Abstract
Trypsin and other intestinal proteases may be taken up in increased amounts early in life and contribute to hepatic inflammation. To test this hypothesis, we gavaged newborn (n=9) and 4 week-old weaned rabbits (n=10) with 200 mg bovine trypsin/100 gm body weight. Four hrs later, serum tryptic activity, as determined by a functional assay, was significantly increased in newborn (p<0.001) but not weaned animals. A radioimmunoassay was used to detect immunoreactive-trypsin (i-trypsin) in serum samples. The concentrations of i-trypsin in the serum of newborn and weaned animals 4 hrs after gavage were 603 ± 97 ng/ml and 40 ± 13 ng/ml respectively (p<0.001). Serum i-trypsin in blood of weaned animals obtained at timed intervals up to 16 hrs after the trypsin feeding did not exceed the 40 ng/ml value. Sephadex G-200 gel filtration was performed on the serum samples. Tryptic activity was detected only in the excluded volume (trypsin bound to α2-macroglobulin), and i-trypsin was detected only in the included volume (trypsin bound toαl-antitrypsin); no free trypsin was detected. In vitro experiments demonstrated that large amounts of trypsin were required to overwhelm the normal serum inhibitors. In small-for-gestational age infants, however, there may be complete or partial deficiencies of serum inhibitors. In these infants, trypsin and other proteases may be taken up from the intestinal lumen into blood, circulate to the liver and induce hepatitis.
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Udall, J., Bloch, K., Newman, A. et al. THE INTESTINAL UPTAKE OF PROTEASES AND NEONATAL HEPATITIS. Pediatr Res 18 (Suppl 4), 215 (1984). https://doi.org/10.1203/00006450-198404001-00735
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DOI: https://doi.org/10.1203/00006450-198404001-00735