Howard C. Goodman

EFFECTS OF INFUSIONS OF SERUM ALBUMIN ON SERUM LIPIDS AND LIPOPROTEINS IN NEPHROSIS

Serum lipid and lipoprotein alterations in nephrosis were discussed in detail in a previous report (1). It was found that there were qualitative as well as quantitative differences in lipoproteins from one patient to another. Despite the differences in lipoprotein pattern, concentrations of serum cholesterol and phospholipids were related inversely to concentrations of serum albumin in a fairly regular manner. Triglycerides were consistently increased only when serum albumin fell below levels of about 1 g per 100 ml. These and other (2) observations suggest that hyperlipoproteinemia in nephrosis may be at least in part a result of hypoalbuminemia. In order to study the effects on serum lipoproteins of altering the level of serum albumin without altering the disease, repeated infusions of serum albumin were administered to patients with nephrosis. Serum lipids and lipoproteins decreased as a result of the infusions. The decreases often were selective, involving principally the particular fractions which were most excessive at the beginning of the infusions. Changes in lipids and lipoproteins during infusions of dextran, and during steroid-induced remissions of the disease, were studied in several patients for comparison with the albumin results.

Effects of dextran, polyvinylpyrrolidone and gamma globulin on the hyperlipidemia of experimental nephrosis.

During the treatment of edema in nephrotic patients by the infusion of dextran, Mollison and Rennie (1) noted falls in serum cholesterol concentration which they believed were due to dilution but which persisted after hematocrits had returned to pretreatment levels, and which by calculation from their data were greater than could be accounted for by hemodilution alone. Subsequently Soothill and Kark (2) and Baxter, Goodman and Havel (3) demonstrated that the intravenous infusion of human albumin into nephrotic patients resulted in a significant lowering of serum lipid concentrations. In their studies on nephrotic rats Rosenman and Friedman (4) demonstrated that the infusion of bovine albumin into these animals lowered serum lipid concentrations. Heymann, Nash, Gilkey and Lewis (5) treated nephrotic rats with dextran and noted significant reductions in the serum concentrations of total lipid and cholesterol. They recognized that these reductions resulted from more than hemodilution, but offered no explanation for this effect. This study was undertaken to investigate more extensively the effects of the administration of dextran on the hyperlipidemia of experimental nephrosis in rats, and to see whether these effects were shared by osmotically active macromolecular substances other than dextran and albumin.

Antibodies in Systemic Lupus Erythematosus and Myasthenia Gravis Which React with Thermally Denatured DNA-Coated Bentonite

Summary Sera from 66% of 35 patients with SLE flocculated bentonite particles coated with thermally denatured DNA while only 29% of these same sera flocculated bentonite particles coated with native DNA. All of these sera contained antinuclear antibody. Twenty per cent of sera from 44 patients with myasthenia gravis flocculated the bentonite particles coated with denatured DNA while none reacted with the native DNA bentonite. Thirty-seven per cent of the sera from patients with myasthenia gravis contained antinuclear antibody. Rheumatoid factor and antibodies to thyroglobulin were occasionally seen in low titer in the serum from patients with myasthenia gravis.

Effect of Adrenalectomy on Spontaneous and Induced Proteinuria in the Rat.

Summary 1. Bilateral adrenalectomy abolishes or greatly reduces the types of experimentally produced proteinuria studied in the saline maintained rat. 2. The normal, spontaneous proteinuria of the male rat is significantly reduced by bilateral adrenalectomy. 3. Cortisone administration to bilaterally adrenalectomized male rats increases their spontaneous proteinuria to normal control levels. 4. Adrenal cortex extract, esoxycorticosterone acetate, and cortisone restore the ability of the salt-maintained, adrenalectomized rat to respond to renin injection with massive proteinuria.

Endocrine Influences on Proteinuria in the Rat Effect of AGTH.

Summary 1. Normal rats respond to the intraperitoneal injection of renin with an intense, transient proteinuria. ACTH administration results in a 60 to 65% increase in proteinuria in the hour following renin administration over and above that shown by non-ACTH treated controls. 2. The normal, spontaneous proteinuria of the male rat is significantly increased by ACTH administration.

Relation between adrenal and pituitary glands and urinary excretion of neutral reducing lipids in the rat.

Summary The neutral reducing lipids were determined in the urine of rats. Adrenalectomy decreased the excretion of this material to one-half the control value. Neither ACTH, growth hormone, nor anterior pituitary powder significantly increased NRL excretion. Posterior pituitary powder increased the excretion approximately 3-fold. This response is considerably diminished in adrenalectomized rats.