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I didn't see anything addressing this exact question. But, I have seen literature suggesting that PJP can attach to type I alveolar epithelial cells, which may increase permeability (and lead to increased LDH).

ncbi.nlm.nih.gov/pubmed/8476628
This study (based on BAL albumin and LDH) concluded that the elevated LDH is from a pulmonary source and that respiratory cell damage is the cause.

They don't specifically say anything about increase rates of glycolysis.

ncbi.nlm.nih.gov/pubmed/3258807
And, LDH elevations are highly sensitive for PJP, other respiratory infections cause increases as well.

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Tony Breu
@tony_breu
1/11
Why isn't insulin administered orally?

Most of our medications are taken by mouth. Not insulin.

What do you think... what is it about insulin that makes the oral route so hard to achieve?
2/
 To understand the answer, we must recall a few properties of insulin:

• it's a peptide
AND
• it's pretty big (5.8 kD)

These properties lead to (1) degradation within the gastrointestinal tract and (2) poor oral bioavailability.

ncbi.nlm.nih.gov/pubmed/3526553
3/
 Let's look first at the degradation of insulin.

Within a few years of its discovery in the early 1920s, Dudley reported that pepsin and trypsin digested insulin.

Interestingly, this same study found that acid had no effect.

ncbi.nlm.nih.gov/pmc/articles/P…
Read 11 tweets
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Tony Breu
@tony_breu
1/13
Why does HIV cause an elevated protein gap?

The protein gap is due to excess immunoglobulin production. And yet, patients with HIV have problems with humoral immunity. Why?

The explanation for this paradox provides insights into other complications of HIV...
2/
 The association between HIV and hypergammaglobulinemia (↑Ig) has been noted since the first appearance of the new syndrome.

For example, in the original papers published in 1991, patients were noted to have ↑Ig.

The relevance wasn't yet clear.

ncbi.nlm.nih.gov/pubmed/6272109
3/
 Amazingly, in 1983 (before HIV was identified as the cause of AIDS), Lane et al used the presence of ↑Ig as a clue that the cause was a virus.

ncbi.nlm.nih.gov/pubmed/6224088
Read 13 tweets
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Tony Breu
@tony_breu
I have grouped my MedTweetorials in separate Moments, each of which can be found in the following thread.

I hope it's easier to find content this way!
Cardiology

twitter.com/i/events/12067…
Pulmonology

twitter.com/i/events/12067…
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