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Mucins obtained from patients with enterocutaneous urinary diversions
S Mårtensson1, A Lundblad, G C Hansson
1Department of Clinical Chemistry, University Hospital, Lund, Sweden.
Scandinavian Journal of Clinical and Laboratory Investigation
|November 1, 1988
Summary
Ureteroenterocutaneostomy surgery uses intestinal segments for urinary diversion, producing mucus-like sediment in urine. This sediment consists of complex mucins, which are glycoproteins that carry blood-group antigens.
Area of Science:
- Biochemistry
- Gastroenterology
- Surgical Oncology
Background:
- Ureteroenterocutaneostomy is a urinary diversion technique utilizing intestinal segments.
- Patients undergoing this procedure often exhibit a mucus-like sediment in their urine.
- Previous studies noted well-preserved colonic mucosa with goblet cells in these segments.
Purpose of the Study:
- To characterize the composition of the mucus-like sediment found in the urine of patients with ureteroenterocutaneostomy.
- To investigate the structure and properties of the mucins present in the urinary sediment.
- To determine the blood-group antigen expression on these mucins.
Main Methods:
- Analysis of urinary sediment using biochemical techniques.
- Solubilization of mucin complexes by disulfide bond reduction.
- Density-gradient centrifugation in cesium chloride (CsCl) and guanidinium chloride.
- Trypsin digestion of mucin subunits.
- High-performance ion-exchange chromatography.
- Immunohistochemical analysis of blood-group antigens (ABH, Lewis).
Main Results:
- The urinary gels are primarily composed of mucins, existing as glycoprotein complexes insoluble in 6 M guanidinium chloride.
- Disulfide bond reduction solubilized the complex into subunits, behaving as typical mucins during density-gradient centrifugation.
- High-molecular-weight glycopeptides from subunits expressed ABH and Lewis antigens, consistent with patient blood type and normal colonic mucosa distribution.
- High-performance ion-exchange chromatography revealed a heterogeneous population of mucin glycopeptides, with the major carbohydrate peak not coinciding with blood-group activity.
Conclusions:
- The mucus-like sediment in ureteroenterocutaneostomy patients is derived from mucins within the intestinal segment used for diversion.
- These mucins are complex glycoproteins that retain blood-group antigen expression.
- The heterogeneity of mucin glycopeptides suggests complex post-translational modifications or variations in glycosylation patterns.