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Churuangsuk C, Catchpole A, Talwar D, Welsh P, Sattar N, Lean MEJ, Combet E. Low thiamine status in adults following low-carbohydrate / ketogenic diets: a cross-sectional comparative study of micronutrient intake and status. Eur J Nutr 2024:10.1007/s00394-024-03459-y. [PMID: 38967675 DOI: 10.1007/s00394-024-03459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 06/22/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Low-carbohydrate diets (LCD) are popular for weight loss but lack evidence about micronutrient sufficiency in real-life use. This study assessed the intake and biochemical status of selected micronutrients in people voluntarily following LCDs. METHODS A cross-sectional study was conducted (2018-20) among 98 adults recruited as self-reporting either LCD (n = 49) or diets not restricting carbohydrates (controls; n = 49). Diets were assessed using the 130-item EPIC-Norfolk food-frequency questionnaire. Red-blood-cell thiamine diphosphate (TDP) was measured for thiamine status using HPLC. Plasma magnesium, zinc, copper, and selenium were measured using inductively coupled plasma mass spectrometry. Between-group biomarker comparisons were conducted using ANCOVA and adjusted for age, sex, body mass index (BMI), and diabetes status. RESULTS LCD-followers (26% male, median age 36 years, median BMI 24.2 kg/m2) reported adhering to LCDs for a median duration of 9 months (IQR 4-36). The most followed LCD type was 'their own variations of LCD' (30%), followed by ketogenic (23%), 'palaeolithic' (15%), and Atkins diets (8%). Among controls, 41% were male (median age 27 years, median BMI 23 kg/m2). Median macronutrient intakes for LCD vs control groups were carbohydrate 16%Energy (E) vs. 50%E; protein 25%E vs. 19%E; and fat 55%E vs 34%E (saturated fat 18%E vs. 11%E). Two-thirds of LCD followers (32/49) and half of the controls (24/49) reported some use of dietary supplements (p = 0.19). Among LCD-followers, assessing from food data only, 21 (43%) failed to meet the reference nutrient intake (RNI) for thiamine (vs.14% controls, p = 0.002). When thiamine from supplementation (single- or multivitamin) was included, there appeared to be no difference in thiamine intake between groups. Still, red-blood-cell TDP was lower in LCD-followers than controls (407 ± 91 vs. 633 ± 234 ng/gHb, p < 0.001). Three LCD-followers were thiamine-deficient (RBC thiamine < 275 ng/gHb) vs. one control. There were no significant differences in dietary intakes or plasma concentrations of magnesium, zinc, copper, and selenium between groups. CONCLUSIONS Following LCDs is associated with lower thiamine intake and TDP status than diets without carbohydrate restriction, incompletely corrected by supplement use. These data, coupled with a lack of RCT evidence on body weight control, do not support recommending LCDs for weight management without appropriate guidance and diet supplementation.
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Affiliation(s)
- Chaitong Churuangsuk
- Human Nutrition, School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.22, Level 2, New Lister Building 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
- Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Anthony Catchpole
- Scottish Trace Element and Micronutrient Diagnostic and Research Laboratory, Glasgow Royal Infirmary, Glasgow, UK
| | - Dinesh Talwar
- Scottish Trace Element and Micronutrient Diagnostic and Research Laboratory, Glasgow Royal Infirmary, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK
| | - Michael E J Lean
- Human Nutrition, School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.22, Level 2, New Lister Building 10-16 Alexandra Parade, Glasgow, G31 2ER, UK
| | - Emilie Combet
- Human Nutrition, School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow Royal Infirmary, Room 2.22, Level 2, New Lister Building 10-16 Alexandra Parade, Glasgow, G31 2ER, UK.
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Artiukhov AV, Solovjeva ON, Balashova NV, Sidorova OP, Graf AV, Bunik VI. Pharmacological Doses of Thiamine Benefit Patients with the Charcot-Marie-Tooth Neuropathy by Changing Thiamine Diphosphate Levels and Affecting Regulation of Thiamine-Dependent Enzymes. BIOCHEMISTRY. BIOKHIMIIA 2024; 89:1161-1182. [PMID: 39218016 DOI: 10.1134/s0006297924070010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 09/04/2024]
Abstract
Charcot-Marie-Tooth (CMT) neuropathy is a polygenic disorder of peripheral nerves with no effective cure. Thiamine (vitamin B1) is a neurotropic compound that improves neuropathies. Our pilot study characterizes therapeutic potential of daily oral administration of thiamine (100 mg) in CMT neuropathy and its molecular mechanisms. The patient hand grip strength was determined before and after thiamine administration along with the blood levels of the thiamine coenzyme form (thiamine diphosphate, ThDP), activities of endogenous holo-transketolase (without ThDP in the assay medium) and total transketolase (with ThDP in the assay medium), and transketolase activation by ThDP [1 - (holo-transketolase/total transketolase),%], corresponding to the fraction of ThDP-free apo-transketolase. Single cases of administration of sulbutiamine (200 mg) or benfotiamine (150 mg) reveal their effects on the assayed parameters within those of thiamine. Administration of thiamine or its pharmacological forms increased the hand grip strength in the CMT patients. Comparison of the thiamin status in patients with different forms of CMT disease to that of control subjects without diagnosed pathologies revealed no significant differences in the average levels of ThDP, holo-transketolase, or relative content of holo and apo forms of transketolase. However, the regulation of transketolase by thiamine/ThDP differed in the control and CMT groups: in the assay, ThDP activated transketolase from the control individuals, but not from CMT patients. Thiamine administration paradoxically decreased endogenous holo-transketolase in CMT patients; this effect was not observed in the control group. Correlation analysis revealed sex-specific differences in the relationship between the parameters of thiamine status in both the control subjects and patients with the CMT disease. Thus, our findings link physiological benefits of thiamine administration in CMT patients to changes in their thiamine status, in particular, the blood levels of ThDP and transketolase regulation.
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Affiliation(s)
- Artem V Artiukhov
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
- Department of Biochemistry, Sechenov University, Moscow, 119991, Russia
| | - Olga N Solovjeva
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - Natalia V Balashova
- Faculty of Advanced Medicine, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, 129110, Russia
- Faculty of Continuing Medical Education, RUDN Medical Institute, Moscow, 117198, Russia
| | - Olga P Sidorova
- Department of Neurology, Vladimirsky Moscow Regional Research and Clinical Institute, Moscow, 129110, Russia
| | - Anastasia V Graf
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
- Faculty of Biology, Lomonosov Moscow State University, Moscow, 119234, Russia
| | - Victoria I Bunik
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, 119234, Russia.
- Department of Biochemistry, Sechenov University, Moscow, 119991, Russia
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, 119234, Russia
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Lamba M, Singh PR, Bandyopadhyay A, Goswami A. Synthetic 18F labeled biomolecules that are selective and promising for PET imaging: major advances and applications. RSC Med Chem 2024; 15:1899-1920. [PMID: 38911154 PMCID: PMC11187557 DOI: 10.1039/d4md00033a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/14/2024] [Indexed: 06/25/2024] Open
Abstract
The concept of positron emission tomography (PET) based imaging was developed more than 40 years ago. It has been a widely adopted technique for detecting and staging numerous diseases in clinical settings, particularly cancer, neuro- and cardio-diseases. Here, we reviewed the evolution of PET and its advantages over other imaging modalities in clinical settings. Primarily, this review discusses recent advances in the synthesis of 18F radiolabeled biomolecules in light of the widely accepted performance for effective PET. The discussion particularly emphasizes the 18F-labeling chemistry of carbohydrates, lipids, amino acids, oligonucleotides, peptides, and protein molecules, which have shown promise for PET imaging in recent decades. In addition, we have deliberated on how 18F-labeled biomolecules enable the detection of metabolic changes at the cellular level and the selective imaging of gross anatomical localization via PET imaging. In the end, the review discusses the future perspective of PET imaging to control disease in clinical settings. We firmly believe that collaborative multidisciplinary research will further widen the comprehensive applications of PET approaches in the clinical management of cancer and other pathological outcomes.
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Affiliation(s)
- Manisha Lamba
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Prasoon Raj Singh
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Anupam Bandyopadhyay
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Avijit Goswami
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
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Hess SY, Smith TJ, Arnold CD, Jones KS, Hampel D, Hiffler L, Trehan I, Fischer PR, Meadows SR, Parkington DA, Brown KH, Sitthideth D, Tan X, Koulman A, Allen LH, Kounnavong S. Assessment of Erythrocyte Transketolase, Whole Blood Thiamine Diphosphate, and Human Milk Thiamine Concentrations to Identify Infants and Young Children Responding Favorably to Therapeutic Thiamine Administration: Findings from the Lao Thiamine Study, a Prospective Cohort Study. Curr Dev Nutr 2024; 8:103786. [PMID: 38974350 PMCID: PMC11225667 DOI: 10.1016/j.cdnut.2024.103786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/16/2024] [Accepted: 05/18/2024] [Indexed: 07/09/2024] Open
Abstract
Background There is limited information on relationships among biomarkers of thiamine status (whole blood thiamine diphosphate [ThDP], erythrocyte transketolase activity coefficient [ETKac], and human milk thiamine [MTh]) and clinical manifestations of thiamine deficiency. Objectives This study aimed to explore correlations among these biomarkers and thiamine responsive disorders (TRDs), a diagnosis based on favorable clinical response to thiamine. Methods Hospitalized infants and young children (aged 21 d to <18 mo) with respiratory, cardiac, and/or neurological symptoms suggestive of thiamine deficiency were treated with parenteral thiamine (100 mg daily) for ≥3 d alongside other treatments and re-examined systematically. Clinical case reports were reviewed by 3 pediatricians, who determined TRD or non-TRD status. Children in a community comparison group were matched by age, sex, and residence. Venous whole blood ThDP and MTh were determined by high-performance liquid chromatography fluorescence detection and ETKac in washed erythrocytes by ultraviolet spectrophotometry. Associations between biomarkers were assessed using Spearman correlations, and biomarker cutoffs predictive of TRD and ETKac >1.25 were explored using area under the receiver operating characteristic curve framework. Results Thiamine biomarkers were available for 287 hospitalized children and 228 community children (mean age 4.7 mo; 59.4% male). Median (interquartile range [IQR]) ThDP and ETKac were 66.9 nmol/L (IQR: 41.4, 96.9 nmol/L) and 1.25 nmol/L (IQR: 1.11, 1.48 nmol/L), respectively, among hospitalized children, and 64.1 nmol/L (IQR: 50.0, 85.3 nmol/L) and 1.22 nmol/L (IQR: 1.12, 1.37 nmol/L) among 228 community children (P > 0.05 for both). Forty-five percent of breastfeeding mothers of infants <6 mo had MTh <90 μg/L. ThDP and ETKac, but not MTh, were significantly different between 152 children with TRD and 122 without TRD, but overlapping distributions undermined prediction of individual responses to thiamine. Conclusions Although ETKac, ThDP, and MTh are useful biomarkers of population thiamine status, none of the biomarkers reliably identified individual children with TRD. ThDP is more practical for population assessment because preparing washed erythrocytes is not required.This trial was registered at clinicaltrials.gov as NCT03626337.
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Affiliation(s)
- Sonja Y Hess
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Taryn J Smith
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Charles D Arnold
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Kerry S Jones
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Daniela Hampel
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
- USDA-Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, United States
| | | | - Indi Trehan
- Departments of Pediatrics, Global Health and Epidemiology, University of Washington, Seattle, WA, United States
- Lao Friends Hospital for Children, Luang Prabang, Lao People’s Democratic Republic
| | - Philip R Fischer
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | - Sarah R Meadows
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Damon A Parkington
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kenneth H Brown
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Dalaphone Sitthideth
- Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | - Xiuping Tan
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
| | - Albert Koulman
- Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Lindsay H Allen
- Institute for Global Nutrition and Department of Nutrition, University of California Davis, Davis, CA, United States
- USDA-Agricultural Research Service Western Human Nutrition Research Center, Davis, CA, United States
| | - Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
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Legen T, Mayer G. Modular Approach for Rapid Identification of RNA-Based Sensors. ACS Sens 2024; 9:753-758. [PMID: 38253513 DOI: 10.1021/acssensors.3c02060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Detection of metabolites in real time and in whole cells requires effective molecular sensors. In this regard, fluorogenic light-up RNAs have recently become important tools for small-molecule detection in cells. However, the construction of light-up RNA sensors is an arduous task that requires structural knowledge of both the sensor and reporter RNA. De novo strategies for selecting sensors from RNA libraries are limited and are mostly restricted to known aptamers and riboswitches. Here, we provide a solution to this problem by developing a capture-SELEX variant that allows the obtained libraries and aptamers to be linked to fluorogenic RNAs in a modular and allosteric manner. The approach is generally applicable and allows for rapid modular allosteric assembly with green- or red-shifted fluorogenic RNAs.
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Affiliation(s)
- Tjasa Legen
- Life and Medical Sciences, University of Bonn, 53121 Bonn, Germany
- Center of Aptamer Research and Development, University of Bonn, 53121 Bonn, Germany
| | - Günter Mayer
- Life and Medical Sciences, University of Bonn, 53121 Bonn, Germany
- Center of Aptamer Research and Development, University of Bonn, 53121 Bonn, Germany
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Berlin N, Pfaff A, Rozanski EA, Chalifoux NV, Hess RS, Donnino MW, Silverstein DC. Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography. J Vet Emerg Crit Care (San Antonio) 2024; 34:49-56. [PMID: 37987121 PMCID: PMC11007751 DOI: 10.1111/vec.13341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/11/2022] [Accepted: 07/29/2022] [Indexed: 11/22/2023]
Abstract
OBJECTIVE To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING Two veterinary university teaching hospitals. ANIMALS A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion. INTERVENTIONS For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS The RI for whole-blood TPP in healthy dogs was 70.9-135.3 μg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes. CONCLUSIONS TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.
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Affiliation(s)
- Noa Berlin
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
- Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alexandra Pfaff
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Elizabeth A Rozanski
- Foster Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Nolan V Chalifoux
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecka S Hess
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W Donnino
- Center for Resuscitation Science, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Deborah C Silverstein
- Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Strandler HS, Strand TA. Thiamin (Vitamin B 1) - A scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2023; 67:10290. [PMID: 38084159 PMCID: PMC10710862 DOI: 10.29219/fnr.v67.10290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 07/15/2022] [Accepted: 10/10/2023] [Indexed: 08/04/2024] Open
Abstract
Only a few studies have explored relationships between thiamine intake and function, and a few studies have examined the effects of supplements on various clinical or biochemical outcomes. None of these studies, however, makes a useful contribution to understanding requirements in healthy populations. The requirement of thiamine relates to energy and carbohydrate intake. Clinical signs of deficiency have been observed at intakes below 0.5 mg/day, which corresponds to 0.05 mg/MJ. In other studies, thiamine excretion in the urine and normalisation of enzyme activity were normalised at intakes of 0.07-0.08 mg/MJ. The lower limit of intake thus estimates at 0.05 mg/MJ. It has not been possible to set a safe upper intake level for thiamine due to a lack of data. Studies on pregnant and lactating women indicate a higher requirement as assessed by biochemical parameters. A few studies indicate that thiamine utilisation is impaired among elderly subjects.
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Affiliation(s)
| | - Tor A. Strand
- Department of Global Public Health and Primary Care, Sykehuset Innlandet HF, University of Bergen, Bergen, Norway
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Uchida N, Ishida M, Yoshioka A, Takahashi T, Furuya D, Ebihara Y, Ito H, Yanagi A, Onishi H, Sato I. Investigation of Whole Blood Thiamine Concentration in Independently Ambulatory Residents of a Provincial Town in Japan: A Cross-Sectional Study. Cureus 2023; 15:e38800. [PMID: 37303326 PMCID: PMC10250136 DOI: 10.7759/cureus.38800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/13/2023] Open
Abstract
Background Thiamine deficiency (TD) is an important public health problem in nutrition, occurring in 2-6% of the population in Europe and the US, whereas thiamine levels are reported to be significantly reduced by 36.6-40% in some populations of East Asia. However, there is little information available at present, regarding factors such as age, despite the continued aging of society. Further, studies such as those mentioned above have not yet been undertaken in Japan, the country in which population aging is most advanced. Objective To investigate TD in the Japanese community-dwelling individuals who are independently ambulatory. Methods We undertook an examination of TD in blood samples obtained from 270 citizens in a provincial town, aged 25-97 years, who were able to walk to the venue and provide informed consent for inclusion in this research and of whom 8.9% had a history of cancer. We summarized the demographic characteristics of the subjects. The whole-blood thiamine concentrations were measured using the high-performance liquid chromatography method. A value of 21.3 ng/ml or less was taken as low and a borderline value was set as less than 28 ng/ml. Results The mean (±SD) whole blood thiamine concentration was 47.6 ± 8.7 ng/ml. No TD was observed to exist participating in this study, with no subjects even showing show borderline values. Further, there was no significant difference in thiamine level between those aged 65 or older and those aged less than 65. Conclusions No cases of TD were observed among the subjects in this study, nor was the concentration of thiamine found to be related to age. It is possible that the frequency of TD might be very low in citizens who have a certain level of activity. In the future, it is necessary to expand the prevalence of TD to a wider range of subjects.
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Affiliation(s)
- Nozomu Uchida
- Department of General Medicine, Ogano Town Central Hospital, Ogano, JPN
- Department of Psycho-oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Mayumi Ishida
- Department of Psycho-oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Akira Yoshioka
- Department of Clinical Oncology, Mitsubishi Kyoto Hospital, Kyoto, JPN
| | - Takao Takahashi
- Department of Supportive Medicine, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Daisuke Furuya
- Department of General Medicine, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Yasuhiro Ebihara
- Department of Laboratory Medicine, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Hiroshi Ito
- Department of General Medicine, Ito Internal Medicine and Pediatric Clinic, Fukuoka, JPN
| | - Akiko Yanagi
- Department of Nursing, Maruyama Memorial General Hospital, Iwatsuki, JPN
| | - Hideki Onishi
- Department of Psycho-oncology, Saitama Medical University International Medical Center, Hidaka, JPN
| | - Izumi Sato
- Department of Clinical Epidemiology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
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McGovern J, Wadsworth J, Catchpole A, Richards C, McMillan DC, Kelliher T, Goodall E, Murray E, Melaugh T, McPhillips S, Brice K, Barbour K, Robinson S, Moffitt P, Kemp O, Talwar D, Maguire D. The relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted to hospital with COVID-19. J Transl Med 2023; 21:284. [PMID: 37118813 PMCID: PMC10139911 DOI: 10.1186/s12967-023-04138-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Micronutrients have been associated with disease severity and poorer clinical outcomes in patients with COVID-19. However, there is a paucity of studies examining if the relationship with micronutrient status and clinical outcomes is independent of recognised prognostic factors, specifically frailty and the systemic inflammatory response (SIR). The aim of the present study was to examine the relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted with COVID-19. METHODS Retrospective analysis of prospectively collected data was performed on patients with confirmed COVID-19, admitted to hospital between the 1st April 2020-6th July 2020. Clinicopathological characteristics, frailty assessment, biochemical and micronutrient laboratory results were recorded. Frailty status was determined using the Clinical Frailty scale. SIR was determined using serum CRP. Clinical outcomes of interest were oxygen requirement, ITU admission and 30-day mortality. Categorical variables were analysed using chi-square test and binary logistics regression analysis. Continuous variables were analysed using the Mann-Whitney U or Kruskal Wallis tests. RESULTS 281 patients were included. 55% (n = 155) were aged ≥ 70 years and 39% (n = 109) were male. 49% (n = 138) of patients were frail (CFS > 3). 86% (n = 242) of patients had a serum CRP > 10 mg/L. On univariate analysis, frailty was significantly associated with thirty-day mortality (p < 0.001). On univariate analysis, serum CRP was found to be significantly associated with an oxygen requirement on admission in non-frail patients (p = 0.004). Over a third (36%) of non-frail patients had a low vitamin B1, despite having normal reference range values of red cell B2, B6 and selenium. Furthermore, serum CRP was found to be significantly associated with a lower median red cell vitamin B1 (p = 0.029). CONCLUSION Vitamin B1 stores may be depleted in COVID-19 patients experiencing a significant SIR and providing rationale for thiamine supplementation. Further longitudinal studies are warranted to delineate the trend in thiamine status following COVID-19.
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Affiliation(s)
- Josh McGovern
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK.
| | - John Wadsworth
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Anthony Catchpole
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Conor Richards
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Tadhg Kelliher
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Emma Goodall
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Ellie Murray
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Terry Melaugh
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | | | - Kathryn Brice
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Katie Barbour
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Sophie Robinson
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Peter Moffitt
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Olivia Kemp
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Dinesh Talwar
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Donogh Maguire
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
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10
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Lin CYR, Kuo SH. Ataxias: Hereditary, Acquired, and Reversible Etiologies. Semin Neurol 2023; 43:48-64. [PMID: 36828010 DOI: 10.1055/s-0043-1763511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A variety of etiologies can cause cerebellar dysfunction, leading to ataxia symptoms. Therefore, the accurate diagnosis of the cause for cerebellar ataxia can be challenging. A step-wise investigation will reveal underlying causes, including nutritional, toxin, immune-mediated, genetic, and degenerative disorders. Recent advances in genetics have identified new genes for both autosomal dominant and autosomal recessive ataxias, and new therapies are on the horizon for targeting specific biological pathways. New diagnostic criteria for degenerative ataxias have been proposed, specifically for multiple system atrophy, which will have a broad impact on the future clinical research in ataxia. In this article, we aim to provide a review focus on symptoms, laboratory testing, neuroimaging, and genetic testing for the diagnosis of cerebellar ataxia causes, with a special emphasis on recent advances. Strategies for the management of cerebellar ataxia is also discussed.
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Affiliation(s)
- Chi-Ying R Lin
- Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas.,Department of Neurology, Alzheimer's Disease and Memory Disorders Center, Baylor College of Medicine, Houston, Texas
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York.,Initiative for Columbia Ataxia and Tremor, Columbia University Irving Medical Center, New York, New York
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11
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Abdelaziz TA, Atfy M, Elalawi SM, Baz EG. Thiamine status during treatment of diabetic ketoacidosis in children - tertiary care centre experience. J Pediatr Endocrinol Metab 2023; 36:179-184. [PMID: 36440592 DOI: 10.1515/jpem-2022-0387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES There is a lack of information regarding thiamine status in children with diabetic ketoacidosis (DKA). This study was designed to assess the thiamine status upon admission and 24 h after treatment initiation of DKA, whether newly diagnosed children or with established T1DM diagnosis, who presented with DKA. METHODS We enrolled 90 children (mean age, 9.8 ± 2.6 years; 58 females and 32 males) with type 1 diabetes mellitus (T1DM), whether newly diagnosed or with an established T1DM diagnosis (from 1 to 5.2 years ago), who presented with DKA. We observed the initial Glasgow Coma Scale (GCS) and recovery time. The whole blood thiamine diphosphate levels were measured upon admission (baseline point) and 24 h after initiation of the DKA treatment (second-time point). RESULTS The mean blood thiamine levels at the second-time point (90.11 ± 15.76 nmol/L) significantly decreased compared with their levels at baseline (108.8 ± 17.6 nmol/L) (p<0.001). We compared thiamine levels with the initial GCS, patient's age, and recovery time. Thiamine levels at the second-time point were positively correlated with baseline thiamine levels (r=0.86, p=0.0001) and the initial GCS (r=0.68, p=0.001) but were negatively correlated with patient's age (r=-0.61, p=0.001) and recovery time (r=-0.724, p=0.001). Based on multiple regression analysis, thiamine levels at the second-time point were directly related to the initial GCS and inversely related to the patient's age. CONCLUSIONS The current study indicates that blood thiamine diphosphate levels significantly decreased after 24 h of DKA treatment initiation compared to pre-treatment levels. After 24 h of treatment initiation, blood thiamine levels are directly related to the initial GCS and inversely related to the patient's age.
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Affiliation(s)
- Tarek A Abdelaziz
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mervat Atfy
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Saffaa M Elalawi
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Gamal Baz
- Pediatric Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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12
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Berger MM, Talwar D, Shenkin A. Pitfalls in the interpretation of blood tests used to assess and monitor micronutrient nutrition status. Nutr Clin Pract 2023; 38:56-69. [PMID: 36335431 DOI: 10.1002/ncp.10924] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/17/2022] [Accepted: 10/02/2022] [Indexed: 11/09/2022] Open
Abstract
Assessment of micronutrient (MN) status is of particular importance in patients who require medical nutrition therapy, especially those requiring parenteral nutrition. Blood testing is generally the only tool available in clinical settings to assess MN status. However, using plasma or serum concentration faces pitfalls mainly because of the impact of inflammation that diverts the MNs from the circulating compartment. This review aims to review the blood tests that are useful and provide information about how to integrate functional markers of status to reach a clinically relevant diagnosis. Most impacted, with a significant and proportional decrease in plasma concentrations, are iron, selenium, zinc, thiamin, folic acid, cobalamin, and vitamins A, C, and D; copper is the only MN for which the plasma concentration increases. Therefore, a surrogate marker of inflammation, C-reactive protein, must always be determined simultaneously. Validated intracellular and functional tests are proposed to improve status assessment. A protocol is suggested for tests required both on commencing and during nutrition support. A timely turnaround of analysis is essential for results to be clinically useful. In some cases, the appropriate provision of MNs should be commenced before results have been obtained to confirm the clinical assessment. Laboratory tests of MN status are an area prone to misuse and misinterpretation. The appropriate use and interpretation of such tests are essential to ensure the correct management of nutrition problems.
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Affiliation(s)
- Mette M Berger
- Department of Adult Intensive Care, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Dinesh Talwar
- Scottish Trace Element and Micronutrient Diagnostic and Research Laboratory, Department of Clinical Biochemistry, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, United Kingdom
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13
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Kareem O, Nisar S, Tanvir M, Muzaffer U, Bader GN. Thiamine deficiency in pregnancy and lactation: implications and present perspectives. Front Nutr 2023; 10:1080611. [PMID: 37153911 PMCID: PMC10158844 DOI: 10.3389/fnut.2023.1080611] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/03/2023] [Indexed: 05/10/2023] Open
Abstract
During pregnancy, many physiologic changes occur in order to accommodate fetal growth. These changes require an increase in many of the nutritional needs to prevent long-term consequences for both mother and the offspring. One of the main vitamins that are needed throughout the pregnancy is thiamine (vitamin B1) which is a water-soluble vitamin that plays an important role in many metabolic and physiologic processes in the human body. Thiamine deficiency during pregnancy can cause can have many cardiac, neurologic, and psychological effects on the mother. It can also dispose the fetus to gastrointestinal, pulmonological, cardiac, and neurologic conditions. This paper reviews the recently published literature about thiamine and its physiologic roles, thiamine deficiency in pregnancy, its prevalence, its impact on infants and subsequent consequences in them. This review also highlights the knowledge gaps within these topics.
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Affiliation(s)
- Ozaifa Kareem
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, India
- *Correspondence: Ozaifa Kareem, ,
| | - Sobia Nisar
- Department of Medicine, Government Medical College, Srinagar, India
| | - Masood Tanvir
- Department of Medicine, Government Medical College, Srinagar, India
| | - Umar Muzaffer
- Department of Medicine, Government Medical College, Srinagar, India
| | - G. N. Bader
- Department of Pharmaceutical Sciences, University of Kashmir, Srinagar, India
- G. N. Bader,
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14
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Lane SL, Dowgos NM, Brainard BM. Evaluation of blood thiamine concentration in hospitalized dogs with and without critical illness. J Vet Emerg Crit Care (San Antonio) 2022; 32:723-732. [PMID: 36082426 DOI: 10.1111/vec.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate blood thiamine concentration in healthy and critically ill hospitalized dogs over 72 hours of hospitalization and to identify any association of thiamine concentration with patient morbidity and mortality. DESIGN Prospective, observational, clinical study. SETTING University veterinary teaching hospital. ANIMALS Thirty-one hospitalized healthy dogs and 37 dogs with critical illness. Dogs with critical illness had nonseptic (n = 24) or septic (n = 13) etiologies. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Whole blood EDTA samples were collected within 24 hours of admission and 72 hours later. Samples were stored at -80°C and batch analyzed. Total thiamine (tB1) and thiamine diphosphate (TDP) concentrations were measured using high-performance liquid chromatography, and free thiamine concentration was determined using liquid chromatography with tandem mass spectrometry. Collected patient data included CBC, biochemistry profile, plasma lactate concentration, shock index, Acute Patient Physiologic and Laboratory Evaluation Score (APPLEfast ) score, comorbid conditions, and patient outcome. Approximately 92% of tB1 present in whole blood is measured as TDP. TDP concentration was strongly correlated with tB1 (R = 0.97, P < 0.0001). Thiamine concentration, represented by TDP, was not different at admission or at 72 hours in all dogs. TDP concentration was lower in septic dogs requiring surgery at admission (P = 0.044) and 72 hours later (P = 0.008), compared to dogs not requiring surgery. TDP concentration was not different between dogs with and without stable chronic diseases at any time point. Older dogs had lower TDP concentration. Positive correlations were seen between TDP and body weight, APPLEfast score, and WBC count. Critically ill dogs with lower admission plasma lactate concentration were more likely to have an increase in thiamine over time (P = 0.0142). CONCLUSIONS Differences in thiamine concentration were not identified in hospitalized healthy or critically ill dogs. Further investigation into the clinical relevance of thiamine deficiency is indicated in septic dogs undergoing surgery.
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Affiliation(s)
- Selena L Lane
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Nicole M Dowgos
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
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15
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Kahoun D, Fojtíková P, Vácha F, Čížková M, Vodička R, Nováková E, Hypša V. Development and validation of an LC-MS/MS method for determination of B vitamins and some its derivatives in whole blood. PLoS One 2022; 17:e0271444. [PMID: 35834588 PMCID: PMC9282541 DOI: 10.1371/journal.pone.0271444] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Obligate symbiotic bacteria associated with the insects feeding exclusively on vertebrate blood are supposed to complement B vitamins presumably lacking in their diet. Recent genomic analyses revealed considerable differences in biosynthetic capacities across different symbionts, suggesting that levels of B vitamins may vary across different vertebrate hosts. However, a rigorous determination of B vitamins content in blood of various vertebrates has not yet been approached. A reliable analytical method focused on B vitamin complex in blood can provide valuable informative background and understanding of general principles of insect symbiosis. In this work, a chromatographic separation of eight B vitamins (thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, folic acid, and cyanocobalamine), four B vitamin derivatives (niacinamide, pyridoxal-5-phosphate, 4-pyridoxic acid, and tetrahydrofolic acid), and 3 stable isotope labelled internal standards was developed. Detection was carried out using dual-pressure linear ion trap mass spectrometer in FullScan MS/MS and SIM mode. Except for vitamin B9 (tetrahydrofolic acid), the instrument quantitation limits of all analytes were ranging from 0.42 to 5.0 μg/L, correlation coefficients from 0.9997 to 1.0000, and QC coefficients from 0.53 to 3.2%. Optimization of whole blood sample preparation step was focused especially on evaluation of two types of protein-precipitation agents: trichloroacetic acid and zinc sulphate in methanol. The best results were obtained for zinc sulphate in methanol, but only nine analytes were successfully validated. Accuracy of the procedure using this protein-precipitating agent was ranging from 89 to 120%, precision from 0.5 to 13%, and process efficiency from 65 to 108%. The content of B vitamins in whole blood samples from human and various vertebrates is presented as an application example of this newly developed method.
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Affiliation(s)
- David Kahoun
- Department of Chemistry, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
- * E-mail:
| | - Pavla Fojtíková
- Department of Chemistry, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
| | - František Vácha
- Department of Chemistry, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
| | - Marie Čížková
- Department of Chemistry, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
| | | | - Eva Nováková
- Department of Parasitology, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
| | - Václav Hypša
- Department of Parasitology, Faculty of Science, University of South Bohemia in České Budějovice, České Budějovice, Czech Republic
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16
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Maguire D, Burns A, Talwar D, Catchpole A, Stefanowicz F, Ross DP, Galloway P, Ireland A, Robson G, Adamson M, Orr L, Kerr JL, Roussis X, Colgan E, Forrest E, Young D, McMillan DC. Randomised trial of intravenous thiamine and/or magnesium sulphate administration on erythrocyte transketolase activity, lactate concentrations and alcohol withdrawal scores. Sci Rep 2022; 12:6941. [PMID: 35484175 PMCID: PMC9051209 DOI: 10.1038/s41598-022-10970-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/08/2022] [Indexed: 02/06/2023] Open
Abstract
Alcohol withdrawal syndrome (AWS) occurs in 2% of patients admitted to U.K. hospitals. Routine treatment includes thiamine and benzodiazepines. Laboratory studies indicate that thiamine requires magnesium for optimal activity, however this has not translated into clinical practice. Patients experiencing AWS were randomized to three groups: (group 1) thiamine, (group 2) thiamine plus MgSO4 or (group 3) MgSO4. Pre- and 2-h post-treatment blood samples were taken. AWS severity was recorded using the Glasgow Modified Alcohol Withdrawal Score (GMAWS). The primary outcome measure was 15% change in erythrocyte transketolase activity (ETKA) in group 3. Secondary outcome measures were change in plasma lactate concentrations and time to GMAWS = 0. 127 patients were recruited, 115 patients were included in the intention-to-treat analysis. Pre-treatment, the majority of patients had normal or high erythrocyte thiamine diphosphate (TDP) concentrations (≥ 275–675/> 675 ng/gHb respectively) (99%), low serum magnesium concentrations (< 0.75 mmol/L) (59%), and high plasma lactate concentrations (> 2 mmol/L) (67%). Basal ETKA did not change significantly in groups 1, 2 or 3. Magnesium deficient patients (< 0.75 mmol/L) demonstrated less correlation between pre-treatment basal ETKA and TDP concentrations than normomagnesemic patients (R2 = 0.053 and R2 = 0.236). Median plasma lactate concentrations normalized (≤ 2.0 mmol/L) across all three groups (p < 0.001 for all groups), but not among magnesium deficient patients in group 1 (n = 22). The median time to achieve GMAWS = 0 for groups 1, 2 and 3 was 10, 5.5 and 6 h respectively (p < 0.001).
No significant difference was found between groups for the primary endpoint of change in ETKA. Co-administration of thiamine and magnesium resulted in more consistent normalization of plasma lactate concentrations and reduced duration to achieve initial resolution of AWS symptoms. ClinicalTrials.gov: NCT03466528.
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Affiliation(s)
- Donogh Maguire
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK. .,Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, UK.
| | - Alana Burns
- Department of Clinical Biochemistry, Queen Elizabeth University Hospital, Govan, G51 4TF, UK
| | - Dinesh Talwar
- The Scottish Trace Element and Micronutrient Diagnostic Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, UK
| | - Anthony Catchpole
- The Scottish Trace Element and Micronutrient Diagnostic Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, UK
| | - Fiona Stefanowicz
- The Scottish Trace Element and Micronutrient Diagnostic Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, UK
| | - David P Ross
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Peter Galloway
- Department of Clinical Biochemistry, Queen Elizabeth University Hospital, Govan, G51 4TF, UK
| | - Alastair Ireland
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Gordon Robson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Michael Adamson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Lesley Orr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Joanna-Lee Kerr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Xenofon Roussis
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Eoghan Colgan
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK
| | - Ewan Forrest
- Department of Gastroenterology and Hepatology, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, Richmond Street, Glasgow, G1 1XH, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, UK
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17
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Bourassa MW, Gomes F, Jones KS, Koulman A, Prentice AM, Cerami C. Thiamine deficiency in Gambian women of reproductive age. Ann N Y Acad Sci 2022; 1507:162-170. [PMID: 34542918 PMCID: PMC9292991 DOI: 10.1111/nyas.14695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 12/11/2022]
Abstract
Thiamine deficiency disorders are associated with a variety of clinical symptoms affecting the nervous and cardiovascular systems. There is growing recognition that thiamine deficiency can occur in populations well beyond the classical region of South Asia, and at-risk populations include those who receive a large proportion of their energy from polished white rice (or other low-thiamine staple foods) and with low dietary diversity. Reports of thiamine deficiency in West Africa over the last century have suggested that this has historically been an issue in this population, but in more recent decades, these reports have been limited to prison populations. To understand if thiamine deficiency might be an unrecognized problem in the communities of this region, erythrocyte samples collected during the wet and dry seasons from 226 women of reproductive age (mean age = 28 years old) were assessed for thiamine status by measuring the erythrocyte transketolase activity coefficient (ETKac). Overall, 35.8% of the sample was at high risk of thiamine deficiency (ETKac ≥ 1.25). Risk of thiamine deficiency was significantly higher in the wet (47.9%) compared with the dry season (22.9%) (P < 0.001). To our knowledge, this is the first report of biochemical thiamine deficiency in a free-living population in West Africa in the 21st century and suggests that further investigation is warranted.
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Affiliation(s)
| | - Filomena Gomes
- Nutrition ScienceThe New York Academy of SciencesNew YorkNew York
- NOVA Medical SchoolLisbonPortugal
| | - Kerry S. Jones
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUnited Kingdom
| | - Albert Koulman
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUnited Kingdom
| | - Andrew M. Prentice
- MRC Unit The Gambia at London School of Hygiene & Tropical MedicineBanjulThe Gambia
| | - Carla Cerami
- MRC Unit The Gambia at London School of Hygiene & Tropical MedicineBanjulThe Gambia
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18
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Hiding in Plain Sight: Modern Thiamine Deficiency. Cells 2021; 10:cells10102595. [PMID: 34685573 PMCID: PMC8533683 DOI: 10.3390/cells10102595] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including those at the entry points and at critical junctures for the glucose, fatty acid, and amino acid pathways. It has a very short half-life, limited storage capacity, and is susceptible to degradation and depletion by a number of products that epitomize modern life, including environmental and pharmaceutical chemicals. The RDA for thiamine is 1.1–1.2 mg for adult females and males, respectively. With an average diet, even a poor one, it is not difficult to meet that daily requirement, and yet, measurable thiamine deficiency has been observed across multiple patient populations with incidence rates ranging from 20% to over 90% depending upon the study. This suggests that the RDA requirement may be insufficient to meet the demands of modern living. Inasmuch as thiamine deficiency syndromes pose great risk of chronic morbidity, and if left untreated, mortality, a more comprehensive understanding thiamine chemistry, relative to energy production, modern living, and disease, may prove useful.
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19
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Verstraete J, Stove C. Volumetric absorptive microsampling (VAMS) as a reliable tool to assess thiamine status in dried blood microsamples: a comparative study. Am J Clin Nutr 2021; 114:1200-1207. [PMID: 34020458 DOI: 10.1093/ajcn/nqab146] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/06/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although populations from low- and middle-income countries are at higher risk for thiamine (vitamin B-1) deficiency, accurate data on the global prevalence of thiamine deficiency are still lacking due to the difficult blood collection in remote regions. Volumetric absorptive microsampling (VAMS) from finger prick blood, generating dried blood microsamples, could simplify blood collection and allow the setup of epidemiological studies to improve the diagnosis, treatment, and prevention of thiamine deficiency. OBJECTIVES To explore the potential of VAMS to serve as an alternative, patient-centric sampling strategy to evaluate the thiamine status. METHODS Venous liquid, venous VAMS, and capillary VAMS samples were collected from 50 healthy volunteers to compare thiamine diphosphate results, as a marker of thiamine (vitamin B-1) status, in the different sample types. In addition, capillary VAMS samples were sent through regular mail to evaluate the influence of noncontrolled transport on the final results. All samples were analyzed using previously described fully validated LC-MS/MS methods. RESULTS A good agreement (94-100% of the results lying within 20% of their mean) was obtained for all comparisons: venous VAMS compared with venous liquid blood samples, capillary VAMS compared with venous VAMS samples, and capillary VAMS compared with venous liquid blood samples, with no significant bias (maximum mean bias of -1.0%; 95% CI: -4.1%, 2.0%) observed between the different methods. Finally, we demonstrated that VAMS samples can be safely transported through regular mail without affecting the final results. CONCLUSIONS VAMS sampling can be used as a reliable alternative tool to evaluate the thiamine status, starting from only one drop of finger prick blood, in both developed and developing countries.
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Affiliation(s)
- Jana Verstraete
- Laboratory of Toxicology, Department of Bioanalysis, Ghent University, Ghent, Belgium
| | - Christophe Stove
- Laboratory of Toxicology, Department of Bioanalysis, Ghent University, Ghent, Belgium
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20
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Jones KS, Parkington DA, Cox LJ, Koulman A. Erythrocyte transketolase activity coefficient (ETKAC) assay protocol for the assessment of thiamine status. Ann N Y Acad Sci 2021; 1498:77-84. [PMID: 33354793 PMCID: PMC8451777 DOI: 10.1111/nyas.14547] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/06/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022]
Abstract
Vitamin B1 (thiamine) is an essential nutrient that acts as a cofactor for a number of metabolic processes, particularly in energy metabolism. Symptoms of classic thiamine deficiency are recognized as beriberi, although clinical symptoms are nonspecific and recognition of subclinical deficiency is difficult. Therefore, reliable biomarkers of thiamine status are required. Thiamine diphosphate is a cofactor for transketolase, including erythrocyte transketolase (ETK). The ETK activity assay as an indirect, functional marker of thiamine status has been used for over 50 years. The ETK activity assay provides a sensitive and specific biomarker of thiamine status; however, there is a lack of consensus over the cutoffs for deficiency, partly due to a lack of assay harmonization. Here, we provide a step-by-step protocol for the measurement of ETK activity and the calculation of the ETK activity coefficient, including detailed explanations of equipment and chemicals required and guidance for quality control procedures. Harmonization of the protocol will provide the basis for the development of internationally recognized cutoffs for thiamine insufficiency. The establishment of quality control materials and a quality assurance scheme are recommended to provide reliability. This will ensure that the ETK activity assay remains an important method for the assessment of thiamine status.
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Affiliation(s)
- Kerry S. Jones
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Damon A. Parkington
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - Lorna J. Cox
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
- MRC Elsie Widdowson LaboratoryCambridgeUK
| | - Albert Koulman
- NIHR BRC Nutritional Biomarker Laboratory, MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
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21
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Rudnicki-Velasquez PB, Storoniak H, Jagiełło K, Kreczko-Kurzawa J, Jankowska M, Krzymiński KJ. Comparative studies on vitamin B 1 deficiency inwholeblood of chronically haemodialysed patients: chromatographic, fluorimetricandPCAstudy. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1180:122880. [PMID: 34375809 DOI: 10.1016/j.jchromb.2021.122880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/30/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
The levels of thiamine diphosphate (ThDP), the most active biologically form of vitamin B1, were assessed in whole blood oflong-term haemodialysed patients (n = 50), by applying chromatographic methods based on RP-HPLC technique with isocratic elution and fluorescence detection. The target analyte, thiochrome diphosphate (ThODP), was obtained by pre-column derivatization of vitamin B1 contained in blood samples, applying deproteination with trichloroacetic acid, following by oxidation with alkaline solution of potassium ferricyanide(III) and stabilization with DTT before assays. A simple and sensitive assay was developed, and the results were referenced to the commercially available test. Steady-state and time-resolved studies on emissive properties of ThODP enabled optimization of the proposed assay. The F-Snedecor test shown no statistically significant differences between both approaches. Assessed parameters of the proposed assay, such as linearity, precision, sensitivity, and recovery, were satisfactory if compared to the reference one. The LOQ value for ThDP in whole blood of studied group of patients was of 0.5 ng/mL and the recovery of88%. The results disclosed high individual variabilities in the interdialytic deficiencies of ThDP among the patients - ranged from afew percent to values close to 100%. A comprehensive clinical data, characterizing patients under study, were processed together, and analysed by employing achemometric discriminative tool, the Principal Components Analysis,to find interdependences among clinical data characterizing patients. The three Principal Components were disclosed, that in sum explained almost 50% of the observed variability of the clinical data set. Among the clinical parameters involved in PCs were dialyzer membrane and type, duration as well as levels of creatinine, haemoglobin, and red blood cells in patients' whole blood.
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Affiliation(s)
| | - Hanna Storoniak
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, M. Skłodowskiej-Curie Str. 3a, Gdańsk 80-210, Poland
| | - Karolina Jagiełło
- Faculty of Chemistry, University of Gdańsk, Wita Stwosza Str. 63, Gdańsk 80-308, Poland
| | - Joanna Kreczko-Kurzawa
- Faculty of Chemistry, University of Gdańsk, Wita Stwosza Str. 63, Gdańsk 80-308, Poland; Institute of Biotechnology and Molecular Medicine, Gdansk Science and Technology Park, Gdańsk, Trzy Lipy 3 Str, Poland
| | - Magdalena Jankowska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, M. Skłodowskiej-Curie Str. 3a, Gdańsk 80-210, Poland
| | - Karol J Krzymiński
- Faculty of Chemistry, University of Gdańsk, Wita Stwosza Str. 63, Gdańsk 80-308, Poland.
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22
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The relation between acute changes in the systemic inflammatory response and circulating thiamine and magnesium concentrations after elective knee arthroplasty. Sci Rep 2021; 11:11271. [PMID: 34050237 PMCID: PMC8163855 DOI: 10.1038/s41598-021-90591-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 05/10/2021] [Indexed: 12/12/2022] Open
Abstract
Thiamine diphosphate (TDP) and magnesium are co-factors for key enzymes in human intermediary metabolism. However, their role in the systemic inflammatory response (SIR) is not clear. Therefore, the aim of the present study was to examine the relation between acute changes in the SIR and thiamine and magnesium dependent enzyme activity in patients undergoing elective knee arthroplasty (a standard reproducible surgical injury in apparently healthy individuals). Patients (n = 35) who underwent elective total knee arthroplasty had venous blood samples collected pre- and post-operatively for 3 days, for measurement of whole blood TDP, serum and erythrocyte magnesium, erythrocyte transketolase activity (ETKA), lactate dehydrogenase (LDH), glucose and lactate concentrations. Pre-operatively, TDP concentrations, erythrocyte magnesium concentrations, ETKA and plasma glucose were within normal limits for all patients. In contrast, 5 patients (14%) had low serum magnesium concentrations (< 0.75 mmol/L). On post-operative day1, both TDP concentrations (p < 0.001) and basal ETKA (p < 0.05) increased and serum magnesium concentrations decreased (p < 0.001). Erythrocyte magnesium concentrations correlated with serum magnesium concentrations (rs = 0.338, p < 0.05) and remained constant during SIR. Post-operatively 14 patients (40%) had low serum magnesium concentrations. On day1 serum magnesium concentrations were directly associated with LDH (p < 0.05), WCC (p < 0.05) and neutrophils (p < 0.01). Whole blood TDP and basal ETKA increased while serum magnesium concentrations decreased, indicating increased requirement for thiamine and magnesium dependent enzyme activity during SIR. Therefore, thiamine and magnesium represent potentially modifiable therapeutic targets that may modulate the host inflammatory response. Erythrocyte magnesium concentrations are likely to be reliable measures of status, whereas serum magnesium concentrations and whole blood TDP may not. ClinicalTrials.gov: NCT03554668.
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23
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Du X, Cheng X, Li W, Ge Z, Zhong C, Fan C, Gu H. Engineering Allosteric Ribozymes to Detect Thiamine Pyrophosphate in Whole Blood. Anal Chem 2021; 93:4277-4284. [PMID: 33635634 DOI: 10.1021/acs.analchem.0c05276] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Thiamine deficiency contributes to several human diseases including Alzheimer's. As its biologically active form, thiamine pyrophosphate (TPP) has been considered as a potential biomarker for Alzheimer's disease (AD) based on several clinical reports that apparently lower blood TPP levels were found in patients with mild cognitive impairment to AD. However, highly sensitive and high-throughput detection of TPP in biological fluids remains an analytical challenge. Here, we report engineering RNA-based sensors to quantitatively measure TPP concentrations in whole blood samples with a detection limit down to a few nM. By fusing a TPP-specific aptamer with the hammerhead ribozyme for in vitro selection, we isolated an allosteric ribozyme with an EC50 value (68 nM) similar to the aptamer's KD value (50 nM) for TPP, which for the first time demonstrates the possibility to maintain the effector binding affinity of the aptamer in such engineered allosteric RNA constructs. Meanwhile, we developed a new blood sample preparation protocol to be compatible with RNA. By coupling the TPP-induced ribozyme cleavage event with isothermal amplification, we achieved fluorescence monitoring of whole blood TPP levels through the "mix-and-read" operation with high-throughput potential. We expect that the engineered TPP-sensing RNAs will facilitate clinical research on AD as well as other thiamine-related diseases.
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Affiliation(s)
- Xinyu Du
- Fudan University Shanghai Cancer Center, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Stomatological Hospital, Fudan University, Shanghai 200032, China.,Department of Neurology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xiaoqin Cheng
- Department of Neurology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Wei Li
- Fudan University Shanghai Cancer Center, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Stomatological Hospital, Fudan University, Shanghai 200032, China.,Department of Neurology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhilei Ge
- School of Chemistry and Chemical Engineering, Frontiers Science Center for Transformative Molecules and National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Chunjiu Zhong
- Department of Neurology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Chunhai Fan
- School of Chemistry and Chemical Engineering, Frontiers Science Center for Transformative Molecules and National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hongzhou Gu
- Fudan University Shanghai Cancer Center, and the Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Shanghai Stomatological Hospital, Fudan University, Shanghai 200032, China.,Department of Neurology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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24
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Raj KM, Baranwal AK, Attri SV, Jayashree M, Kumar-M P, Patial A, Saini AG. Thiamine Status in Children with Septic Shock from a Developing Country: A Prospective Case-Control Study. J Trop Pediatr 2021; 67:6056050. [PMID: 33381852 DOI: 10.1093/tropej/fmaa107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Mitochondrial dysfunction is central to sepsis-induced multi-organ dysfunction. Thiamine deficiency may contribute to mitochondrial dysfunction and thus high mortality. Study was planned to assess thiamine status in children with septic shock in comparison to healthy controls from a developing country and to study the effect of thiamine levels on its outcome. METHODS A prospective case-control study (April 2017 to May 2018) enrolling consecutive children with septic shock as 'cases' (n = 76), their healthy siblings (n = 51) and apparently healthy children from immunization clinic (n = 35) as 'controls'. Whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1-month post-discharge. Outcome parameters were acute care area free days on days 14 and 28, and mortality. RESULTS WBTT [nMol/l; median (interquartile range, IQR)] was significantly lower on day 1 in cases compared with sibling controls [23.1 (21.8-26.3) vs. 36.9 (33.6-40.5); p < 0.001]. It fell further on day 10 [20.8 (18.1-21.1); p < 0.02]. Levels rose significantly 1-month post-discharge [35.5 (31.2-36.6)] and became comparable to sibling controls (p = 0.4). Immunization clinic controls also had lower WBTT [42.3 (40.1-45.9)], but was significantly higher than sibling controls and cases at 1-month post-discharge (p < 0.001). Survivors and non-survivors of septic shock were similar. WBTT levels did not correlate with any of the severity indicators of septic shock or its outcomes. CONCLUSIONS WBTT was significantly low in all children, and fell further during septic shock. Observed severe deficiency might have precluded any further association of thiamine levels with severity of septic shock and its outcome. Data obtained may inform trials on metabolic resuscitation in paediatric septic shock in developing countries. Lay summaryThiamine deficiency may contribute to high mortality in paediatric septic shock as thiamine is an essential factor for functioning of mitochondria, the powerhouse of the cells. This prospective case-control study was conducted to assess thiamine status in children with septic shock in comparison with healthy controls in a developing country. Consecutive children with fluid-refractory septic shock were enrolled as 'cases'. Their apparently healthy siblings, and apparently healthy children from immunization clinic, were enrolled as 'controls'. The whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1 month after hospital discharge. Seventy-six children were enrolled as cases, 51 children as sibling controls and 35 children as immunization clinic controls. WBTT was significantly lower on day 1 in cases as compared with their sibling controls. It fell further on day 10. The level rose significantly after a month of discharge and became comparable to sibling controls. Immunization clinic controls also had lower WBTT but was significantly higher compared with sibling controls and cases at 1-month post-discharge. Survivors and non-survivors of septic shock had similar WBTT levels. Observed severe deficiency might have precluded any further association of thiamine levels with septic shock outcome.
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Affiliation(s)
- Kumar Manish Raj
- Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arun K Baranwal
- Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Pediatric Biochemistry Unit, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Muralidharan Jayashree
- Division of Pediatric Critical Care, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Praveen Kumar-M
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Patial
- Pediatric Biochemistry Unit, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arushi Gahlot Saini
- Division of Pediatric Neurology, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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25
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Gonçalves SEAB, Gonçalves TJM, Guarnieri A, Risegato RC, Guimarães MP, de Freitas DC. Association between thiamine deficiency and hyperlactatemia among critically ill patients with diabetes infected by SARS-CoV-2. J Diabetes 2021; 13:413-419. [PMID: 33448683 PMCID: PMC8014215 DOI: 10.1111/1753-0407.13156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The present study aims to verify the association between diabetes and thiamine deficiency in critically ill patients infected by severe acute respiratory syndrome coronavirus 2. METHODS This is a descriptive cross-sectional study, whose demographic, anthropometric, and laboratory data (arterial lactate, bicarbonate, and plasma thiamine) were obtained in the first hours of admission to the intensive care unit. Patients with diabetes were compared with individuals without diabetes, and the correlation was performed between thiamine and lactate levels. Thiamine levels <28 μg/L were considered as thiamine deficiency. RESULTS Overall, 270 patients met the inclusion criteria; 51.1% were men, and the median age was 74 years (66.8-81). The median value of thiamine was 54.0 μg/L (38-72.3), and 15.6% had thiamine deficiency. Among patients with diabetes, 26.3% had thiamine deficiency, and 69.3% had hyperlactatemia. There was an association between thiamine deficiency and diabetes (odds ratio 4.28; 95% CI, 2.08-8.81; P < .001). There was a strong negative correlation between thiamine and arterial lactate in patients with diabetes (r = -0.711, P < .001) and a moderate negative correlation in critically ill patients without diabetes (r = -0.489, P < .001). CONCLUSIONS The prevalence of thiamine deficiency in critically ill patients due to coronavirus disease 2019 is higher in patients with diabetes. There is a negative correlation between thiamine and arterial lactate levels, which is higher in people with diabetes.
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Affiliation(s)
| | | | - Andreia Guarnieri
- Sancta Maggiore Hospital, Prevent Senior Private Health OperatorSão PauloBrazil
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26
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Smith TJ, Hess SY. Infantile thiamine deficiency in South and Southeast Asia: An age-old problem needing new solutions. NUTR BULL 2021; 46:12-25. [PMID: 33776582 PMCID: PMC7986856 DOI: 10.1111/nbu.12481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/23/2020] [Accepted: 12/22/2020] [Indexed: 12/29/2022]
Abstract
Infantile beriberi, a potentially fatal disorder caused by thiamine deficiency, is often viewed as a disease confined to history in regions of the world with predominant white rice consumption. Recent case reports have, however, highlighted the persistence of thiamine deficiency as a cause of infant mortality in South and Southeast Asia. Low infant thiamine status and incidence of beriberi is attributable to maternal thiamine deficiency and insufficient breast milk thiamine. Poor dietary diversity, food preparation and cooking practices and traditional post‐partum food restrictions likely play a role in these high‐risk regions. Given the contribution of thiamine deficiency to infant mortality and emerging evidence of long‐lasting neurodevelopmental deficits of severe and even subclinical deficiency in early life, public health strategies to prevent thiamine deficiency are urgently needed. However, efforts are hampered by uncertainties surrounding the identification and assessment of thiamine deficiency, due to the broad non‐specific clinical manifestations, commonly referred to as thiamine deficiency disorders (TDD), that overlap with other conditions resulting in frequent misdiagnosis and missed treatment opportunities, and secondly the lack of readily available and agreed upon biomarker analysis and cut‐off thresholds. This review will discuss the key challenges and limitations in the current understanding of TDD and explore how ongoing initiatives plan to fill persistent knowledge gaps, namely in the development of a standardised case definition to help more accurately diagnose and treat TDD in low‐resource settings. Given more attention and ensuring greater recognition of TDD will support the design and implementation of treatment and prevention programmes, and ensure beriberi can truly be considered ‘the forgotten disease of Asia’.
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Affiliation(s)
- T J Smith
- Institute for Global Nutrition University of California Davis Davis CA USA
| | - S Y Hess
- Institute for Global Nutrition University of California Davis Davis CA USA
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27
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Verstraete J, Stove C. Patient-Centric Assessment of Thiamine Status in Dried Blood Volumetric Absorptive Microsamples Using LC–MS/MS Analysis. Anal Chem 2021; 93:2660-2668. [DOI: 10.1021/acs.analchem.0c05018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Jana Verstraete
- Laboratory of Toxicology, Department of Bioanalysis, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - Christophe Stove
- Laboratory of Toxicology, Department of Bioanalysis, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
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28
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Smith TJ, Johnson CR, Koshy R, Hess SY, Qureshi UA, Mynak ML, Fischer PR. Thiamine deficiency disorders: a clinical perspective. Ann N Y Acad Sci 2020; 1498:9-28. [PMID: 33305487 PMCID: PMC8451766 DOI: 10.1111/nyas.14536] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022]
Abstract
Thiamine is an essential water‐soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due to the broad clinical spectrum, referred to as thiamine deficiency disorders (TDDs), affecting the metabolic, neurologic, cardiovascular, respiratory, gastrointestinal, and musculoskeletal systems. Concurrent illnesses and overlapping signs and symptoms with other disorders can further complicate this. As such, TDDs are frequently misdiagnosed and treatment opportunities missed, with fatal consequences or permanent neurologic sequelae. In the absence of specific diagnostic tests, a low threshold of clinical suspicion and early therapeutic thiamine is currently the best approach. Even in severe cases, rapid clinical improvement can occur within hours or days, with neurological involvement possibly requiring higher doses and a longer recovery time. Active research aims to help better identify patients with thiamine‐responsive disorders and future research is needed to determine effective dosing regimens for the various clinical presentations of TDDs. Understanding the clinical diagnosis and global burden of thiamine deficiency will help to implement national surveillance and population‐level prevention programs, with education to sensitize clinicians to TDDs. With concerted effort, the morbidity and mortality related to thiamine deficiency can be reduced.
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Affiliation(s)
- Taryn J Smith
- Institute for Global Nutrition, University of California Davis, Davis, California
| | - Casey R Johnson
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Roshine Koshy
- Makunda Christian Leprosy and General Hospital, Karimganj, Assam, India
| | - Sonja Y Hess
- Institute for Global Nutrition, University of California Davis, Davis, California
| | - Umar A Qureshi
- G.B. Pant Hospital, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mimi Lhamu Mynak
- Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Philip R Fischer
- Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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29
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Letter to the editor: On the assessment of micronutrient status in children with systemic inflammation. Clin Nutr 2020; 39:3530. [DOI: 10.1016/j.clnu.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/07/2020] [Indexed: 11/24/2022]
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30
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Wang C, Zhang S, Zou Y, Ma H, Jiang D, Sheng L, Sang S, Jin L, Guan Y, Gui Y, Xu Z, Zhong C. A novel PET tracer 18F-deoxy-thiamine: synthesis, metabolic kinetics, and evaluation on cerebral thiamine metabolism status. EJNMMI Res 2020; 10:126. [PMID: 33079296 PMCID: PMC7575681 DOI: 10.1186/s13550-020-00710-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022] Open
Abstract
Background Some neuropsychological diseases are associated with abnormal thiamine metabolism, including Korsakoff–Wernicke syndrome and Alzheimer’s disease. However, in vivo detection of the status of brain thiamine metabolism is still unavailable and needs to be developed. Methods A novel PET tracer of 18F-deoxy-thiamine was synthesized using an automated module via a two-step route. The main quality control parameters, such as specific activity and radiochemical purity, were evaluated by high-performance liquid chromatography (HPLC). Radiochemical concentration was determined by radioactivity calibrator. Metabolic kinetics and the level of 18F-deoxy-thiamine in brains of mice and marmosets were studied by micro-positron emission tomography/computed tomography (PET/CT). In vivo stability, renal excretion rate, and biodistribution of 18F-deoxy-thiamine in the mice were assayed using HPLC and γ-counter, respectively. Also, the correlation between the retention of cerebral 18F-deoxy-thiamine in 60 min after injection as represented by the area under the curve (AUC) and blood thiamine levels was investigated. Results The 18F-deoxy-thiamine was stable both in vitro and in vivo. The uptake and clearance of 18F-deoxy-thiamine were quick in the mice. It reached the max standard uptake value (SUVmax) of 4.61 ± 0.53 in the liver within 1 min, 18.67 ± 7.04 in the kidney within half a minute. The SUV dropped to 0.72 ± 0.05 and 0.77 ± 0.35 after 60 min of injection in the liver and kidney, respectively. After injection, kidney, liver, and pancreas exhibited high accumulation level of 18F-deoxy-thiamine, while brain, muscle, fat, and gonad showed low accumulation concentration, consistent with previous reports on thiamine distribution in mice. Within 90 min after injection, the level of 18F-deoxy-thiamine in the brain of C57BL/6 mice with thiamine deficiency (TD) was 1.9 times higher than that in control mice, and was 3.1 times higher in ICR mice with TD than that in control mice. The AUC of the tracer in the brain of marmosets within 60 min was 29.33 ± 5.15 and negatively correlated with blood thiamine diphosphate levels (r = − 0.985, p = 0.015). Conclusion The 18F-deoxy-thiamine meets the requirements for ideal PET tracer for in vivo detecting the status of cerebral thiamine metabolism.
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Affiliation(s)
- Changpeng Wang
- Department of Neurology, Zhongshan Hospital, State Key Laboratory of Medical Neurobiology and Institute of Brain Science, Fudan University, Shanghai, 200032, China
| | - Siwei Zhang
- Jiangsu Huayi Technology Co., Ltd., Jiangsu, 215519, China
| | - Yuefei Zou
- Jiangsu Huayi Technology Co., Ltd., Jiangsu, 215519, China
| | - Hongzhao Ma
- Jiangsu Huayi Technology Co., Ltd., Jiangsu, 215519, China
| | - Donglang Jiang
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Lei Sheng
- Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Shaoming Sang
- Department of Neurology, Zhongshan Hospital, State Key Laboratory of Medical Neurobiology and Institute of Brain Science, Fudan University, Shanghai, 200032, China
| | - Lirong Jin
- Department of Neurology, Zhongshan Hospital, State Key Laboratory of Medical Neurobiology and Institute of Brain Science, Fudan University, Shanghai, 200032, China
| | - Yihui Guan
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - Yuan Gui
- Jiangsu Huayi Technology Co., Ltd., Jiangsu, 215519, China
| | - Zhihong Xu
- Jiangsu Huayi Technology Co., Ltd., Jiangsu, 215519, China
| | - Chunjiu Zhong
- Department of Neurology, Zhongshan Hospital, State Key Laboratory of Medical Neurobiology and Institute of Brain Science, Fudan University, Shanghai, 200032, China.
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31
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Measuring thiamine status in dried blood spots. Clin Chim Acta 2020; 509:52-59. [DOI: 10.1016/j.cca.2020.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
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32
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Taylor AJ, Talwar D, Lee SJ, Cox L, Mayxay M, Newton PN. Comparison of Thiamin Diphosphate High-Performance Liquid Chromatography and Erythrocyte Transketolase Assays for Evaluating Thiamin Status in Malaria Patients without Beriberi. Am J Trop Med Hyg 2020; 103:2600-2604. [PMID: 32996449 PMCID: PMC7695103 DOI: 10.4269/ajtmh.20-0479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Thiamin deficiency, or beriberi, is an increasingly re-recognized cause of morbidity and mortality in the developing world. Thiamin status has traditionally been measured through the erythrocyte activation assay (ETKA) or basal transketolase activity (ETK), which indirectly measure thiamin diphosphate (TDP). Thiamin diphosphate can also be measured directly by high-performance liquid chromatography (HPLC), which may allow a more precise estimation of thiamin status. We compared the direct measurement of TDP by HPLC with basal ETK activity and ETKA in 230 patients with Plasmodium falciparum malaria in rural southern Laos without overt clinical beriberi, as part of a trial of thiamin supplementation. Admission thiamin status measured by basal ETK activity and ETKA (α) were compared with thiamin status assessed by the measurement of TDP by HPLC. 55% of 230 included patients were male, and the median age was 10 (range 0.5–73) years. Using α ≥ 25% as the gold standard of thiamin deficiency, the sensitivity of TDP < 275 ng/gHb as a measure of thiamin deficiency was 68.5% (95% CI: 54.4–80.5%), with specificity of 60.8 (95% CI: 53.2–68.1%). There was a significant inverse correlation between the results of the two tests (Kendall’s tau = −0.212, P < 0.001). Basal ETK activity was also significantly positively correlated with TDP levels (Kendall’s tau = 0.576, P < 0.001). Thiamin diphosphate measurement may have a role in measuring thiamin levels in clinical settings. Further studies evaluating TDP concentration in erythrocytes with basal ETK activity and ETKA (α) in beriberi patients would help establish comparative values of these assays.
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Affiliation(s)
- Andrew J Taylor
- Centre for Tropical Medicine and Global Health, Churchill Hospital, University of Oxford, Oxford, United Kingdom.,Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
| | - Dinesh Talwar
- Scottish Trace Element and Micronutrient Diagnostic and Research Laboratory, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Sue J Lee
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Churchill Hospital, University of Oxford, Oxford, United Kingdom
| | - Lorna Cox
- MRC Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Mayfong Mayxay
- Centre for Tropical Medicine and Global Health, Churchill Hospital, University of Oxford, Oxford, United Kingdom.,Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
| | - Paul N Newton
- Lao Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.,Centre for Tropical Medicine and Global Health, Churchill Hospital, University of Oxford, Oxford, United Kingdom.,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Song JH, Jung DI. Thiamine deficiency in a dog associated with exclusive consumption of boiled sweet potato (Ipomoea batatas): Serial changes in clinical findings, magnetic resonance imaging findings and blood lactate and thiamine concentrations. Vet Med Sci 2020; 7:69-76. [PMID: 32966700 PMCID: PMC7840196 DOI: 10.1002/vms3.352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/24/2020] [Accepted: 08/29/2020] [Indexed: 12/30/2022] Open
Abstract
Thiamine (vitamin B1) is an essential nutrient that significantly influences ATP production in the body. It needs to be supplemented consistently through an exogenous source to prevent deficiency; however, it is easily affected by a variety of mitigating factors. Additionally, thiamine requirements can be influenced by an individual's dietary composition. The nervous system is particularly vulnerable to thiamine deficiency due to its high metabolic demand. Thiamine deficiency is typically diagnosed based on clinical signs, dietary history and response to thiamine administration. A 5‐year‐old neutered male Maltese Terrier dog presented with an acute onset of seizures and generalized ataxia. The dog was exclusively fed boiled sweet potato (Ipomoea batatas) as a primary diet source for 4 weeks. MR findings and hyperlactatemic conditions were consistent with thiamine deficiency, and the diagnosis was confirmed by measuring thiamine concentrations in blood using high‐performance liquid chromatography (HPLC). Appropriate thiamine supplementation and diet changes resulted in a rapid improvement in neurological signs. Repeated MR imaging 2 weeks after starting the treatment completely resolved the previously identified abnormalities, and repeated measurements of blood lactate and thiamine levels revealed complete recovery of the thiamine‐deficient status.
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Affiliation(s)
- Joong-Hyun Song
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju, Republic of Korea.,Department of Research Center, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea
| | - Dong-In Jung
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju, Republic of Korea
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Pacei F, Tesone A, Laudi N, Laudi E, Cretti A, Pnini S, Varesco F, Colombo C. The Relevance of Thiamine Evaluation in a Practical Setting. Nutrients 2020; 12:nu12092810. [PMID: 32933220 PMCID: PMC7551939 DOI: 10.3390/nu12092810] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 02/07/2023] Open
Abstract
Thiamine is a crucial cofactor involved in the maintenance of carbohydrate metabolism and participates in multiple cellular metabolic processes. Although thiamine can be obtained from various food sources, some common food groups are deficient in thiamine, and it can be denatured by high temperature and pH. Additionally, different drugs can alter thiamine metabolism. In addition, the half-life of thiamine in the body is between 1 and 3 weeks. All these factors could provide an explanation for the relatively short period needed to develop thiamine deficiency and observe the consequent clinical symptoms. Thiamine deficiency could lead to neurological and cardiological problems. These clinical conditions could be severe or even fatal. Marginal deficiency too may promote weaker symptoms that might be overlooked. Patients undergoing upper gastrointestinal or pancreatic surgery could have or develop thiamine deficiency for many different reasons. To achieve the best outcome for these patients, we strongly recommend the execution of both an adequate preoperative nutritional assessment, which includes thiamine evaluation, and a close nutritional follow up to avoid a nutrient deficit in the postoperative period.
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Affiliation(s)
- Federico Pacei
- ASST Nord Milano, UOC Neurologia, Ospedale Bassini, 20092 Cinisello Balsamo, Italy
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
- Correspondence:
| | - Antonella Tesone
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
| | - Nazzareno Laudi
- Faculty of Medicine and Surgery, Medizinische Universitat Innsbruck, Christoph-Probst-Platz 1, Innrain 52 A, 6020 Innsbruck, Austria;
| | - Emanuele Laudi
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
| | - Anna Cretti
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
| | - Shira Pnini
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
| | - Fabio Varesco
- Department of Physical Rehabilitation, Casa di Cura Bonvicini, Via Michael Pacher 12, 39100 Bolzano, Italy; (A.T.); (E.L.); (A.C.); (S.P.); (F.V.)
| | - Chiara Colombo
- Lombardy Regional Course for General Practitioner, PoliS-Lombardia, Via Taramelli 12/F, 20100 Milano, Italy;
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Blood thiamine pyrophosphate concentration and its correlation with the stage of diabetic retinopathy. Int Ophthalmol 2020; 40:3279-3284. [PMID: 32715366 DOI: 10.1007/s10792-020-01513-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the possible relationship between blood thiamine pyrophosphate (TPP) concentration and stage of diabetic retinopathy (DR). METHODS This comparative cross-sectional study included 80 patients with type 2 diabetes mellitus (T2DM) and 20 age- and gender-matched healthy controls. Diabetic patients were subclassified into four groups each consisting of 20 subjects: no DR, mild-moderate non-proliferative DR (mild-moderate NPDR), severe NPDR, and proliferative DR (PDR). Blood TPP concentration was assessed with high-performance liquid chromatography (HPLC) assay and was correlated with the stage of DR. RESULTS Mean blood TPP concentration was 80.2 ± 14.8 nmol/L in control group. It was, respectively, 69.85 ± 18.1, 64.95 ± 13.4, 61.9 ± 13.4 and 60.75 ± 14.3 nmol/L in no DR, mild-moderate NPDR, severe NPDR and PDR groups. For mild-moderate NPDR, severe NPDR and PDR groups, TPP concentrations were significantly lower compared with controls (p: 0.014, 0.002, 0.001, respectively). Mean TPP concentration for NPDR patients was higher than for PDR patients, but the difference was not significant (p: 0.478). ANOVA revealed a significant difference between TPP concentrations of groups (p: 0.001). Mean TPP concentration decreased with the stage of DR, and number of patients with thiamine deficiency increased gradually with the stage of DR. A negative correlation was found between the TPP level and occurrence of DR (p: 0.000). CONCLUSION The results suggest that lower blood TPP concentrations were associated with higher risk of DR. Thiamine might play an important role in the pathophysiology and progression of DR. Thiamine and its derivatives might represent an approach to the prevention and/or treatment of early DR.
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Abstract
Wernicke’s encephalopathy is caused by thiamine deficiency and has a
range of presenting features, including gait disturbance, altered
cognitive state, nystagmus and other eye movement disorders. In the
past, Wernicke’s encephalopathy was described almost exclusively in
the alcohol-dependent population. However, in current times,
Wernicke’s encephalopathy is also well recognized in many other
patient groups, including patients following bariatric surgery,
gastrointestinal surgery, cancer and pancreatitis. Early recognition
of Wernicke’s encephalopathy is vital, as prompt treatment can restore
cognitive or ocular function and can prevent permanent disability.
Unfortunately, Wernicke’s encephalopathy is often undiagnosed –
presumably because it is relatively uncommon and has a variable
clinical presentation. Clinical biochemists have a unique role in
advising clinicians about potential nutritional or metabolic causes of
unexplained neurological symptoms and to prompt consideration of
thiamine deficiency as a potential cause in high-risk patient groups.
The aim of this review is to summarize the clinical features,
diagnosis and treatment of Wernicke’s encephalopathy and to highlight
some non-traditional causes, such as after bariatric surgery.
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Affiliation(s)
- Sara Kohnke
- Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
| | - Claire L Meek
- Institute of Metabolic Science, Metabolic Research Laboratories, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.,Department of Clinical Biochemistry, North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.,Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, UK
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Isen DR, Kline LB. Neuro-ophthalmic Manifestations of Wernicke Encephalopathy. Eye Brain 2020; 12:49-60. [PMID: 32636690 PMCID: PMC7335288 DOI: 10.2147/eb.s234078] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
Wernicke encephalopathy (WE) is a life-threatening but reversible syndrome resulting from acute thiamine deficiency that is frequently overlooked and underdiagnosed. It is classically characterized by a triad of ocular dysfunction, ataxia, and altered mental status. However, less than 1/3 patients have the complete triad, so it is crucial to have a high index of suspicion. Awareness of the early signs of WE is essential to prevent clinical progression, as patients with the full triad already have a profoundly thiamine-deficient state. This review highlights the neuro-ophthalmic manifestations of WE to guide the clinician in identifying the condition. In addition, we provide an update regarding the clinical characteristics, pathophysiology, neuroimaging and laboratory findings, treatment options, and prognosis of WE.
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Affiliation(s)
- Danielle R Isen
- Department of Neurology, University of South Alabama School of Medicine, Mobile, AL, USA
| | - Lanning B Kline
- Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA
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Activation of Mitochondrial 2-Oxoglutarate Dehydrogenase by Cocarboxylase in Human Lung Adenocarcinoma Cells A549 Is p53/p21-Dependent and Impairs Cellular Redox State, Mimicking the Cisplatin Action. Int J Mol Sci 2020; 21:ijms21113759. [PMID: 32466567 PMCID: PMC7312097 DOI: 10.3390/ijms21113759] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/22/2022] Open
Abstract
Genetic up-regulation of mitochondrial 2-oxoglutarate dehydrogenase is known to increase reactive oxygen species, being detrimental for cancer cells. Thiamine diphosphate (ThDP, cocarboxylase) is an essential activator of the enzyme and inhibits p53–DNA binding in cancer cells. We hypothesize that the pleiotropic regulator ThDP may be of importance for anticancer therapies. The hypothesis is tested in the present work on lung adenocarcinoma cells A549 possessing the p53–p21 pathway as fully functional or perturbed by p21 knockdown. Molecular mechanisms of ThDP action on cellular viability and their interplay with the cisplatin and p53–p21 pathways are characterized. Despite the well-known antioxidant properties of thiamine, A549 cells exhibit decreases in their reducing power and glutathione level after incubation with 5 mM ThDP, not observed in non-cancer epithelial cells Vero. Moreover, thiamine deficiency elevates glutathione in A549 cells. Viability of the thiamine deficient A549 cells is increased at a low (0.05 mM) ThDP. However, the increase is attenuated by 5 mM ThDP, p21 knockdown, specific inhibitor of the 2-oxoglutarate dehydrogenase complex (OGDHC), or cisplatin. Cellular levels of the catalytically competent ThDP·OGDHC holoenzyme are dysregulated by p21 knockdown and correlate negatively with the A549 viability. The inverse relationship between cellular glutathione and holo-OGDHC is corroborated by their comparison in the A549 and Vero cells. The similarity, non-additivity, and p21 dependence of the dual actions of ThDP and cisplatin on A549 cells manifest a common OGDHC-mediated mechanism of the viability decrease. High ThDP saturation of OGDHC compromises the redox state of A549 cells under the control of p53–p21 axes.
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Ehsanian R, Anderson S, Schneider B, Kennedy D, Mansourian V. Prevalence of Low Plasma Vitamin B1 in the Stroke Population Admitted to Acute Inpatient Rehabilitation. Nutrients 2020; 12:nu12041034. [PMID: 32290066 PMCID: PMC7230706 DOI: 10.3390/nu12041034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/01/2020] [Accepted: 04/07/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To determine the prevalence of vitamin B1 (VitB1) deficiency in the stroke population admitted to acute inpatient rehabilitation. DESIGN Retrospective cohort study. SETTING Acute inpatient rehabilitation facility at an academic medical center. PARTICIPANTS 119 consecutive stroke patients admitted to stroke service from 1 January 2018 to 31 December 2018. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Plasma VitB1 level. RESULTS There were 17 patients (14%; 95% CI 9-22%) with low VitB1 with a range of 2-3 nmol/L, an additional 58 (49%; CI 40-58%) patients had normal low VitB1 with a range of 4-9 nmol/L, twenty-five patients (21%; CI 15-29%) had normal high VitB1 with a range of 10-15 nmol/L, and nineteen patients (16%; CI 10-24%) had high VitB1 with a range of 16-43 nmol/L. CONCLUSIONS In this cohort of patients admitted to the stroke service at an acute rehabilitation facility, there is evidence of thiamine deficiency. Moreover, the data suggest that there is inadequate acute intake of VitB1. Given the role of thiamine deficiency in neurologic function, further study of the role of thiamine optimization in the acute stroke rehabilitation population is warranted.
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Affiliation(s)
- Reza Ehsanian
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA; (R.E.); (S.A.); (B.S.); (D.K.)
- Department of Neurosurgery, Stanford University, Palo Alto, CA 34304, USA
- Division of Physical Medicine and Rehabilitation, Department of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
| | - Sean Anderson
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA; (R.E.); (S.A.); (B.S.); (D.K.)
| | - Byron Schneider
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA; (R.E.); (S.A.); (B.S.); (D.K.)
| | - David Kennedy
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA; (R.E.); (S.A.); (B.S.); (D.K.)
| | - Vartgez Mansourian
- Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN 37212, USA; (R.E.); (S.A.); (B.S.); (D.K.)
- Correspondence: ; Tel.: +615-936-7708
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40
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Hess SY, Smith TJ, Fischer PR, Trehan I, Hiffler L, Arnold CD, Sitthideth D, Tancredi DJ, Schick MA, Yeh J, Stein-Wexler R, McBeth CN, Tan X, Nhiacha K, Kounnavong S. Establishing a case definition of thiamine responsive disorders among infants and young children in Lao PDR: protocol for a prospective cohort study. BMJ Open 2020; 10:e036539. [PMID: 32060165 PMCID: PMC7044841 DOI: 10.1136/bmjopen-2019-036539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Diagnosis of infantile thiamine deficiency disorders (TDD) is challenging due to the non-specific, highly variable clinical presentation, often leading to misdiagnosis. Our primary objective is to develop a case definition for thiamine responsive disorders (TRD) to determine among hospitalised infants and young children, which clinical features and risk factors identify those who respond positively to thiamine administration. METHODS AND ANALYSIS This prospective study will enrol 662 children (aged 21 days to <18 months) seeking treatment for TDD symptoms. Children will be treated with intravenous or intramuscular thiamine (100 mg daily for a minimum of 3 days) alongside other interventions deemed appropriate. Baseline assessments, prior to thiamine administration, include a physical examination, echocardiogram and venous blood draw for the determination of thiamine biomarkers. Follow-up assessments include physical examinations (after 4, 8, 12, 24, 36, 48 and 72 hours), echocardiogram (after 24 and 48 hours) and one cranial ultrasound. During the hospital stay, maternal blood and breast-milk samples and diet, health, anthropometric and socio-demographic information will be collected for mother-child pairs. Using these data, a panel of expert paediatricians will determine TRD status for use as the dependent variable in logistic regression models. Models identifying predictors of TRD will be developed and validated for various scenarios. Clinical prediction model performance will be quantified by empirical area under the receiver operating characteristic curve, using resampling cross validation. A frequency-matched community-based cohort of mother-child pairs (n=265) will serve as comparison group for evaluation of potential risk factors for TRD. ETHICS AND DISSEMINATION Ethical approval has been obtained from The National Ethics Committee for Health Research, Ministry of Health, Lao PDR and the Institutional Review Board of the University of California Davis. The results will be disseminated via scientific articles, presentations and workshops with representatives of the Ministry of Health. TRIAL REGISTRATION NUMBER NCT03626337.
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Affiliation(s)
- Sonja Y Hess
- Department of Nutrition, Institute for Global Nutrition, University of California Davis, Davis, California, USA
| | - Taryn J Smith
- Department of Nutrition, Institute for Global Nutrition, University of California Davis, Davis, California, USA
| | - Philip R Fischer
- Pediatric and Adolescent Medicine, Mayo, Rochester, Minnesota, USA
| | - Indi Trehan
- Department of Pediatrics and Department of Global Health, University of Washington, Seattle, Washington, USA
- Lao Friends Hospital for Children, Luang Prabang, Lao People's Democratic Republic
| | | | - Charles D Arnold
- Department of Nutrition, Institute for Global Nutrition, University of California Davis, Davis, California, USA
| | - Dalaphone Sitthideth
- Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
| | - Daniel J Tancredi
- Department of Pediatrics, University of California Davis Health System, Sacramento, California, USA
| | - Michael A Schick
- Emergency Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Jay Yeh
- Department of Pediatrics, Division of Cardiology, University of California Davis Health System, Sacramento, California, USA
| | - Rebecca Stein-Wexler
- Department of Radiology, University of California Davis Health System, Sacramento, California, USA
| | - Christine N McBeth
- Emergency Medicine, University of California Davis Health System, Sacramento, California, USA
| | - Xiuping Tan
- Department of Nutrition, Institute for Global Nutrition, University of California Davis, Davis, California, USA
| | - Kouyang Nhiacha
- Lao-Korea Children Hospital, Vientiane, Lao People's Democratic Republic
| | - Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
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41
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Gwathmey KG, Grogan J. Nutritional neuropathies. Muscle Nerve 2019; 62:13-29. [PMID: 31837157 DOI: 10.1002/mus.26783] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 12/07/2019] [Accepted: 12/07/2019] [Indexed: 12/17/2022]
Abstract
Neuropathies associated with nutritional deficiencies are routinely encountered by the practicing neurologist. Although these neuropathies assume different patterns, most are length-dependent, sensory axonopathies. Cobalamin deficiency neuropathy is the exception, often presenting with a non-length-dependent sensory neuropathy. Patients with cobalamin and copper deficiency neuropathy characteristically have concomitant myelopathy, whereas vitamin E deficiency is uniquely associated with a spinocerebellar syndrome. In contrast to those nutrients for which deficiencies produce neuropathies, pyridoxine toxicity results in a non-length-dependent sensory neuronopathy. Deficiencies occur in the context of malnutrition, malabsorption, increased nutrient loss (such as with dialysis), autoimmune conditions such as pernicious anemia, and with certain drugs that inhibit nutrient absorption. When promptly identified, therapeutic nutrient supplementation may result in stabilization or improvement of these neuropathies.
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Affiliation(s)
| | - James Grogan
- University of Virginia, Charlottesville, Virginia
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42
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Maguire D, Talwar D, Burns A, Catchpole A, Stefanowicz F, Robson G, Ross DP, Young D, Ireland A, Forrest E, Galloway P, Adamson M, Colgan E, Bell H, Orr L, Kerr JL, Roussis X, McMillan DC. A prospective evaluation of thiamine and magnesium status in relation to clinicopathological characteristics and 1-year mortality in patients with alcohol withdrawal syndrome. J Transl Med 2019; 17:384. [PMID: 31752901 PMCID: PMC6873772 DOI: 10.1186/s12967-019-02141-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/15/2019] [Indexed: 12/12/2022] Open
Abstract
Background Alcohol withdrawal syndrome (AWS) is routinely treated with B-vitamins. However, the relationship between thiamine status and outcome is rarely examined. The aim of the present study was to examine the relationship between thiamine and magnesium status in patients with AWS. Methods Patients (n = 127) presenting to the Emergency Department with AWS were recruited to a prospective observational study. Blood samples were drawn to measure whole blood thiamine diphosphate (TDP) and serum magnesium concentrations. Routine biochemistry and haematology assays were also conducted. The Glasgow Modified Alcohol Withdrawal Score (GMAWS) measured severity of AWS. Seizure history and current medications were also recorded. Results The majority of patients (99%) had whole blood TDP concentration within/above the reference interval (275–675 ng/gHb) and had been prescribed thiamine (70%). In contrast, the majority of patients (60%) had low serum magnesium concentrations (< 0.75 mmol/L) and had not been prescribed magnesium (93%). The majority of patients (66%) had plasma lactate concentrations above 2.0 mmol/L. At 1 year, 13 patients with AWS had died giving a mortality rate of 11%. Male gender (p < 0.05), BMI < 20 kg/m2 (p < 0.01), GMAWS max ≥ 4 (p < 0.05), elevated plasma lactate (p < 0.01), low albumin (p < 0.05) and elevated serum CRP (p < 0.05) were associated with greater 1-year mortality. Also, low serum magnesium at time of recruitment to study and low serum magnesium at next admission were associated with higher 1-year mortality rates, (84% and 100% respectively; both p < 0.05). Conclusion The prevalence of low circulating thiamine concentrations were rare and it was regularly prescribed in patients with AWS. In contrast, low serum magnesium concentrations were common and not prescribed. Low serum magnesium was associated more severe AWS and increased 1-year mortality.
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Affiliation(s)
- Donogh Maguire
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK. .,Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK.
| | - Dinesh Talwar
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Alana Burns
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK.,Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, G51 4TF, Scotland, UK
| | - Anthony Catchpole
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Fiona Stefanowicz
- The Scottish Trace Element and Micronutrient Diagnostic and Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - Gordon Robson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - David P Ross
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK.,Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
| | - David Young
- Department of Mathematics and Statistics, University of Strathclyde, 26 Richmond Street, Glasgow, G1 1XH, Scotland, UK
| | - Alastair Ireland
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Ewan Forrest
- Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, G4 0SF, Scotland, UK
| | - Peter Galloway
- Department of Biochemistry, Queen Elizabeth University Hospital, Glasgow, G51 4TF, Scotland, UK
| | - Michael Adamson
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Eoghan Colgan
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Hannah Bell
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Lesley Orr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Joanna-Lee Kerr
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Xen Roussis
- Emergency Medicine Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, Scotland, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, UK
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Transketolase and vitamin B1 influence on ROS-dependent neutrophil extracellular traps (NETs) formation. PLoS One 2019; 14:e0221016. [PMID: 31415630 PMCID: PMC6695114 DOI: 10.1371/journal.pone.0221016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 07/30/2019] [Indexed: 12/23/2022] Open
Abstract
Neutrophil extracellular traps (NETs) are a recently identified, web-like, extracellular structure composed of decondensed nuclear DNA and associated antimicrobial granules. NETs are extruded into the extracellular environment via the reactive oxygen species (ROS)-dependent cell death pathway participating in inflammation and autoimmune diseases. Transketolase (TKT) is a thiamine pyrophosphate (vitamin B1)-dependent enzyme that links the pentose phosphate pathway with the glycolytic pathway by feeding excess sugar phosphates into the main carbohydrate metabolic pathways to generate biosynthetic reducing capacity in the form of NADPH as a substrate for ROS generation. In this work, TKT was selected as a lead candidate from 24 NET-associated proteins obtained by literature screening and knowledge gap assessment. Consequently, we determined whether TKT influenced NET formation in vitro. We firstly established that the release of ROS-dependent NETs was significantly decreased after purified human PMNs were pretreated with oxythiamine, a TKT inhibitor, and in a concentration dependent manner. As a cofactor for TKT reaction, we evaluated the release of NET formation either in vitamin B1 treatment or in combined use of oxythiamine and vitamin B1, and found that those treatments also exerted a significant suppressive effect on the amount of NET-DNA and ROS production. The regulation of TKT by oxythiamine and/or vitamin B1 may therefore be associated with response to the modulation of NET formation by preventing generation of excessive NETs in inflammatory diseases.
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Sivaprasad M, Shalini T, Reddy PY, Seshacharyulu M, Madhavi G, Kumar BN, Reddy GB. Prevalence of vitamin deficiencies in an apparently healthy urban adult population: Assessed by subclinical status and dietary intakes. Nutrition 2019; 63-64:106-113. [DOI: 10.1016/j.nut.2019.01.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/21/2018] [Accepted: 01/21/2019] [Indexed: 10/27/2022]
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45
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Kim YN, Cho YO. Prevalent Low Thiamine Status Among Adults Living in Seoul Metropolitan Area (South Korea). INT J VITAM NUTR RES 2019; 89:314-320. [PMID: 30982440 DOI: 10.1024/0300-9831/a000489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The thiamine status of South Korean people has not been recently reported. Therefore, the aim of this study was to determine thiamine intake and status of Korean adults based on a biochemical index. Three consecutive 24-h food recalls and morning first-urine samples were obtained from 143 healthy adults (65 men and 78 women), aged 20-64 years, living in Seoul metropolitan area, Korea. Daily dietary thiamine intake of men and women was 1.42 ± 0.37 mg and 1.18 ± 0.24 mg, respectively. Only 9.1% of the subjects consumed less total thiamine (dietary plus supplemental thiamine) than the estimated average requirement for Koreans. The top 10 major dietary thiamine sources were pork, polished rice, ramyeon (Korean instant noodles), baechukimchi (Chinese cabbage), mandarin oranges, chicken, cow's milk, bread, beef, and potatoes. Those top 10 foods provided 57.85% of the subjects' dietary thiamine intake and the top 30 food sources provided 77.23% of their dietary thiamine intake. Urinary thiamine excretions for men and women were 37.20 ± 26.54 and 39.09 ± 28.80 μg/g creatinine, respectively. Urinary thiamine excretion was positively correlated with total thiamine intake (r = 0.3349, p < 0.0001). Approximately 40% of the subjects had urinary thiamine excretion < 27 μg/g creatinine, indicating thiamine deficiency. In conclusion, thiamine intake among Korean adults in this study was generally adequate, but there was a high prevalence of a low thiamine status. Further study is required to explain the incongruity of adequate intake and low thiamine status thiamine in the South Korean population.
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Affiliation(s)
- Young-Nam Kim
- Department of Food and Nutrition, Duksung Women's University, Seoul, South Korea
| | - Youn-Ok Cho
- Department of Food and Nutrition, Duksung Women's University, Seoul, South Korea
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Dhir S, Tarasenko M, Napoli E, Giulivi C. Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults. Front Psychiatry 2019; 10:207. [PMID: 31019473 PMCID: PMC6459027 DOI: 10.3389/fpsyt.2019.00207] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/22/2019] [Indexed: 01/19/2023] Open
Abstract
Thiamine (vitamin B1) is an essential nutrient that serves as a cofactor for a number of enzymes, mostly with mitochondrial localization. Some thiamine-dependent enzymes are involved in energy metabolism and biosynthesis of nucleic acids whereas others are part of the antioxidant machinery. The brain is highly vulnerable to thiamine deficiency due to its heavy reliance on mitochondrial ATP production. This is more evident during rapid growth (i.e., perinatal periods and children) in which thiamine deficiency is commonly associated with either malnutrition or genetic defects. Thiamine deficiency contributes to a number of conditions spanning from mild neurological and psychiatric symptoms (confusion, reduced memory, and sleep disturbances) to severe encephalopathy, ataxia, congestive heart failure, muscle atrophy, and even death. This review discusses the current knowledge on thiamine deficiency and associated morbidity of neurological and psychiatric disorders, with special emphasis on the pediatric population, as well as the putative beneficial effect of thiamine supplementation in autism spectrum disorder (ASD) and other neurological conditions.
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Affiliation(s)
- Shibani Dhir
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Maya Tarasenko
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Eleonora Napoli
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Cecilia Giulivi
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
- Medical Investigations of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Davis, CA, United States
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Evliyaoglu O, van Helden J, Imöhl M, Weiskirchen R. Vitamin B1 interpretation: Erroneous higher levels in non-anemic populations. Nutrition 2019; 60:25-29. [DOI: 10.1016/j.nut.2018.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/14/2018] [Accepted: 09/03/2018] [Indexed: 02/06/2023]
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Pourhassan M, Angersbach B, Lueg G, Klimek CN, Wirth R. Blood Thiamine Level and Cognitive Function in Older Hospitalized Patients. J Geriatr Psychiatry Neurol 2019; 32:90-96. [PMID: 30572755 DOI: 10.1177/0891988718819862] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM We sought to identify any association between whole blood thiamine level and functional status in older hospitalized patients. METHODS This cross-sectional study retrospectively analyzed the results of routine measurements of whole blood thiamine levels of 233 older patients who were consecutively hospitalized to a geriatric acute care ward. Nutritional status, depression, and the participants' cognitive impairment were evaluated using the Mini Nutritional Assessment-Short Form, Depression in Old Age Scale, and Montreal Cognitive Assessment, respectively. Activities of daily living were determined using Barthel Index (BI) on admission and at the time of discharge. Diagnoses of dementia and delirium were derived from the patients' medical records. RESULTS Of 233 participants (mean age 82.1 [7.1]), 47.0% and 39.0% were at risk of malnutrition and malnourished, respectively. There was no thiamine deficiency (<20 ng/mL) in total population. Nearly all patients (95%) were screened with impaired cognitive function, in which 36% and 9% had the diagnosis of dementia and delirium, respectively. Patients with dementia (P = .040) and delirium (P = .002) demonstrated lower mean thiamine blood levels compared to patients without. Mean blood vitamin B1 was higher in patients with functional recovery (change in BI ≥5 points during hospitalization; P = .018). In a binary logistic regression analysis, blood vitamin B1, weight loss, and female gender were the major independent risk factors for delirium but not for dementia. CONCLUSION Despite the absence of thiamine deficiency, whole blood thiamine was lower in patients with dementia and delirium compared to those without. Higher thiamine levels were significantly associated with functional recovery during hospitalization.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Bjoern Angersbach
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Christiane Nicola Klimek
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
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Zhang M, Liu H, Huang X, Shao L, Xie X, Wang F, Yang J, Pei P, Zhang Z, Zhai Y, Wang Q, Zhang T, Huang J, Cui X. A novel LC-MS/MS assay for vitamin B 1, B 2 and B 6 determination in dried blood spots and its application in children. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1112:33-40. [PMID: 30844694 DOI: 10.1016/j.jchromb.2019.02.028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 12/21/2022]
Abstract
Thiamin, riboflavin and pyridoxal phosphate (PLP) concentrations are useful indices for evaluating vitamin B1, B2 and B6 status. Several HPLC assays have been developed for determining thiamin, riboflavin and PLP in biological matrix. However, no existing LC-MS/MS methods can be used to quantify thiamin, riboflavin and PLP in dried blood spots (DBSs), which are often used as a sampling/storage vessel for blood from infants and children. This study evaluated the validity, reliability and stability of an LC-MS/MS assay for measuring thiamin, riboflavin and PLP in DBS cards. DBS samples were deproteinized by adding trichloroacetic acid containing thiamine-[13C4], riboflavin-[13C4,15N2] and pyridoxal-d3 as internal standards. Thiamin, riboflavin and PLP were separated on a C8 column with a 5-min run time. Both the between-run and within-run variable coefficients (CV% values) were < 8.56%. The accuracies were good and showed relative errors (RE% values) from -7.40% to 3.12%. The lower limits of quantification (LLOQs) ranged from 0.2 to 0.5 ng/mL, and the recoveries were from 81.49% to 112.23% for all 3 analytes. The matrix effects (ME% values) were acceptable, and the CV% values of the internal standard-normalized matrix factors were <15% (n = 6). Thiamin, riboflavin and PLP were stable on the DBS card during at least 15 days of room-temperature storage under vacuum in the dark, and the measurements of thiamin, riboflavin and PLP in the DBSs showed good agreement with the corresponding concentrations determined from liquid blood (R2 values >0.96). The validated method was successfully applied to the nutritional assessment of vitamins B1, B2, and B6 in 48 Chinese children.
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Affiliation(s)
- Min Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - HongJun Liu
- IPhase Pharma Services, Beijing 101111, China
| | - XiaoLan Huang
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China
| | - LiJun Shao
- IPhase Pharma Services, Beijing 101111, China
| | - XiaoLu Xie
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Fang Wang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Jian Yang
- Department of Neurology, Capital Institute of Pediatrics, Beijing 100020, China
| | - Pei Pei
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China
| | | | | | - Qian Wang
- IPhase Pharma Services, Beijing 101111, China
| | - Ting Zhang
- Beijing Municipal Key Laboratory of Child Development and Nutriomics, Capital Institute of Pediatrics, Beijing 100020, China
| | - Jian Huang
- Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - XiaoDai Cui
- Clinical Central Laboratory, Capital Institute of Pediatrics, Beijing 100020, China.
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Ray TR, Choi J, Bandodkar AJ, Krishnan S, Gutruf P, Tian L, Ghaffari R, Rogers JA. Bio-Integrated Wearable Systems: A Comprehensive Review. Chem Rev 2019; 119:5461-5533. [PMID: 30689360 DOI: 10.1021/acs.chemrev.8b00573] [Citation(s) in RCA: 432] [Impact Index Per Article: 86.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bio-integrated wearable systems can measure a broad range of biophysical, biochemical, and environmental signals to provide critical insights into overall health status and to quantify human performance. Recent advances in material science, chemical analysis techniques, device designs, and assembly methods form the foundations for a uniquely differentiated type of wearable technology, characterized by noninvasive, intimate integration with the soft, curved, time-dynamic surfaces of the body. This review summarizes the latest advances in this emerging field of "bio-integrated" technologies in a comprehensive manner that connects fundamental developments in chemistry, material science, and engineering with sensing technologies that have the potential for widespread deployment and societal benefit in human health care. An introduction to the chemistries and materials for the active components of these systems contextualizes essential design considerations for sensors and associated platforms that appear in following sections. The subsequent content highlights the most advanced biosensors, classified according to their ability to capture biophysical, biochemical, and environmental information. Additional sections feature schemes for electrically powering these sensors and strategies for achieving fully integrated, wireless systems. The review concludes with an overview of key remaining challenges and a summary of opportunities where advances in materials chemistry will be critically important for continued progress.
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Affiliation(s)
- Tyler R Ray
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
| | - Jungil Choi
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
| | - Amay J Bandodkar
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
| | - Siddharth Krishnan
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
| | - Philipp Gutruf
- Department of Biomedical Engineering University of Arizona Tucson , Arizona 85721 , United States
| | - Limei Tian
- Department of Biomedical Engineering , Texas A&M University , College Station , Texas 77843 , United States
| | - Roozbeh Ghaffari
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
| | - John A Rogers
- Northwestern University , 2145 Sheridan Road , Evanston , Illinois 60208 , United States
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