Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.2.1.108 (lactase)
 2,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lactose breath hydrogen tests were given to 70 children and adolescents with chronic ulcerative colitis and Crohn's disease in order to determine the prevalence of lactose malabsorption in childhood inflammatory bowel disease. Twenty-nine percent of these patients demonstrated lactose malabsorption; the majority of these children (70%) experienced gastro-intestinal symptoms during the test. The prevalence was not significantly different whether the diagnosis was ulcerative colitis or Crohn's disease. With the exception of those with diffuse small bowel disease, the location of intestinal involvement with Crohn's disease and the severity of clinical symptoms did not affect lactose malabsorption. Lactose malabsorption was not more frequent in patients with inflammatory bowel disease than in a group of children with recurrent abdominal pain and normal gastrointestinal x-rays, although significant differences in the prevalence of lactose malabsorption were observed in relation to ethnic background. Milk incubated with commercially available yeast lactase (lactAid, Surgarlo Co., Atlantic City, N.J.) for greater than 24 h prevented an increase in breath hydrogen when administered to 6 patients previously shown to have lactose malabsorption.
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PMID:Lactose malabsorption in children and adolescents with inflammatory bowel disease. 689 2

Using breath hydrogen analysis after 139 mmol (50 g) oral lactose load, we investigated the prevalence of lactose malabsorption in 200 Greek adults and examined the relationship between symptoms and small bowel transit time. One hundred and fifty subjects had increased breath hydrogen concentrations (greater than 20 ppm) after the lactose load. In these individuals peak breath hydrogen concentration was inversely related to small bowel transit time (r = 0.63, 6 = 6.854, p less than 0.001) and the severity of symptoms decreased with increasing small bowel transit time. Lactose malabsorbers with diarrhoea during the lactose tolerance test had a small bowel transit time of 51 +/- 22 minutes (x +/- SD; n = 90) which was significantly shorter than the small bowel transit time of patients with colicky pain, flatulence, and abdominal distension (74 +/- 30, n = 53; p less than 0.001) and both groups had significantly shorter small bowel transit time than that of asymptomatic malabsorbers (115 +/- 21 n:7; p less than 0.001). When the oral lactose load was reduced to 33 mmol (12 g), the small bowel transit time increased five-fold and the overall incidence of diarrhoea and/or symptoms decreased dramatically. These results indicate that the prevalence of lactase deficiency in Greece may be as high as 75% and suggest that symptom production in lactose malabsorbers is brought about by the rapid passage down the small intestine of the malabsorbed lactose.
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PMID:Lactose malabsorption in Greek adults: correlation of small bowel transit time with the severity of lactose intolerance. 712 6

To determine the sensitivity and specificity of breath hydrogen (H2) in detecting lactase deficiency, breath H2 collected by end-expiratory sampling and capillary blood glucose were measured after ingestion of 50 g of lactose in 36 patients with biopsy-proved isolated lactase deficiency, 42 with normal lactase activity and 6 with lactase deficiency secondary to mucosal lesions. All patients had digestive symptoms clinically compatible with lactose malabsorption. The maximum increase in breath H2 concentration was more than 1.1 mumol/l (25 ppm) in all patients with isolated lactase deficiency, and less than 0.88 mumol/l (20 ppm) in 88% of patients with normal lactase activity; there were 5 false-positive results, attributed in one case to small bowel colonization and in another case to rapid transit after gastric surgery. Secondary lactase deficiency was accurately detected by neither breath H2 nor blood glucose.
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PMID:[Diagnosis of lactase deficiency with the expired hydrogen (H2) test]. 722 24

The in vitro and in vivo production of hydrogen gas (H2) from various carbohydrates or proteins has been examined in normal rats and in rats infected with the nematode Nippostrongylus brasiliensis. Normal rat fecal homogenates were capable of producing H2 in vitro from glucose, sucrose, xylose, lactulose, bovine serum albumin, or casein hydrolysate. Direct injection of glucose, sucrose, xylose, lactulose, bovine serum albumin, or casein hydrolysate into the cecum of normal rats resulted in approximately twice as much H2 production in vivo than when these same carbohydrates or proteins were administered to the normal rats by gavage. Partial small intestinal villous atrophy was produced by infecting rats with the nematode N. brasiliensis. Impaired small intestinal cell function and evidence of malabsorption in the nematode-infected rats included: (a) decreased activity of intestinal cell lactase (-43%), sucrase (-33%), and alkaline phosphatase (-46%); (b) decreased gut sac uptake of 3-O-(methyl-3H]-D-glucose (-21%) or 1-[carboxyl-14C]-aminocyclopentane-1-carboxylic acid (-28%); and (c) increased (+ 64%-561%) 14CO2 production after D-[U-14C]xylose administration. These rats produced approximately twice as much H2 after gavage administration of glucose, sucrose, xylose, bovine serum albumin, or casein hydrolysate compared with normal rats. The present study suggests that H2 analysis may be useful in the evaluation of small intestinal malabsorption states in rats.
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PMID:Use of hydrogen gas (H2) analysis to assess intestinal absorption. Studies in normal rats and in rats infected with the nematode, Nippostrongylus brasiliensis. 728 87

To evaluate the role of the lactose breath hydrogen test for the detection of lactose malabsorption in children with chronic nonspecific abdominal complaints, breath hydrogen excretion was measured in 131 children with recurrent abdominal pain (n = 75) or chronic nonspecific diarrhea (n = 56) following a lactose load (2 gm/kg; maximum 50 gm). The data were compared to those obtained from lactose tolerance tests (n = 113) and symptom response following a lactose load (n = 109) performed simultaneously with the lactose breath hydrogen test, and with results from small bowel biopsies obtained in 31 children to determine dissacharidase activity and mucosal histology. The results indicate that an increase in breath hydrogen of greater than 10 ppm above base line values (delta ppm) by 120 minutes ("early increase" response) completely discriminates between biopsy-proven isolated lactase-insufficient and lactase-sufficient children. A similar increase after 120 minutes ("late increase" response) is consistent both with normal mucosal function and partial lactase insufficiency due to mucosal injury. Breath hydrogen responses predicted assayed lactase activity in all patients with isolated lactase insufficiency, but were "falsely negative" in four of ten children whose lactase insufficiency was secondary to mucosal injury. In both clinical groups, lactose malabsorbers report significantly more symptoms than absorbers (P less than .001), but neither symptom reports nor tolerance tests are accurate methods for distinguishing lactose malabsorbers from absorbers. Although the lactose breath hydrogen test provides objective documentation of lactose malabsorption, it is equally predictive of assayed lactase activity in all clinical groups.
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PMID:Mucosal function and breath hydrogen excretion: comparative studies in the clinical evaluation of children with nonspecific abdominal complaints. 732 85

An oral sucrose tolerance test was performed in a group of 103 children, aged between 3 months and 15 years because of episodic diarrhea and/or abdominal pains. Sucrose malabsorption defined as an abnormal increase in expired hydrogen, was found in only 3 children who suffered from congenital sucrase-isomaltase deficiency. This 1% incidence of sucrose malabsorption was lower than the incidence of lactose malabsorption found in this group (33%). Mean rise in blood glucose during the sucrose test was higher (3.4 +/- 1.4 vs. 2.4 +/- 1.2 mmol/l, p less than 0.0001) and the occurrence of false flat blood glucose curves was lower (3% vs. 12.8%, p less than 0.05) than during the lactose test. These findings are consistent with the higher sucrase activity in the small bowel mucosa compared to lactase. In contrast to the lactose tolerance test, sucrose tolerance test should not be used as a screening procedure for secondary disaccharidase deficiency in children.
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PMID:Diagnostic value of sucrose tolerance test in children evaluated by breath hydrogen measurement. 736 16

Lactose malabsorption can be demonstrated by detecting hydrogen (H2) in the expired air after oral loading with lactose. A comparative study was carried out on 24 subjects. Following an oral loading dose of lactose, the H2 eliminated during expiration was assayed by gas chromatography, and blood galactose levels were measured. The results showed that the test was reliable, well tolerated and reproductible. However, the method does not measure the amounts of lactase present in the intestinal mucosa. The lactose loading test seems to be valuable for studies on lactose and carbohydrate malabsorption.
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PMID:[Lactase deficiency in the intestinal mucosa. Demonstration by hydrogen detection in the expired air after lactose loading (author's transl)]. 744 88

Milk lactose is hydrolysed to D-galactose and D-glucose in the small intestine of mammals by the lactase-phlorizin hydrolase complex (LPH, EC 3.2.1.23-62). Lactase activity has broad substrate selectivity and several glycosides are substrates. Recently, using the monodeoxy derivatives of methyl beta-lactoside (1), we have shown the importance of each hydroxyl group in the substrate molecule concerning the interaction with the enzyme. Now we have studied the corresponding O-methyl derivatives, as well as some of the halo derivatives of 1. We have found that the enzyme presents steric restrictions to the recognition of substrates modified in the galactose moiety. In contrast, the binding site for the aglycon part of the substrate is looser. On the other hand, we have previously shown that HO-3' and HO-6 were important for the recognition of the substrate by the enzyme. Now we have found that the corresponding fluorine derivatives are not, or very poorly, recognized. This suggests that the HO-3' and HO-6 participate, as donors, in hydrogen bonds in the interaction with the enzyme.
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PMID:Substrate specificity of small-intestinal lactase: study of the steric effects and hydrogen bonds involved in enzyme-substrate interaction. 764 81

Lactose in yogurt is better absorbed by lactase-deficient subjects than is an equivalent quantity of lactose in milk, presumably because of the microbial activity of the beta-galactosidase present in yogurt. In this study, we describe a process that increases the beta-galactosidase of yogurt 5- to 6-fold and the ability of this high lactase yogurt to enhance lactose absorption in lactase-deficient subjects. These subjects ingested the yogurt meals after a 12-h fast, and lactose malabsorption was determined by measuring breath hydrogen. Breath hydrogen was reduced 39% following ingestion of high lactase yogurt from that after consumption of conventional yogurt, indicating that the high lactase yogurt enhanced lactose absorption. However, the reduction after high lactase yogurt was less than expected, given the 5- to 6-fold increment in beta-galactosidase measured in vitro. In vivo activity of beta-galactosidase requires that the enzyme resist acid denaturation in the stomach. The beta-galactosidase in high lactase yogurt was much less acid resistant than was the beta-galactosidase in conventional yogurt, and the relative inability of high lactase yogurt to enhance lactose absorption was likely due to the destruction of the beta-galactosidase in the stomach.
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PMID:Factors affecting the ability of a high beta-galactosidase yogurt to enhance lactose absorption. 769 33

The term lactase deficiency is widely used to indicate a low or absent level of lactase enzyme in the small intestine, leading to lactose intolerance. This term is correctly used when the intestinal mucosa is damaged and results in secondary lactase deficiency. In the case of the genetically determined decrease of lactase activity during childhood, however, low lactase levels suggest that the majority of the world's population is "abnormal," whereas individuals from caucasian extraction with high levels of lactase enzyme throughout life are then considered "normal." It would be better to ascribe racial and ethnic lactose malabsorption as the result of genetically determined reduction of lactase activity, rather then implying an "abnormality" by the term, "deficiency." Recent studies reveal that this genetic control is at the transcriptional level. The symptomatology of lactose intolerance varies widely, and the diagnostic method of choice is the lactose breath hydrogen test in combination with clinical findings, although small intestinal biopsies should be performed when mucosal diseases are suspected. Treatment of lactose intolerance depends on the age of the child. In young infants complete restriction of lactose containing foods is rarely necessary.
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PMID:Lactose intolerance and lactase deficiency in children. 782 Feb 3


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