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The paper is concerned with the results of morphological and biochemical studies of the duodenum and ileum in young rabbits with salmonellosis. It was shown that all the parts of the small intestine were involved into the pathological process. Enzymopathy developed in the presence of acute catarrhal inflammation and erosive enteritis accompanied by ulceration of necrotized lymph follicles of Peyer's patches of the small intestine. The activity of maltase and alkaline phosphatase was found to be most vulnerable. Of crucial significance in the development of diarrhea in experimental young rabbits were pronounced morphological alterations and derangement of enzyme-forming function in the small intestine.

The method of aspiration biopsy and carbohydrate and lipid tolerance tests were employed for a study of cavitary and membranous digestion in 59 patients. This disease was characterized by an irregular decrease in the level of various enzymes and the rates of absorption of nutritional monomers. The clinical symptoms of disease were shown to be caused by structural changes in the intestinal mucous membrane leading to a syndrome of intolerance of some nutrients. In a grave course of disease membranous digestion remained considerably lowered in spite of therapeutic measures.

The activity of enterokinase and some dipeptidases (glycylalanine, glycylleucine, glycylvaline and glycylglycine) was studied in the intestinal mucosa biopsy specimens of 52 patients with chronic enteritis. Hydroxyproline excretion in the urine was defined before and after gelatin tolerance testing which showed a decrease in hydrolysis and protein absorption in the small intestine in chronic enteritis. A decrease in the level of dipeptidases and enterokinase involved in membranous digestion was noted whereas the level of glycylglycine acting intracellularly was practically unchanged. A decrease in the enzymatic activity correlated with a degree of gravity of disease and a degree of change in a morphological picture of the intestinal mucosa.

Serum isoamylases were determined prospectively in dogs with pancreatic and extrapancreatic diseases. Mean serum isoamylase determinations were significantly different (p less than 0.05) between normal dogs and dogs with pancreatitis and exocrine pancreatic insufficiency. The sensitivity of serum isoamylase determination exceeded that of total amylase activity for the diagnosis of pancreatitis. Serum isoamylase determinations were less influenced by extrapancreatic diseases compared to total amylase activity when used in the diagnosis of pancreatic disease. Neither serum isoamylase determination nor total amylase activity had adequate sensitivity to support their use in the diagnosis of exocrine pancreatic insufficiency. There were significant (p less than 0.05) linear correlations between isoamylase determinations, total amylase activity, and trypsin-like immunoreactivity concentration.

The results are reported from the study on 120 patients, 30 of them with gluten enteropathy, 50--with chronic unspecified enteritis and 40--with chronic ulcerous colitis. Small intestinal aspiration biopsy was performed to all patients with histomorphological, electron microscopic, enzymatic and immune-fluorescent study. The secretory immunoglobulins in the jejunal juice were studied in 40 patients. Morphological changes, various degrees, were established, that correlate with the increased number of IgG and IgM secretory cells. The exclusion of gluten from the diet in case of gluten enteropathy was followed by normalization of the number and percentage ratio of IgSC and of secretory immunoglobulins. The enzymatic and immune disorders, in chronic unspecific enteritis correlate with the electron microscopic and precede the histologic ones. The role of immune system of small intestine in the etiology and pathogenesis of the various intestinal diseases is discussed.

Serum lysozyme (muramidase) concentrations were determined in patients with different types of inflammatory bowel disease and in normal subjects. The mean (plus or minus S.E.M.) lysozyme concentration for each group was as follows: controls, 8.8 plus or minus 0.3, ulcerative colitis, 9.3 plus or minus 0.6, Crohn's disease, 26.3 plus or minus 1.4. a and bacterial and nonbacterial enteritis, 8.9 plus or minus 0.7 mug per milliliter. Thus, mean enzyme levels were significantly greater in Crohn's disease than in ulcerative colitis (p smaller than 0.001), bacterial and nonbacterial enteritis (p smaller than 0.001) and healthy volunteers (p smaller than 0.001). The elevation of serum lysozyme in Crohn's disease may be related to tissue macrophages because no correlation was found between either the serum lysozyme concentration and the white-cell counts or the absolute numbers of circulating granulocytes or monocytes. Our findings suggest that serum lysozyme may be useful in the differential diagnosis of Crohn's disease from other types of bowel inflammation.

Enzymological alterations in functional disturbances and in diseases of the intestine are reviewed. Examples are given for diagnostic significance (e.g. in Hirschsprung's and Crohn's diseases), for pathogenetic considerations (e.g. in hypolactasia and in celiac disease), and for secondary involvement of the liver (e.g. in intestinal tumors and after bypass surgery) and are discussed in more detail.

An assay was devised to quantitate acute intestinal inflammation based on the assessment of myeloperoxidase activity. Myeloperoxidase is an enzyme found in neutrophils and, in much smaller quantities, in monocytes and macrophages. Myeloperoxidase was solubilized with hexadecyltrimethylammonium bromide and myeloperoxidase activity was measured with a dianisidine-H2O2 assay. In neutrophil suspensions, myeloperoxidase activity was directly related to cell number down to as few as 500 cells. Myeloperoxidase activity was assayed in two animal models of inflammation: acetic acid-induced colitis in rats and Clostridium difficile enterotoxin-induced enteritis in hamsters. In both models, the activity of myeloperoxidase solubilized from the inflamed tissue was directly proportional to the number of neutrophils seen in histologic sections. Histologic evaluation of neutrophil accumulation was performed by counting the number of neutrophils in a histologic section 0.18 mm long and 5 micron thick. In both animal models, myeloperoxidase activity was linearly related to neutrophil number from 400 and 4000 cells/mm. Myeloperoxidase activity from chronically inflamed colon, in which both neutrophils and histiocytes were present, was directly related to neutrophil content. Histiocytes did not contribute significantly to myeloperoxidase activity. The determination of myeloperoxidase activity in the intestine is a simple biochemical assay that can be used to quantitate inflammation.

Serum angiotensin-converting enzyme (SACE) activity was significantly higher in 90 patients with sarcoidosis (55 +/- [S.D.] 23 nmol min-1 ml-1) than in 80 healthy controls (34 +/- 9 nmol min-1 ml-1). Steroid therapy modified SACE activity; 60 sarcoidosis patients who were not being treated with steroids had significantly higher enzyme activities (58 +/- 24 nmol min-1 ml-1) than 30 steroid-treated sarcoidosis patients (40 +/- 19 nmol min-1 ml-1). In 50% of the non-steroid treated sarcoidosis patients SACE activity was more than 2 S.D. above the mean value for the controls. SACE activity was measured in 22 tuberculous patients (38 +/- 14 nmol min-1 ml-1), 20 leprosy patients (34 +/- 9 nmol min-1 ml-1), 31 with primary biliary cirrhosis (44 +/- 20 nmol min-1 ml-1), 26 with inflammatory bowel disease (31 +/- 9 nmol min-1 ml-1), 8 with hepatic granulomatous disease, 5 with Hodgkin's disease, and 2 with schistosomiasis. The combined false-positive rate for these non-sarcoidosis patients was 10%. Serial SACE assays provide useful information on the course of sarcoidosis and response to steroid treatment.

Dipeptidase activity in homogenate from small intestinal mucosa is determined according to the method of Josefsson (1965) in 45 patients with chronic non-specific enteritis. The majority of the enzymes are of the endopeptidase group, degrading the dipeptides of the neural aminoacids; glycyl-alanine, alanyl-l-valine, glycyl-l-isoleucine, analyl-glycine, leucyl-l-leucine, alanyl-l-leucine, alanyl-l-proline, glycyl-l-glutamic acid; only one enzyme-glycyl-l-leucine dipeptidase belongs to the enzymes of the brush-like zone of the enterocyte. The glycyl-l-alanine dipeptidase enzyme activity was established to be decreased with 49,2 per cent, glycyl-l-leucine--with 33,2 per cent, glycyl-l-valine with 19,6 per cent, glycyl-l-isoleucine--with 61 per cent, etc. The diminished enzyme activity corresponds, in the majority of the cases, to the severity of the disease and to the degree of the histological changes. It does not reach the decreased degree, found in the patients with coliac sprue. In a series of cases the enzymatic activity does not correspond to the morphological changes: "normal activity" and decreased peptidase activity were found in six cases and in two cases--"partial mucosal atrophy" and normal or elevated peptidase activity. Very likely, the pointed out enzymes, are of a substantial importance for the pathogenetic digestive and resorbtive disturbances in chronic non-specific enteritis, especially protein disturbances.