Lactate dehydrogenase isoenzymes were investigated in supernatants of small-intestinal mucosa of 24 men and 18 females with the method of electrophoresis in agar gel and tétrazolium staining. In nontropical sprue and children with celiac disease the most positively charged fraction (LDH 5) was always decreased with simultaneous elevations of LDH 4, LDH 3, the ratio (LDH 3 + LDH 4) : LDH 5 and the value of H subunits. These changes were significant in comparison with controls and patients with secondary malabsorption of small-intestinal as well as pancreatic origin. In advanced exocrine pancreatic insufficiency changes significant in comparison with controls were also observed. The distribution of LDH isoenzymes in ileal adenocarcinoma resembled more closely the pattern of primary malabsorption than any other condition examined. The pattern of LDH isoenzymes of small intestinal mucosa in primary malabsorption approximates the distribution found in human foetal tissues. The evidence of identity of nontropical sprue and celiac disease of children at the molecular evel of the cell is presented. The relative activities of genes controlling the synthesis of LDH monomers in small-intestinal mucosa appear to be altered in favor of the gene controlling the synthesis of H subunits. LDH isoenzymes of jejunal supernatants in advanced pancreatic insufficiency may be influenced by various factors and more definite explanation of the observed changes cannot be given on the basis of the present material. The results are discussed in view of their possible significance for future studies on pathophysiology and heredity of primary malabsorption.

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