In recent years a diphenylamine-positive substance has gradually acquired considerable clinical importance as an acute phase reactant. Although that substance is generally regarded as sialic acid, much still remains unexplained as to the nature of the diphenylamine reaction.
The present study was made, with the following results, to investigate the clinical significance of that reaction and its nature in relation to other test results:
1) The value of the reaction in healthy subjects was 0.175±0.020 and there was no difference according to sex and age.
2) Patients with internal diseases who exhibited high values comprised cases of malignant tumors, cholecystitis, pleurisy, pneumonia, rheumatic fever, and rheumatoid arthritis in the stadium incrementi, whereas cases of hepatitis and hepatic cirrhosis showed low values.
3) In general the reaction was closely related to the destruction, growth and inflammation of tissue and was in good agreement with the intensity and course of a disease. It is a useful aid in the assessment of therapeutic effects or prognosis.
4) The reaction was clearly correlated with mucoprotein, protein bound polysaccharide and C-reactive protein. A slight parallelism existed between the reaction and the blood sedimentation value, but the cephalin cholesterol flocculation test, the antistreptolysin O test and the icteric index were not related to the reaction.
5) On paper electrophoresis the reaction showed a correlationship with α
2- and α
1-globulin and a more significant correlationship with α
1-and α
2-glycoprotein, while it had no correlation with the lipoprotein fraction. Accordingly, the diphenylamine-positive substance can be thought to be protein bound polysaccharide which is located mainly in the α-globulins.
6) It can be presumed that the reactant might originate in the liver, tissue from inflammation and tumors.
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