Plasma lipid and lipoprotein changes in obstructive jaundice: Immunochemical identification of abnormal alpha lipoprotein forms

Rifkind, Basil M (1971) Plasma lipid and lipoprotein changes in obstructive jaundice: Immunochemical identification of abnormal alpha lipoprotein forms. MD thesis, University of Glasgow.

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1. Alpha lipoprotein levels have been variously described as increased or decreased in the plasma of subjects with jaundice due to intra- or extrahepatic biliary obstruction, including biliary cirrhosis, the findings varying with the method used. 2. To resolve this paradox, a chemical and immunochemical study of the changes that occurred in the plasma lipids and lipoproteins of 21 subjects with various types of obstructive jaundice was performed. Three patterns of lipoprotein disturbances were recognised. 3. In 9 subjects an abnormal alpha lipoprotein form was detected by immunoelectrophoretic and immunodiffusion studies within the d 1.006 - 1.063 fraction, together with beta lipoproteino This low density alpha lipoprotein displayed cathodal or retarded electrophoretic mobility in agar and agarose gels respectively, and abnormal features in immunodiffusion studies. These subjects also showed, on paper electrophoresis/electrophoresis of their d 1.006 - 1.063 fraction, an additional lipoprotein hand migrating between the origin and the beta lipoprotein band, or cathodally; this band displayed unusual staining characteristics in that it usually stained for protein but not for lipid although the latter was shown to be present. It is thought to correspond to the abnormal alpha lipoprotein detected on immunoelectrophoresis. These abnormalities disappeared with relief of jaundice. 4. An abnormal alpha lipoprotein form vas also detected at d 1.006 - 1.063 in the plasma of 2 subjects; unlike the previous form it shoved normal electrophoretic mobility in agarose and agar gels, and in paper in which it stained for lipid and for protein. Its immunodiffusion characteristics vere unaltered. 5. In 10 subjects alpha lipoprotein was not identified outwith its normal density class, and in this group/ group elevated levels of beta lipoprotein of altered composition were found establishing the occurrence of a pure hyperbetalipoproteinaemia. 6. Quantitative studies of the plasma lipid and lipoprotein levels, and of lipoprotein composition showed several significant differences between the groups, with the maximum disturbances occurring in the subjects with the low density alpha lipoprotein of altered electrophoretic mobility. 7. On the basis of these findings it is suggested that the appearance of alpha lipoproteir forms of abnormally low density, with or without altered electrophoretic mobility, results from the over-lipidation of alpha lipoprotein secondary to biliary obstruction. 8. The demonstration of an alpha lipoprotein form of low density, altered electrophoretic mobility and unusual staining properties resolves the previous conflicting reports regarding alpha lipoprotein changes/changes in obstructive jaundice. 9. A lipoprotein of beta mobility was found within the d < 1.006 fraction of 11 subjects, similar to the "floating" beta lipoprotein of familial Type III hyperlipoproteinaemia. 10. Subjects with jaundice due to extra- or intrahepatic biliary obstruction could not be distinguished from those with biliary cirrhosis by their lipid and lipoprotein abnormalities.

Item Type: Thesis (MD)
Qualification Level: Doctoral
Additional Information: Adviser: Robert Levy
Keywords: Immunology
Date of Award: 1971
Depositing User: Enlighten Team
Unique ID: glathesis:1971-73794
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 14 Jun 2019 08:56
Last Modified: 14 Jun 2019 08:56

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