Weisdorf S A, Salati L M, Longsdorf J A, Ramsay N K, Sharp H L
Gastroenterology. 1983 Nov;85(5):1076-81.
Severe hypoproteinemia often accompanies the development of graft-versus-host disease of the intestine in allogeneic bone marrow transplant patients. To determine whether or not protein loss occurs across the intestinal mucosa in this severe diarrheal illness, we measured fecal alpha 1-antitrypsin once per week in 24-h stool specimens from 25 consecutive patients during hospitalization for bone marrow transplantation. The mean alpha 1-antitrypsin concentration and serum clearance for these patients before transplantation were below 2.6 mg/g stool and 13.0 ml/day (upper limits for normals). Values for all patients increased moderately after pretransplant conditioning. Values for patients who did not develop graft-versus-host disease of the intestine returned to baseline levels; however, those for patients with graft-versus-host disease of the intestine became markedly and persistently elevated (concentration ranged from 16.6 to 51.1 mg/g, clearance from 66.6 to 384.5 ml/day). We conclude that mucosal protein exudation contributes to the hypoproteinemia of graft-versus-host disease of the intestine and that measurement of fecal alpha 1-antitrypsin can be used as a marker for this disease.
严重低蛋白血症常伴随异基因骨髓移植患者肠道移植物抗宿主病的发生。为了确定在这种严重腹泻性疾病中是否存在蛋白质经肠黏膜丢失的情况，我们在25例连续进行骨髓移植住院患者的24小时粪便标本中每周测量一次粪便α1 -抗胰蛋白酶。这些患者移植前的粪便α1 -抗胰蛋白酶平均浓度和血清清除率低于2.6毫克/克粪便和13.0毫升/天（正常上限）。所有患者在移植前预处理后数值均有适度升高。未发生肠道移植物抗宿主病的患者数值恢复至基线水平；然而，发生肠道移植物抗宿主病的患者数值显著且持续升高（浓度范围为16.6至51.1毫克/克，清除率为66.6至384.5毫升/天）。我们得出结论，黏膜蛋白渗出导致肠道移植物抗宿主病的低蛋白血症，并且粪便α1 -抗胰蛋白酶的测量可作为该疾病的标志物。
