in the PEM group. Significantly lower levels of lactoferrin, BAGP, and anti-S mutans IgA were found in unstimulated saliva from children in the PEM group, but significantly higher levels of total IgG. We conclude that children with severe or moderate PEM, who have reduced secretion rate, buffer capacity, lower Ca2+, and protein secretion in stimulated saliva, also have impaired immunological and agglutinating defense factors in unstimulated saliva.

The effect of in utero protein malnutrition and subsequent renutrition on rat saliva and some salivary enzymes

1. Rat pups developed chronic protein insufficiency resulting from malnutrition diet in utero while their dams received 40 g protein/kg diet. 2. Before weaning they were found to have decreased salivary amylase (EC 3.2.1.1) and aminopeptidase activities. 3. A complete diet (250 g protein/kg) rapidly restored salivary amylase activity before weight normalization. However, renourished pups (malnourished pups given 250 g protein/kg for 14 d) still had increased numbers of Streptococcus multans in their plaque.