UMLS:C0020639 - FACTA Search

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Query: UMLS:C0020639 (hypoproteinemia)
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When blood plasma proteins are depleted by bleeding with return of the washed red blood cells (plasmapheresis) it is possible to bring dogs to a steady state of hypoproteinemia and a uniform plasma protein production on a basal low protein diet. These dogs are clinically normal. Introduction of variables into their standardized life gives insight into the production of plasma protein. Casein retested as the basal protein in the ration may show high yield of plasma protein, equal to 33 per cent of the protein fed. This equals the potency of liver protein (17 to 33 per cent) and approaches the utilization of plasma protein by mouth (40 per cent). Zein has no effect upon plasma protein regeneration but when it is supplemented with cystine, tryptophane, lysine, and glycine, there is a doubling of the liver basal plasma protein production and a retention of the fed protein nitrogen. Threonine does not modify the above reaction. Liver protein supplemented with cystine, leucine, glutamic acid, and glycine in the basal diet yields double the amount of new formed plasma protein compared with liver alone. This combination is then as potent as plasma protein itself when given by mouth-40 per cent utilization. Tyrosine or lysine, arginine, and isoleucine do not modify the above responses. Methionine is not as effective as cystine in supplementing gelatin and tyrosine to produce plasma protein. Cystine, leucine, and glutamic acid appear to be of primary importance in the building of new plasma protein in these experiments. Plasma protein formation is dependent upon materials coming from the body reserve and from the diet. Given an exhaustion of the reserve store there is very little plasma protein produced during a protein fast (3 to 6 gm. per week). A turpentine abscess does not modify this fasting plasma protein reaction. Homologous plasma given by vein will promptly correct experimental hypoproteinemia due to bleeding. It will maintain nitrogen equilibrium and replenish protein stores. Even during hypoproteinemia plasma protein may promptly pass out of the circulation to supply body needs for protein. Perhaps the most significant concept which derives from all these experiments is the fluidity of the body protein (including plasma protein)-a ready give and take between the protein depots-a "dynamic equilibrium" of body protein.
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PMID:BLOOD PLASMA PROTEIN PRODUCTION AND UTILIZATION : THE INFLUENCE OF AMINO ACIDS AND OF STERILE ABSCESSES. 1987 Sep 63

When blood plasma proteins are depleted by bleeding with return of the washed red cells (plasmapheresis) it is possible to bring dogs to a steady state of hypoproteinemia and a constant level of plasma protein production if the diet protein intake is controlled and limited. Such dogs are outwardly normal but have a lowered resistance to infection and to certain intoxications. When the protein intake of such dogs is completely replaced by the growth mixture (Rose) of crystalline amino acids, plasma protein production is excellent, weight and nitrogen balance are maintained. This growth mixture consists of ten amino acids, threonine, valine, leucine, isoleucine, tryptophane, lysine, phenylalanine, methionine, histidine, arginine, and is as effective as most diet proteins in plasma protein production. The above amino acid mixture in aqueous solution may be given by vein with equally good plasma protein production and no apparent clinical disturbance even when given rapidly. Cystine may replace methionine in the above mixture with equally good plasma protein production for 7 to 10 days but at the expense of the body tissues, that is, with weight loss and a negative nitrogen balance. The addition of cystine to the protein-free, otherwise adequate diet may result in the production of considerable new plasma protein during a period as long as 1 week (cystine effect). This reaction may depend upon the amino acid constitution of the preceding diet protein in that it occurred following a liver feeding but did not occur after pancreas feeding. Arginine is required in the diet of the protein depleted dog for fabrication of plasma protein. It is apparently not needed for nitrogen balance for as long as 1 or 2 weeks. The omission of either threonine or valine from the growth mixture is quickly followed by a sharp decline in plasma protein formation and by a negative nitrogen balance. When histidine, arginine, and most of the lysine are omitted from the growth mixture, nitrogen balance and weight may be maintained for as long as 1 week but plasma protein production falls off markedly. The findings indicate that the growth mixture of amino acids should be a valuable addition to transfusion and infusion therapy in disease states associated with deficient nitrogen intake or tissue injury and accelerated nitrogen loss, including shock, burns, and major operative procedures.
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PMID:TEN AMINO ACIDS ESSENTIAL FOR PLASMA PROTEIN PRODUCTION EFFECTIVE ORALLY OR INTRAVENOUSLY. 1987 Dec 82

When blood plasma proteins are depleted by bleeding with return of red cells suspended in saline (plasmapheresis) it is possible to bring dogs to a steady state of hypoproteinemia and a constant level of plasma protein production if the diet nitrogen intake is controlled and limited. Such dogs are outwardly normal but have a lowered resistance to infection and to certain intoxications. The ten growth essential amino acids of Rose plus glycine will maintain nitrogen balance and produce as much new plasma protein as will good diet proteins. This good utilization is demonstrated over periods of several months when the amino acids are given either orally or parenterally. There is no evidence of toxicity in general nor to unnatural forms of these synthetic amino acids in particular. Given parenterally appropriate mixtures of these amino acids are well tolerated even upon rapid injection. The minimal daily requirements for a 10 kilo dog may be given intravenously in 10 minutes without reaction. Subcutaneously a 10 per cent solution may be given rapidly without reaction. Among various mixtures tested Vt approximates a minimum for a 10 kilo dog. It contains in grams (dl-threonine 0.7, dl-valine 1.5, l-(-) leucine 1.5, dl-isoleucine 1.4, dl-lysine hydrochloride 1.5, l(-) tryptophane 0.4, dl-phenylalanine 1.0, dl-methionine 0.6, l(+)-histidine hydrochloride 0.5, l(+)-arginine hydrochloride 0.5, and glycine 1.0. The presence of glycine improves tolerance to rapid intravenous injection, but excess glycine does not improve utilization of the mixture. Over a long period this mixture appears suboptimal in quantity. Doubled it is more than ample. Of two casein digests tested the one prepared by enzymatic hydrolysis provided good nitrogen retention and fairly good plasma protein production but was much less tolerable upon intravenous injection than certain mixtures of pure amino acids. The other one prepared by acid hydrolysis and tryptophane fortification afforded bare nitrogen equilibrium and produced virtually no plasma protein. Skin lesions observed after 10 to 20 weeks of synthetic diet probably reflect a deficiency of some member or members of the vitamin B(2) group. A persistent slight weight loss in the face of a strongly positive nitrogen balance may accompany this deficiency.
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PMID:AMINO ACID MIXTURES EFFECTIVE PARENTERALLY FOR LONG CONTINUED PLASMA PROTEIN PRODUCTION. CASEIN DIGESTS COMPARED. 1987 90

Hemoglobin (presumably its essential protein globin), given intraperitoneally to a protein-fasting dog, will be used effectively to supply the protein requirements of the body. Nitrogen balance may thus be maintained for 20 days under favorable conditions. New hemoglobin and plasma protein will be formed related to hemoglobin injections in depleted dogs where there is urgent need for these proteins (anemia and hypoproteinemia). Obviously this calls for supplementary amino acids which in globin are low and we assume these amino acids must be contributed from body protein stores. Plasma proteins (in plasma) tested in the same manner are completely utilized with no loss of nitrogen, positive nitrogen balance, weight balance, and no change in the albumin-globulin ratios. Hemoglobin (globin) is less effectively utilized as compared with plasma protein given parenterally and there is some increase in urinary nitrogen above control periods. The albumin-globulin ratio may be somewhat modified by hemoglobin injections intraperitoneally. Hemoglobin (globin) digests contribute effectively to body maintenance of nitrogen equilibrium. These digests are about as effective as whole hemoglobin in maintaining nitrogen balance but cause a rise in undetermined nitrogen not seen when hemoglobin alone is given intraperitoneally. Pigment radicles derived from hemoglobin given intraperitoneally are thrown away and appear as surplus bile pigment even when there is urgent need for all available nitrogenous material-given protein fasting, anemia, and hypoproteinemia in a bile fistula dog. The body evidently prefers to make rather than conserve the pyrrol aggregate (pigment radicle). We assume that the injected hemoglobin (globin) or hemoglobin digests contribute to the body protein pool and from this pool various proteins emerge to supply protein requirements of tissue or organ cells or to produce new hemoglobin or plasma protein if needed. We have no explanation as to what determines the pattern of this protein flow but new hemoglobin is very high on the priority list.
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PMID:HEMOGLOBIN AND PLASMA PROTEIN : THEIR RELATION TO INTERNAL BODY PROTEIN METABOLISM. 1987 66

When blood plasma proteins are depleted by bleeding with return of red cells suspended in saline (plasmapheresis) it is possible to bring dogs to a steady state of hypoproteinemia and a constant level of plasma protein production if the diet nitrogen intake is controlled and limited. Such dogs are outwardly normal but have a lowered resistance to infection and intoxication and probably to vitamin deficiency. When the diet nitrogen is provided by certain mixtures of the ten growth essential amino acids plus glycine, given intravenously at a rapid rate, plasma protein production is good. The same mixture absorbed subcutaneously at a slower rate may be slightly better utilized. Fed orally the same mixture is better utilized and associated with a lower urinary nitrogen excretion. An ample amino acid mixture for the daily intake of a 10 kilo dog may contain in grams dl-threonine 1.4, dl-valine 3, dl-leucine 3, dl-isoleucine 2, l(+)-lysine.HCl.H(2)O 2.2, dl-tryptophane 0.3, dl-phenylalanine 2, dl-methionine 1.2, l(+)-histidine.HCl.H(2)O 1, l(+)-arginine.HCl 1, and glycine 2. Half this quantity is inadequate and not improved by addition of a mixture of alanine, serine, norleucine, proline, hydroxyproline, and tyrosine totalling 1.4 gm. Aspartic acid appears to induce vomiting when added to a mixture of amino acids. The same response has been reported for glutamic acid (8). Omission from the intake of leucine or of leucine and isoleucine results in negative nitrogen balance and rapid weight loss but plasma protein production may be temporarily maintained. It is possible that leucine may be captured from red blood cell destruction. Tryptophane deficiency causes an abrupt decline in plasma protein production. No decline occurred during 2 weeks of histidine deficiency but the urinary nitrogen increased to negative balance. Plasma protein production may be impaired during conditions of dietary deficiency not related to the protein or amino acid intake. Skin lesions and liver function impairment are described. Unidentified factors present in liver and yeast appear to be involved.
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PMID:PLASMA PROTEIN PRODUCTION INFLUENCED BY AMINO ACID MIXTURES AND LACK OF ESSENTIAL AMINO ACIDS : A DEFICIENCY STATE RELATED TO UNKNOWN FACTORS. 1987 90

When blood plasma proteins are depleted by bleeding, with return of the washed red cells (plasmapheresis), it is possible to bring dogs to a steady state of hypoproteinemia and a constant level of plasma protein production if the diet nitrogen is controlled and limited. Such dogs are outwardly normal but have a lowered resistance to infection and to certain intoxications. Certain protein digests given by vein may favor good production of plasma protein, as well as nitrogen and weight equilibrium, over long periods in these standardized dogs. These digests may be equally effective when given subcutaneously or intraperitoneally and more effective orally (one dog). Certain other digests may not be well utilized. The total nitrogen of the protein digests is better retained upon oral feeding than parenteral injection. Most of the excess nitrogen excretion is not in the urea and ammonia fraction of the urine. The rate of plasma protein production may reach as high as 1 gm./kilo/day in the dog when ample protein of good quality is fed. The products of catabolism of red blood cells in vivo may add to the production of plasma protein, at least during the administration of casein digest by vein.
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PMID:PLASMA PROTEIN PRODUCTION AS INFLUENCED BY PARENTERAL PROTEIN DIGESTS, VERY HIGH PROTEIN FEEDING, AND RED BLOOD CELL CATABOLISM. 1987 93

The maximal output ceiling for hemoglobin in anemia due to blood loss is about 60 gm. per week-the dog receiving a rich protein diet plus high iron intake. Ferrous and ferric salts are equally effective. Iron intravenously plus a rich protein diet may push this level up to 90 to 100 gm. per week. Evidently iron absorption is a limiting factor. Maximal output for hemoglobin plus plasma protein in doubly depleted dogs may reach 120 to 130 gm. per week and using intravenous iron may reach 140 to 160 gm. per week. Maximal output for plasma protein alone in hypoproteinemia due to plasmapheresis reaches 60 to 70 gm. per week but this is not the true ceiling. Technically we cannot remove the new plasma protein as fast as it is formed and the hypoproteinemia is not maintained in the face of a rich protein diet intake. Furthermore the evidence points to the protein circulating pool contributing to the accretion of tissue protein in such dogs with a strong positive nitrogen balance and weight gain. Maximal figures for hemoglobin production in anemia run close to 1 gm. hemoglobin per kilo per day. Maximal figures for new hemoglobin plus plasma protein production in anemia and hypoproteinemia using iron given intravenously, may reach 1.5 gm. blood protein per kilo per day. The actual maximal plasma protein production equals about 1 gm. per kilo per day but the true production ceiling cannot be reached by this technique, for reasons given above.
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PMID:MAXIMAL HEMOGLOBIN AND PLASMA PROTEIN PRODUCTION UNDER THE STIMULUS OF DEPLETION. 1987 2

Given healthy dogs fed abundant iron and protein-free or low protein diets with sustained anemia and hypoproteinemia, we can study the capacity of these animals to produce simultaneously new hemoglobin and plasma protein. Reserve stores of blood protein-building materials are measurably depleted and levels of 6 to 8 gm. per cent for hemoglobin and 4 to 5 gm. per cent for plasma protein can be maintained for weeks or months depending upon the intake of food proteins or amino acid mixtures. These dogs are very susceptible to infection and various poisons. Dogs tire of these diets and loss of appetite terminates many experiments. Under these conditions (double depletion) standard growth mixtures of essential amino acids are tested to show the response in blood protein output and urinary nitrogen balance. As a part of each tabulated experiment one of the essential amino acids is deleted from the complete growth mixture to compare such response with that of the whole mixture. Methionine, threonine, phenylalanine, and tryptophane when singly eliminated from the complete amino acid mixture do effect a sharp rise in urinary nitrogen. This loss of urinary nitrogen is corrected when the individual amino acid is replaced in the mixture. Histidine, lysine, and valine have a moderate influence upon urinary nitrogen balance toward nitrogen conservation. Leucine, isoleucine, and arginine have minimal or no effect upon urinary nitrogen balance when these individual amino acids are deleted from the complete growth mixture of amino acids during 3 to 4 week periods. Tryptophane and to a less extent phenylalanine and threonine when returned to the amino acid mixture are associated with a conspicuous preponderance of plasma protein output over the hemoglobin output (Table 4). Arginine, lysine, and histidine when returned to the amino acid mixture are associated with a large preponderance of hemoglobin output. Various amino acid mixtures under these conditions may give a positive urinary nitrogen balance and a liberal output of blood proteins but there is always weight loss, however we may choose to explain this loss. These experiments touch on the complex problems of parenteral nutrition, experimental and clinical.
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PMID:PLASMA PROTEIN AND HEMOGLOBIN PRODUCTION : DELETION OF INDIVIDUAL AMINO ACIDS FROM GROWTH MIXTURE OF TEN ESSENTIAL AMINO ACIDS. SIGNIFICANT CHANGES IN URINARY NITROGEN. 1987 12

Dogs with sustained anemia and hypoproteinemia due to bleeding and a continuing low protein or protein-free diet with abundant iron are used to test the value of food proteins as contrasted with mixtures of pure amino acids. The stimulus of double depletion (anemia and hypoproteinemia) drives the body to use every source of protein and all protein-building materials with the utmost conservation. Raiding of body tissue protein to produce plasma protein and hemoglobin is a factor when protein-building factors are supplied in small amounts. In this severe test (double depletion) the good food proteins in adequate amounts are able to maintain body weight, a strongly positive nitrogen balance, and produce considerable amounts of new hemoglobin and plasma protein. Casein, lactalbumin, whole egg protein, liver protein are all adequate in amounts of 150 to 250 gm. protein per week. Under comparable conditions mixtures of pure amino acids (essential for growth) do produce large amounts of new hemoglobin and plasma protein and a positive nitrogen balance but do not maintain body weight. The loss of weight is conspicuous even with large amounts of amino acids (200 to 300 gm. protein equivalent per week). Methionine, threonine, and phenylalanine are related to nitrogen conservation in growth mixtures of essential amino acids (Paper I) but when these three are given together they have little influence on the doubly depleted dog (Table 3). Some unidentified substance or compound present in certain proteins but absent in mixtures of the essential amino acids may be responsible for these differences in the response of the doubly depleted dog.
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PMID:ANEMIA AND HYPOPROTEINEMIA : WEIGHT MAINTENANCE EFFECTED BY FOOD PROTEINS BUT NOT BY MIXTURES OF PURE AMINO ACIDS. 1987 13

Dogs with sustained anemia and hypoproteinemia due to bleeding and a continuing low protein or protein-free diet with abundant iron will continue to produce much new hemoglobin and plasma protein for many weeks. The stimulus of double depletion (anemia and hypoproteinemia) leads to raiding of body and tissue protein to fill the demand for new hemoglobin and plasma protein. The blood proteins in these experiments take priority over the organ and tissue proteins. This is another illustration of the "ebb and flow" or dynamic equilibrium between organ or tissue protein and blood proteins. The average dog cannot tolerate this drain of double depletion for more than 7 to 11 weeks and during this time may lose 30 to 40 per cent of body weight. Some dogs are much more resistant to this raiding than others. Some dogs show a high blood protein output during every week up to the danger point. With the largest blood protein output one usually observes the most rapid weight loss. For every kilogram of weight loss we observe 50 to 140 gm. blood protein output. The weekly blood protein production ranges from 40 to 66 gm. These experiments make heavy demands on the body protein and we expected to record a "premortal rise" in urinary nitrogen. No such observations are noted, rather a most frugal use of all protein and minimum figures for urinary nitrogen. We suspect that "premortal rise" in many experiments means a terminal infection with the related catabolism of tissue protein and high urinary nitrogen.
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PMID:RAIDING OF BODY TISSUE PROTEIN TO FORM PLASMA PROTEIN AND HEMOGLOBIN : WHAT IS PREMORTAL RISE OF URINARY NITROGEN? 1987 14

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