Copper deficiency as a cause of neutropenia in a case of coeliac disease

Anorexia Nervosa-What Has Changed in the State of Knowledge about Nutritional Rehabilitation for Patients over the Past 10 Years? A Review of Literature

Anorexia nervosa (AN) is a psycho-metabolic disorder with a high risk of somatic complications such as refeeding syndrome (RFS) and carries the highest mortality rate of all psychiatric illnesses. To date, the consensus on the care for patients with AN has been based on recommendations for a combination of alimentation and psychotherapy. It is important to establish an initial caloric intake that will provide weight gain and minimize the risk of complications in the treatment of undernourished patients. Research over the past few years suggests that current treatment recommendations may be too stringent and should be updated. The aim of this paper is to systematize the current reports on nutritional rehabilitation in AN, to present the results of studies on the safe supplementation of patients and its potential impact on improving prognosis and the healing process. This review of literature, from 2011-2021, describes the changing trend in the nutritional protocols used and the research on their efficacy, safety, and long-term effects. In addition, it presents previous reports on the potential benefits of introducing vitamin, pro-and prebiotic and fatty acid supplementation.

Proteomic Analysis of Copper Toxicity in Human Fungal Pathogen Cryptococcus neoformans

Cryptococcus neoformans is an invasive human fungal pathogen that causes more than 181,000 deaths each year. Studies have demonstrated that pulmonary C. neoformans infection induces innate immune responses involving copper, and copper detoxification in C. neoformans improves its fitness and pathogenicity during pulmonary C. neoformans infection. However, the molecular mechanism by which copper inhibits C. neoformans proliferation is unclear. We used a metallothionein double-knockout C. neoformans mutant that was highly sensitive to copper to demonstrate that exogenous copper ions inhibit fungal cell growth by inducing reactive oxygen species generation. Using liquid chromatography-tandem mass spectrometry, we found that copper down-regulated factors involved in protein translation, but up-regulated proteins involved in ubiquitin-mediated protein degradation. We propose that the down-regulation of protein synthesis and the up-regulation of protein degradation are the main effects of copper toxicity. The ubiquitin modification of total protein and proteasome activity were promoted under copper stress, and inhibition of the proteasome pathway alleviated copper toxicity. Our proteomic analysis sheds new light on the antifungal mechanisms of copper.

Hyperregenerative macrocytic anaemia: the role of copper and zinc

In a patient with a history of bariatric surgery, severe copper deficiency presenting with macrocytic hyperregenerative anaemia was diagnosed. Besides the impaired intestinal absorption due to a short bowel syndrome, the enteral zinc supplementation competitively decreased the intestinal copper uptake. Once the zinc supplementation was stopped, enteral copper replacement ensued and normalised haemoglobin levels with decreasing median corpuscular volume were observed during follow-up visits.

Simple admixture of 4-nitrobenzaldehyde and 2,4-dimethylpyrrole for efficient colorimetric sensing of copper(II) ions

An easily accessible chemo-probe based on physical mixture of 2,4-dimethylpyrrole and 4-nitrobenzaldehyde has been developed. Based on NMR spectroscopic analysis, catalyst free formation of dipyrromethane was observed in the physical mixture of chemo-probe. The probe is utilized in effective colorimetric sensing of copper(II) ions present in environmental solutions by instantaneous appearance of red colour, even in the co-existence of various metal ions. The lowest detection limit of 2.51 μM for this chemo-probe towards copper(II) sensing is significantly lower than the WHO prescribed level (<30 μM of copper(II) ions) in potable water. The sensing mechanism is explained via rapid formation of bis(dipyrrinato)copper(II) complex, as confirmed by Jobs plot, UV-Vis spectroscopy and IR spectroscopy.

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

Introduction: Anorexia nervosa (AN) is a complex psychiatric disorder, which can lead to specific somatic complications. Undernutrition is a major diagnostic criteria of AN which can be associated with several micronutrients deficiencies. Objectives: This study aimed to determinate the prevalence of micronutrients deficiencies and to compare the differences between the two subtypes of AN (restricting type (AN-R) and binge-eating/purging type (AN-BP)). Methods: We report a large retrospective, monocentric study of patients hospitalized in a highly specialized nutrition unit between January 2011 and August 2017 for severe malnutrition treatment in the context of anorexia nervosa. Results: Three hundred and seventy-four patients (360 (96%) women, 14 (4%) men), age: 31.3 ± 12.9 years, Body Mass Index (BMI): 12.5 ± 1.7 kg/m² were included; 253 (68%) patients had AN-R subtype while, 121 (32%) had AN-BP. Zinc had the highest deficiency prevalence 64.3%, followed by vitamin D (54.2%), copper (37.1%), selenium (20.5%), vitamin B1 (15%), vitamin B12 (4.7%), and vitamin B9 (8.9%). Patients with AN-BP type had longer disease duration, were older, and had a lower left ventricular ejection fraction (LVEF) (p < 0.001, p = 0.029, p = 0.009), when compared with AN-R type, patients who instead, had significantly higher Alanine Aminotransferase (ALT) and Brain Natriuretic Peptide (BNP) levels (p < 0.001, p < 0.021). In the AN-BP subgroup, as compared to AN-R, lower selenium (p < 0.001) and vitamin B12 plasma concentration (p < 0.036) were observed, whereas lower copper plasma concentration was observed in patients with AN-R type (p < 0.022). No significant differences were observed for zinc, vitamin B9, vitamin D, and vitamin B1 concentrations between the two types of AN patients. Conclusion: Severely malnourished AN patients have many micronutrient deficiencies. Differences between AN subtypes are identified. Micronutrients status of AN patients should be monitored and supplemented to prevent deficiencies related complications and to improve nutritional status. Prospective studies are needed to explore the symptoms and consequences of each deficiency, which can aggravate the prognosis during recovery.

The Role of Copper Homeostasis at the Host-Pathogen Axis: From Bacteria to Fungi

Copper is an essential trace element participating in many vital biological processes, however it becomes a toxic agent when in excess. Thus, precise and tight regulation of copper homeostasis processes, including transport, delivery, storage, detoxification, and efflux machineries, is important, ensuring that only the amount needed to sustain basic biological functions and simultaneously prevent copper toxicity in the cell is maintained. Numerous exciting studies have revealed that copper plays an indispensable role at the microbial pathogen-host axis for entities ranging from pathogenic bacteria to deadly fungal species. Analyses of copper homeostases in bacteria and fungi extensively demonstrate that copper is utilized by the host immune system as an anti-microbial agent. The expression of copper efflux and detoxification from microbial pathogens is induced to counteract the host's copper bombardment, which in turn disrupts these machineries, resulting in the attenuation of microbial survival in host tissue. We hereby review the latest work in copper homeostases in pathogenic bacteria and fungi and focus on the maintenance of a copper balance at the pathogen-host interaction axis.