Mm. Kohli et al., URINARY-EXCRETION OF RENAL BRUSH-BORDER MEMBRANE ENZYMES IN LEPROSY PATIENTS - EFFECT OF MULTIDRUG THERAPY, Experientia, 52(2), 1996, pp. 127-130
Renal function at the brush border membrane level has been studied usi
ng characteristic enzymes, such as alkaline phosphatase, leucine-amino
peptidase and gamma-glutamyl transpeptidase. Urinary enzyme studies we
re performed using leprosy patients, classified on the basis of bacter
iological index (BI > 3; n = 20, BI < 3; n = 12, BI-ve; n = 10) and co
mpared with control subjects (n = 10). The role of enzymuria in monito
ring WHO-recommended multidrug therapy (MDT) has been evaluated in the
se patients. A significant increase in the enzyme activities (p < 0.01
), as well as significant (p < 0.01) proteinurea in 24-hour urine samp
les of both the smear positive groups (Bf > 3, BI < 3) prior to therap
y compared to control subjects, indicates proximal tubular functional
impairment at brush border membrane level. In the smear negative (BI-v
e) group, no significant difference was observed in enzyme activities
as compared with the control group. In a follow-up study (BI > 3; n =
13, BI < 3; n = 4) the activities of all the enzymes decreased signifi
cantly in all the groups when compared to a corresponding untreated gr
oup. The follow-up study was not carried out on the smear negative gro
up. The surprising finding was the differential behaviour of r-glutamy
l transpeptidase, whose activity increased significantly (p < 0.01) ev
en after therapy in BI > 3 group when compared with untreated patients
. However in a detailed work-up including hepatic and renal function t
ests, the serum biochemistry was found to be normal both before and af
ter therapy. Urinary excretion of brush border enzymes seems to be rel
ated to bacterial load, and their potential in studying the effect of
MDT remains unclear.