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Casazza K, Swanson E. Nutrition as Medicine to Improve Outcomes in Adolescents Sustaining a Sports-related Concussion. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2017; 2:1-9. [DOI: 10.14218/erhm.2017.00029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Dash PK, Hergenroeder GW, Jeter CB, Choi HA, Kobori N, Moore AN. Traumatic Brain Injury Alters Methionine Metabolism: Implications for Pathophysiology. Front Syst Neurosci 2016; 10:36. [PMID: 27199685 PMCID: PMC4850826 DOI: 10.3389/fnsys.2016.00036] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/13/2016] [Indexed: 11/21/2022] Open
Abstract
Methionine is an essential proteinogenic amino acid that is obtained from the diet. In addition to its requirement for protein biosynthesis, methionine is metabolized to generate metabolites that play key roles in a number of cellular functions. Metabolism of methionine via the transmethylation pathway generates S-adenosylmethionine (SAM) that serves as the principal methyl (−CH3) donor for DNA and histone methyltransferases (MTs) to regulate epigenetic changes in gene expression. SAM is also required for methylation of other cellular proteins that serve various functions and phosphatidylcholine synthesis that participate in cellular signaling. Under conditions of oxidative stress, homocysteine (which is derived from SAM) enters the transsulfuration pathway to generate glutathione, an important cytoprotective molecule against oxidative damage. As both experimental and clinical studies have shown that traumatic brain injury (TBI) alters DNA and histone methylation and causes oxidative stress, we examined if TBI alters the plasma levels of methionine and its metabolites in human patients. Blood samples were collected from healthy volunteers (HV; n = 20) and patients with mild TBI (mTBI; GCS > 12; n = 20) or severe TBI (sTBI; GCS < 8; n = 20) within the first 24 h of injury. The levels of methionine and its metabolites in the plasma samples were analyzed by either liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry (LC-MS or GC-MS). sTBI decreased the levels of methionine, SAM, betaine and 2-methylglycine as compared to HV, indicating a decrease in metabolism through the transmethylation cycle. In addition, precursors for the generation of glutathione, cysteine and glycine were also found to be decreased as were intermediate metabolites of the gamma-glutamyl cycle (gamma-glutamyl amino acids and 5-oxoproline). mTBI also decreased the levels of methionine, α-ketobutyrate, 2 hydroxybutyrate and glycine, albeit to lesser degrees than detected in the sTBI group. Taken together, these results suggest that decreased levels of methionine and its metabolic products are likely to alter cellular function in multiple organs at a systems level.
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Affiliation(s)
- Pramod K Dash
- Department of Neurobiology and Anatomy, UTHealth McGovern Medical SchoolHouston, TX, USA; The Vivian L. Smith Department of Neurosurgery, UTHealth McGovern Medical SchoolHouston, TX, USA
| | - Georgene W Hergenroeder
- The Vivian L. Smith Department of Neurosurgery, UTHealth McGovern Medical School Houston, TX, USA
| | - Cameron B Jeter
- Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry Houston, TX, USA
| | - H Alex Choi
- The Vivian L. Smith Department of Neurosurgery, UTHealth McGovern Medical School Houston, TX, USA
| | - Nobuhide Kobori
- Department of Neurobiology and Anatomy, UTHealth McGovern Medical School Houston, TX, USA
| | - Anthony N Moore
- Department of Neurobiology and Anatomy, UTHealth McGovern Medical School Houston, TX, USA
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Tamanna N, Mahmood N. Emerging Roles of Branched-Chain Amino Acid Supplementation in Human Diseases. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:235619. [PMID: 27351005 PMCID: PMC4897441 DOI: 10.1155/2014/235619] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/25/2014] [Accepted: 10/17/2014] [Indexed: 12/28/2022]
Abstract
The branched-chain amino acids (BCAAs), namely, valine, leucine, and isoleucine, are indispensable amino acids required for body protein synthesis. Unlike other amino acids, the BCAAs are primarily catabolised in the extrahepatic tissues. The BCAAs play role in regulation of protein synthesis and turnover as well as maintenance of the body glutamate-glutamine level. In strenuous and traumatic conditions, the BCAAs are oxidized which limits their availability in tissues. Such condition affects the body glutamate-glutamine pool and protein synthesis mechanisms. Thus BCCA supplementation is emerging as a nutritional strategy for treating many diseases. Many studies have found that BCAA administration is able to improve the health status of the patients suffering from different diseases even though there are conditions where they do not exert any effect. There are also some reports where elevated BCAAs have been shown to be associated with the pathogenesis of diseases. In this review, we have discussed the implication of BCAA supplementation in different pathological conditions and their relevant outcomes.
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Affiliation(s)
- Nahid Tamanna
- Graduate Program in Biological Sciences, University of Manitoba, Winnipeg, MB, Canada R3T 2N2
| | - Niaz Mahmood
- Graduate Program in Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB, Canada R3E 0J9
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Corsetti G, D’Antona G, Ruocco C, Stacchiotti A, Romano C, Tedesco L, Dioguardi F, Rezzani R, Nisoli E. Dietary supplementation with essential amino acids boosts the beneficial effects of rosuvastatin on mouse kidney. Amino Acids 2014; 46:2189-203. [PMID: 24923264 PMCID: PMC4133027 DOI: 10.1007/s00726-014-1772-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 05/26/2014] [Indexed: 12/25/2022]
Abstract
The effects of high-potency statins on renal function are controversial. To address the impact of statins on renal morpho-functional aspects, normotensive young mice were treated with rosuvastatin (Rvs). Moreover, because statins may impair mitochondrial function, mice received either dietary supplementation with an amino acid mixture enriched in essential amino acids (EAAm), which we previously demonstrated to increase mitochondrial biogenesis in muscle or an unsupplemented control diet for 1 month. Mitochondrial biogenesis and function, apoptosis, and insulin signaling pathway events were studied, primarily in cortical proximal tubules. By electron microscopy analysis, mitochondria were more abundant and more heterogeneous in size, with dense granules in the inner matrix, in Rvs- and Rvs plus EAAm-treated animals. Rvs administration increased protein kinase B and endothelial nitric oxide synthase phosphorylation, but the mammalian target of rapamycin signaling pathway was not affected. Rvs increased the expression of sirtuin 1, peroxisome proliferator-activated receptor γ coactivator-1α, cytochrome oxidase type IV, cytochrome c, and mitochondrial biogenesis markers. Levels of glucose-regulated protein 75 (Grp75), B-cell lymphoma 2, and cyclin-dependent kinase inhibitor 1 were increased in cortical proximal tubules, and expression of the endoplasmic reticulum-mitochondrial chaperone Grp78 was decreased. EAAm supplementation maintained or enhanced these changes. Rvs promotes mitochondrial biogenesis, with a probable anti-apoptotic effect. EAAm boosts these processes and may contribute to the efficient control of cellular energetics and survival in the mouse kidney. This suggests that appropriate nutritional interventions may enhance the beneficial actions of Rvs, and could potentially prevent chronic renal side effects.
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Affiliation(s)
- Giovanni Corsetti
- Division of Human Anatomy, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Giuseppe D’Antona
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Chiara Ruocco
- Department of Medical Biotechnology and Translational Medicine, University of Milan, via Vanvitelli 32, 20129 Milan, Italy
| | - Alessandra Stacchiotti
- Division of Human Anatomy, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Claudia Romano
- Division of Human Anatomy, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Laura Tedesco
- Department of Medical Biotechnology and Translational Medicine, University of Milan, via Vanvitelli 32, 20129 Milan, Italy
| | - Francesco Dioguardi
- Department of Clinical Sciences and Community, University of Milan, 20122 Milan, Italy
| | - Rita Rezzani
- Division of Human Anatomy, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Enzo Nisoli
- Department of Medical Biotechnology and Translational Medicine, University of Milan, via Vanvitelli 32, 20129 Milan, Italy
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Chen YH, Kang JH, Lin HC. Patients with traumatic brain injury: population-based study suggests increased risk of stroke. Stroke 2011; 42:2733-9. [PMID: 21799162 DOI: 10.1161/strokeaha.111.620112] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies have identified an array of morbidities following traumatic brain injury (TBI), including certain neurological disorders. However, no direct evidence has been reported on the link between TBI and stroke. This population-based study was designed to estimate the risk of stroke during a period of 5 years following a TBI, compared with individuals who did not suffer TBI during the same period. METHODS Data were obtained from the Longitudinal Health Insurance Database 2000 (LHID 2000). A total of 23 199 patients receiving ambulatory or hospitalization care with a diagnosis of TBI were included, together with 69 597 non-TBI patients as our comparison group, matched by sex, age, and year of index use of health care. Each individual was followed for 5 years to identify subsequent occurrence of stroke. Cox proportional hazard regressions were performed for analysis. RESULTS During the 3-month follow-up period, 675 strokes (2.91%) occurred in TBI patients and in 207 patients (0.30%) in the non-TBI comparison cohort. A diagnosis of TBI was independently associated with a 10.21 (95% CI, 8.71-11.96), 4.61 (95% CI, 4.16-5.11), and 2.32 (95% CI, 2.17-2.47) times greater risk of stroke during 3-month, 1-year, and 5-year follow-up, respectively, after adjusting for sociodemographic characteristics and selected comorbidities. The risk of intracerebral hemorrhage was more noticeable among patients with TBI compared with those without a TBI. CONCLUSIONS This is the first report showing an increased risk of stroke among individuals who have sustained a TBI. We suggest a need for more intensive medical monitoring and health education following TBI, especially during the first few months and years.
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Affiliation(s)
- Yi-Hua Chen
- School of Public Health, Taipei Medical University, and Neuroscience Research Center, Taipei Medical University Hospital, 250 Wu-Hsing St., Taipei 110, Taiwan
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Abstract
Traumatic brain injury (TBI) is seen by the insurance industry and many health care providers as an "event." Once treated and provided with a brief period of rehabilitation, the perception exists that patients with a TBI require little further treatment and face no lasting effects on the central nervous system or other organ systems. In fact, TBI is a chronic disease process, one that fits the World Health Organization definition as having one or more of the following characteristics: it is permanent, caused by non-reversible pathological alterations, requires special training of the patient for rehabilitation, and/or may require a long period of observation, supervision, or care. TBI increases long-term mortality and reduces life expectancy. It is associated with increased incidences of seizures, sleep disorders, neurodegenerative diseases, neuroendocrine dysregulation, and psychiatric diseases, as well as non-neurological disorders such as sexual dysfunction, bladder and bowel incontinence, and systemic metabolic dysregulation that may arise and/or persist for months to years post-injury. The purpose of this article is to encourage the classification of TBI as the beginning of an ongoing, perhaps lifelong process, that impacts multiple organ systems and may be disease causative and accelerative. Our intent is not to discourage patients with TBI or their families and caregivers, but rather to emphasize that TBI should be managed as a chronic disease and defined as such by health care and insurance providers. Furthermore, if the chronic nature of TBI is recognized by government and private funding agencies, research can be directed at discovering therapies that may interrupt the disease processes months or even years after the initiating event.
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Affiliation(s)
- Brent E Masel
- Department of Neurology, Transitional Learning Center at Galveston, The Moody Center for Traumatic Brain & Spinal Cord Injury Research/Mission Connect, The University of Texas Medical Branch, Galveston, Texas 77550, USA.
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Krakau K, Hansson A, Karlsson T, de Boussard CN, Tengvar C, Borg J. Nutritional treatment of patients with severe traumatic brain injury during the first six months after injury. Nutrition 2007; 23:308-17. [DOI: 10.1016/j.nut.2007.01.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Revised: 12/12/2006] [Accepted: 01/23/2007] [Indexed: 11/29/2022]
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Børsheim E, Bui QUT, Wolfe RR. Plasma Amino Acid Concentrations During Late Rehabilitation in Patients With Traumatic Brain Injury. Arch Phys Med Rehabil 2007; 88:234-8. [PMID: 17270522 DOI: 10.1016/j.apmr.2006.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate whether the basal plasma amino acid concentrations in patients with traumatic brain injury (TBI) have returned to levels found in healthy controls at about 17 months postinjury and to determine the effect of intake of a mixture of essential amino acids (EAA) on plasma amino acid concentrations in TBI versus healthy controls. DESIGN Peripheral venous amino acid concentrations in subjects with TBI were compared with concentrations in healthy controls both at rest and for 1 hour after intake of 7g of EAA. SETTING Postacute brain injury rehabilitation center. PARTICIPANTS Six men with TBI (age +/- standard deviation, 27+/-6y; months postinjury, 17+/-4) and 6 healthy men (age, 43+/-7y). INTERVENTION Intake of a drink consisting of 7g of EAA. MAIN OUTCOME MEASURES Individual and total plasma amino acid concentrations. RESULTS Total amino acid concentration was about 12% lower in TBI versus controls (P=.022). Valine was reduced by 33% in the TBI group versus controls (P=.003), whereas the other EAA did not differ between groups. After intake of the EAA drink, plasma non-EAA increased to a significantly higher level in controls versus TBI subjects (P=.017). CONCLUSIONS Plasma total amino acid concentration is still reduced 17 months postinjury in patients with TBI versus healthy controls, mainly because of a lower valine level. This may be of importance for both brain and muscle metabolic functions, and warrant further study. Further, ingested EAA are apparently not as readily converted to non-EAA in TBI patients as in healthy controls, suggesting that in recovery from TBI, certain non-EAA may become provisionally essential.
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Affiliation(s)
- Elisabet Børsheim
- Department of Surgery, Metabolism Unit, Shriners Hospital for Children/UTMB, Galveston, TX 77550, USA.
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Krakau K, Omne-Pontén M, Karlsson T, Borg J. Metabolism and nutrition in patients with moderate and severe traumatic brain injury: A systematic review. Brain Inj 2006; 20:345-67. [PMID: 16716982 DOI: 10.1080/02699050500487571] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PRIMARY OBJECTIVE To examine the evidence on the metabolic state and nutritional treatment of patients with moderate-to-severe traumatic brain injury (TBI). RESEARCH DESIGN A systematic review of the literature. METHODS AND PROCEDURES From 1547 citations, 232 articles were identified and retrieved for text screening. Thirty-six studies fulfilled the criteria and 30 were accepted for data extraction. MAIN OUTCOMES AND RESULTS Variations in measurement methods and definitions of metabolic abnormalities hampered comparison of studies. However, consistent data demonstrated increased metabolic rate (96-160% of the predicted values), of hypercatabolism (-3 to -16 g N per day) and of upper gastrointestinal intolerance in the majority of the patients during the first 2 weeks after injury. Data also indicated a tendency towards less morbidity and mortality in early fed patients. CONCLUSIONS The impact of timing, content and ways of administration of nutritional support on neurological outcome after TBI remains to be demonstrated.
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Affiliation(s)
- Karolina Krakau
- Centre for Clinical Research Dalarna, Dummy institution, Sweden.
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Aquilani R, Iadarola P, Contardi A, Boselli M, Verri M, Pastoris O, Boschi F, Arcidiaco P, Viglio S. Branched-chain amino acids enhance the cognitive recovery of patients with severe traumatic brain injury. Arch Phys Med Rehabil 2005; 86:1729-35. [PMID: 16181934 DOI: 10.1016/j.apmr.2005.03.022] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate whether supplementation with branched-chain amino acids (BCAAs) in patients with severe traumatic brain injury (TBI) improves recovery of cognition and influences plasma concentrations of tyrosine and tryptophan, which are precursors of, respectively, catecholamine and serotonin neurotransmitters in the brain. DESIGN Forty patients with TBI were randomly assigned to 15 days of intravenous BCAA supplementation (19.6g/d) (n=20) or an isonitrogenous placebo (n=20). SETTING Tertiary care rehabilitation setting in Italy. PARTICIPANTS Forty men (mean age, 32+/-15 y) with TBI and 20 healthy subjects (controls) matched for age, sex, and sedentary lifestyle. INTERVENTION Supplementation with BCAAs. MAIN OUTCOME MEASURES Disability Rating Scale (DRS) and plasma concentrations of BCAAs, tyrosine, and tryptophan. RESULTS Fifteen days after admission to the rehabilitation department, the DRS score had improved significantly in both the placebo group (P<.05 vs baseline) and in the BCAA-supplemented group (P<.01 vs baseline). The difference between the 2 groups was significant (P<.004). Plasma tyrosine concentration improved in the group given BCAA supplementation, and tryptophan concentration increased in patients receiving placebo. CONCLUSIONS Supplemental BCAAs enhance the retrieval of DRS without causing negative effects on tyrosine and tryptophan concentration.
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Affiliation(s)
- Roberto Aquilani
- Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica
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Aquilani R, Iadarola P, Boschi F, Pistarini C, Arcidiaco P, Contardi A. Reduced plasma levels of tyrosine, precursor of brain catecholamines, and of essential amino acids in patients with severe traumatic brain injury after rehabilitation11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated. Arch Phys Med Rehabil 2003; 84:1258-65. [PMID: 13680559 DOI: 10.1016/s0003-9993(03)00148-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To investigate whether levels of plasma tyrosine and tryptophan, precursors of brain catecholamine and serotonin neurotransmitters, respectively, and other essential amino acids (EAA) may return to normal in patients with severe traumatic brain injury (TBI) after 2 months in a hospital rehabilitation center. DESIGN Peripheral plasma concentrations of tyrosine, tryptophan, and other EAAs in subjects with severe TBI, both at admission (44+/-11d postinjury) and at discharge from the center (110+/-15d after acute event) were compared with concentrations in control subjects. SETTING Tertiary care rehabilitation setting in Italy. PARTICIPANTS Ten men (26.6+/-12.6y) with TBI and 6 healthy subjects (controls) matched for age, sex, voluntary loss of body weight, and sedentary lifestyle. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Concentrations of brain neurotransmitter precursor amino acids and of EAA. RESULTS On admission, patients had lower plasma tyrosine, leucine, valine, methionine, and phenylalanine concentrations than did control subjects. The plasma concentrations of tryptophan were similar in the 2 groups. These amino acid abnormalities were still present at discharge. CONCLUSION The levels of plasma tyrosine and many EAA in patients with TBI did not recover by discharge (110+/-15d) from rehabilitation. Plasma tryptophan concentrations were similar in patients and controls.
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Affiliation(s)
- Roberto Aquilani
- Servizio di Fisiopatologia Metabolico-Nutrizionale e Nutrizione Clinica, Fondazione S. Maugeri, Istituto Scientifico di Montescano, Pavia, Italy
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