الفهرس 
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Abstract
Alfa-l-antitrypsin is a glycoprotein synthesized in the liver and secreted in the serum as a major a 1- globulin component (Sharp, et al., 1971). It is the major component of a-1-electrphoretic band of human plasma protein (Jeppson et al., 1982). It acts upon proteolytic enzymes causes inhibition to their action. So, it is also known as a 1 protease inhibitor enzyme (Carell et al., 1982). It is an acute phase reactant protein (Blorn et al., 1979). It inhibits also leukocyte protease including elastase, plasmin, Ragman factor (Sharp, 1976).
Alpha—l-antitrypsin is normally secreted in G.I.T. not exceeding 13 mild. It cannot resist pH < 3 of the stomach, so it is partially destroyed but it resists pancreatic enzyme (Hirondel et al., 1978).
Normal secretion rate is 32 mg /kgl day(Koj et ai.,l978). Normal serum level in healthy individual is 180 - 280 mg/lOO ml (Pierce, 1972). Serum to faecal ratio is 0 — 1.00 (Florent et al., 1981).
Protein losing enteropathy can be defined as the abnormal loss of serum proteins into the gastrointestinal tract resulting from gastrointestinal and systemic diseases and hypoproteinemia occuring in the context of the mucosal lesion in gastrointestinal tract (Waldmann, 1987).
Protein loss can occurs from variety of categories of diseases, firstly diseases with intestinal lymphatics eg. (intestinal lymphangectasia, neoplasm with lymphatics, and congestive heart failure, constrictive pericarditis and valvular diseases of the heart). Second category associated with inflammatory diseases of the gastrointestinal tract including variety of diseases due to local release of mediators eg. allergic gastroenteropathy angioneurotic oedema, carcinoid syndrome. Thirdly related to inflammation and/or ulceration diseases of gastrointestinal mucosa, eg. parasitic infestation, hook worm, intestinal schistosomiasis or Giardia and Amoebiasis or ulcerative diseases eg. ulcerative colitis and polypoid lesion (Bocker S et al., 1987).
Since most proteins are digested in the gastrointestinal tract and not quantified after secretion. So, protein losing enteropathy is best measured by radioactive protein labeled not broken down or absorbed or excreted in G.I.T. (Mistilis et al., 1965). CS1_albumin succeded to measure protein losing enteropathy but it was nonphysiological material and rapidly cleared from the circulation (Waldmann, 1961), also I’s’ released can reabsorbed; Cu6’7 ceruloplasmin has short chemical half life and difficult to obtain (Waldiuann et al., 1967).
C5’ labelled albumin can be measured by two methods firstly; simple method by injecting C5’- albumin or C5’Cl3 and stool sample collected for four days to determine the percentage of the injected dose excerted in that time, normally not exceeding 0.7 % of injected dose (Waldmann, 1961).
Other method by calculate C5’ clearance as measuring creatinine clearance by measuring the amount excreted over a given period of time divided by average number of counts in the serum during this period. Normally not exceed 2 % / day. (Bockus et al., 1987).
Recently, a new approach to the measurement of protein losing enteropathy has been developed involve non-labelled protein, a 1-antitrypsin which is not broken down in the gastrointestinal tract except in the stomach so, the appearance in the stool is a measure of protein losing enteropathy (Florent et al., 1981). The clearance of C51-albumin is 40 ml / day, while clearance value for a—1-antitrypsin is 13 ml / day, due to fact that some a 1-antitrypsin degradated in the stomach (Florent et al., 1981).
There is significant correlation between a-i— antitrypsin faecal clearance and C5--plasma—proteins. The sensitivity of o—l-antitrypsin test compared to C’-albumin is 93.3% and the specificity is 90% (Florent et al., 1981). Differences in preparing stool as dilution, homagenisation or centrifugation had no influence of determination of a 1-antitrypsin (Karbach et al., 1983). It is of low cost and do not need any hazard of radioactivity and it is normal endogenous marker used as indicator of protein loss (Florent et al., 1981).
So, the aim of this work is to evaluate the a—iantitrypsin intestinal clearance and some immunological parameter (IgG and 1gM), in some diseases suspected to be associated with protein loss in the gastrointestinal tract with variable mechnisms, such as intestinal Bilharziasis, Amoebiasis and patients with Cor - pulmonal.