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Morasso C, Truffi M, Vanna R, Albasini S, Mazzucchelli S, Colombo F, Sorrentino L, Sampietro G, Ardizzone S, Corsi F. Raman Analysis Reveals Biochemical Differences in Plasma of Crohn's Disease Patients. J Crohns Colitis 2020; 14:1572-1580. [PMID: 32343792 DOI: 10.1093/ecco-jcc/jjaa080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUNDS AND AIMS There is no accurate and reliable circulating biomarker to diagnose Crohn's disease [CD]. Raman spectroscopy is a relatively new approach that provides information on the biochemical composition of samples in minutes and virtually without any sample preparation. We aimed to test the use of Raman spectroscopy analysis of plasma samples as a potential diagnostic tool for CD. METHODS We analysed by Raman spectroscopy dry plasma samples obtained from 77 CD patients [CD] and 45 healthy controls [HC]. In the dataset obtained, we analysed spectra differences between CD and HC, as well as among CD patients with different disease behaviours. We also developed a method, based on principal component analysis followed by a linear discrimination analysis [PCA-LDA], for the automatic classification of individuals based on plasma spectra analysis. RESULTS Compared with HC, the CD spectra were characterised by less intense peaks corresponding to carotenoids [p <10-4] and by more intense peaks corresponding to proteins with β-sheet secondary structure [p <10-4]. Differences were also found on Raman peaks relative to lipids [p = 0.0007] and aromatic amino acids [p <10-4]. The predictive model we developed was able to classify CD and HC subjects with 83.6% accuracy [sensitivity 80.0% and specificity 85.7%] and F1-score of 86.8%. CONCLUSIONS Our results indicate that Raman spectroscopy of blood plasma can identify metabolic variations associated with CD and it could be a rapid pre-screening tool to use before further specific evaluation.
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Affiliation(s)
- Carlo Morasso
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marta Truffi
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Renzo Vanna
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Sara Albasini
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Serena Mazzucchelli
- Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università degli studi di Milano, Milano, Italy
| | - Francesco Colombo
- ASST Fatebenefratelli Sacco Ospedale 'Luigi Sacco', Polo Universitario, Milano, Italy
| | | | - Gianluca Sampietro
- ASST Fatebenefratelli Sacco Ospedale 'Luigi Sacco', Polo Universitario, Milano, Italy
| | - Sandro Ardizzone
- ASST Fatebenefratelli Sacco Ospedale 'Luigi Sacco', Polo Universitario, Milano, Italy
| | - Fabio Corsi
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.,Department of Biomedical and Clinical Sciences 'Luigi Sacco', Università degli studi di Milano, Milano, Italy
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Verma P, Subodh S, Tiwari V, Rampal R, Tuteja A, Toteja GS, Gupta SD, Ahuja V. Correlation of Serum Vitamin A Levels with Disease Activity Indices and Colonic IL-23R and FOXP3 mRNA Expression in Ulcerative Colitis Patients. Scand J Immunol 2016; 84:110-7. [DOI: 10.1111/sji.12450] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 12/19/2022]
Affiliation(s)
- P. Verma
- Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences; New Delhi India
| | - S. Subodh
- The Centre for Genomic Application (An IGIB-IMM collaboration); New Delhi India
| | - V. Tiwari
- Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences; New Delhi India
| | - R. Rampal
- Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences; New Delhi India
| | - A. Tuteja
- The Centre for Genomic Application (An IGIB-IMM collaboration); New Delhi India
| | - G. S. Toteja
- ICMR laboratory in Centre for Promotion of Nutrition Research and Training with Special Focus on North- East, Tribal and Inaccessible Population; New Delhi India
| | - S. D. Gupta
- Department of Pathology; All India Institute of Medical Sciences; New Delhi India
| | - V. Ahuja
- Department of Gastroenterology and Human Nutrition; All India Institute of Medical Sciences; New Delhi India
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Abstract
Phrynoderma is a type of follicular hyperkeratosis associated with nutritional deficiencies. It is rarely seen in developed countries, although cases have been reported in patients with severe malnutrition or malabsorption secondary to various causes. This report describes a 19-year-old patient with poorly controlled Crohn's disease and malnutrition who developed the characteristic hyperkeratotic papules and plaques on his trunk and extremities in the setting of low serum vitamin A levels. To our knowledge, there are no reports of phrynoderma associated with Crohn's disease. It is likely that our patient's low vitamin A level and subsequent phrynoderma was the result of increased Crohn's disease activity and malnutrition.
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Affiliation(s)
- Gabriela Cobos
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Soares-Mota M, Silva TA, Gomes LM, Pinto MAS, Mendonça LMC, Farias MLF, Nunes T, Ramalho A, Zaltman C. High prevalence of vitamin A deficiency in Crohn's disease patients according to serum retinol levels and the relative dose-response test. World J Gastroenterol 2015; 21:1614-1620. [PMID: 25663781 PMCID: PMC4316104 DOI: 10.3748/wjg.v21.i5.1614] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Revised: 10/01/2014] [Accepted: 10/21/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the vitamin A status of patients with Crohn’s disease (CD) by evaluating serum retinol levels and the relative dose response (RDR) test (liver retinol stores).
METHODS: Vitamin A nutritional status was measured by serum retinol obtained by high performance liquid chromatography and the RDR test for evaluation of the hepatic stores. Body composition was performed by densitometry by dual-energy X-ray absorptiometry. Vitamin A dietary intake was assessed from a semi-quantitative food frequency questionnaire.
RESULTS: This study included 38 CD patients and 33 controls. Low serum retinol concentrations were detected in 29% of CD patients vs 15% in controls (P < 0.005). The RDR test was positive in 37% of CD patients vs 12% in controls, which indicated inadequate hepatic vitamin A stores (P < 0.005). Individuals with hypovitaminosis A had lower BMI and body fat compared with those without this deficiency. There was no association between vitamin A deficiency and its dietary intake, ileal location, presence of disease activity and prior bowel resections.
CONCLUSION: Patients with CD have higher prevalence of vitamin A deficiency, as assessed by two independent methods.
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De Waele B, Vierendeels T, Willems G. Vitamin status in patients with acute pancreatitis. Clin Nutr 2012; 11:83-6. [PMID: 16839977 DOI: 10.1016/0261-5614(92)90015-i] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/1991] [Accepted: 01/07/1992] [Indexed: 02/08/2023]
Abstract
The serum levels of 6 vitamins were prospectively evaluated in 20 patients with acute biliary pancreatitis and in 20 patients with acute alcoholic pancreatitis. Twenty healthy subjects acted as controls. There were no statistically significant differences in the levels of vitamin B12 and D among the groups. Patients with alcoholic pancreatitis had significantly lower levels of vitamins A, E (p < 0.01) and C (p < 0.001) than those of the control group. Plasma levels of vitamin K were decreased or undetectable in 6 patients with biliary and 3 with alcoholic pancreatitis. The pathophysiological and clinical implications of this abnormal vitamin status in patients with acute pancreatitis are unknown. Nevertheless, multi-vitamin supplementation seems justified, especially in patients affected by alcoholic pancreatitis. Vitamin K should be administered in both types of pancreatitis when blood coagulation tests are disturbed.
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Affiliation(s)
- B De Waele
- Department of Surgery, VUB University Hospital, Laarbeeklaan 101, B-1090 Brussels, Belgium
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Macular and serum carotenoid concentrations in patients with malabsorption syndromes. J Ocul Biol Dis Infor 2008; 1:12-8. [PMID: 19081745 PMCID: PMC2600549 DOI: 10.1007/s12177-008-9008-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 04/28/2008] [Indexed: 01/28/2023] Open
Abstract
The carotenoids lutein and zeaxanthin are believed to protect the human macula by absorbing blue light and quenching free radicals. Intestinal malabsorption syndromes such as celiac and Crohn’s disease are known to cause deficiencies of lipid-soluble nutrients. We hypothesized that subjects with nutrient malabsorption syndromes will demonstrate lower carotenoid levels in the macula and blood, and that these lower levels may correlate with early-onset maculopathy. Resonance Raman spectrographic (RRS) measurements of macular carotenoid levels were collected from subjects with and without a history of malabsorption syndromes. Carotenoids were extracted from serum and analyzed by high performance liquid chromatography (HPLC). Subjects with malabsorption (n = 22) had 37% lower levels of macular carotenoids on average versus controls (n = 25, P < 0.001). Malabsorption was not associated with decreased serum carotenoid levels. Convincing signs of early maculopathy were not observed. We conclude that intestinal malabsorption results in lower macular carotenoid levels.
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Hengstermann S, Valentini L, Schaper L, Buning C, Koernicke T, Maritschnegg M, Buhner S, Tillinger W, Regano N, Guglielmi F, Winklhofer-Roob BM, Lochs H. Altered status of antioxidant vitamins and fatty acids in patients with inactive inflammatory bowel disease. Clin Nutr 2008; 27:571-8. [PMID: 18316141 DOI: 10.1016/j.clnu.2008.01.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2007] [Revised: 11/01/2007] [Accepted: 01/11/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Data regarding the nutritional status, antioxidant compounds and plasma fatty acid (FA) composition in inactive IBD are conflicting. We compared plasma levels of antioxidants and FA of patients with inactive IBD with active IBD and controls. METHODS Plasma levels of vitamin C, vitamin E, carotenoids, saturated, monounsaturated and polyunsaturated FA, inflammatory markers and nutritional status were determined after an overnight fast in 132 patients with quiescent IBD (40.6+/-13.2 years, 87F/45M), 35 patients with active disease (37.9+/-12.1 years, 25F/10M) and 45 age- and BMI-matched healthy controls (38.1+/-10.5 years, 39F/6M). Results are expressed as mean+/-SD or median [25th percentile;75th percentile]. RESULTS Body mass index (BMI) was normal in inactive (23.9+/-4.7 kg/m(2)), active IBD (22.7+/-4.2 kg/m(2)) and controls (22.3+/-1.9 kg/m(2)). Compared with controls patients with quiescent IBD showed significantly decreased plasma levels of carotenoids (1.85 [1.37;2.56] vs 1.39 [0.88;1.87] micromol/L) and vitamin C (62.3 [48.7;75.0] vs 51.0 [36.4;77.6] micromol/L), increased levels of saturated FA (3879 [3380;4420] vs 3410 [3142;3989] micromol/L) and monounsaturated FA (2578 [2258;3089] vs 2044 [1836;2434] micromol/L) and similar levels of vitamin E and polyunsaturated FA. Results in active disease were similar to inactive disease. CONCLUSION This study shows that antioxidant status and FA profile in a larger population of IBD patients are disturbed independently from disease activity and despite normal overall nutritional status.
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Affiliation(s)
- Susanne Hengstermann
- Charité-Universitatsmedizin Berlin, Campus Mitte, Department of Gastroenterology, Charitéplatz 1, 10117 Berlin, Germany
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Chae T, Foroozan R. Vitamin A deficiency in patients with a remote history of intestinal surgery. Br J Ophthalmol 2006; 90:955-6. [PMID: 16774959 PMCID: PMC1857201 DOI: 10.1136/bjo.2006.092502] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS Vitamin A deficiency, often presenting with nyctalopia, has been described in a number of patients with malabsorption as a result of intestinal bypass surgery and, more recently, bariatric surgery. In these reports vitamin A deficiency developed within several years of gastric or intestinal surgery. Three patients who developed decreased vision from vitamin A deficiency more than 18 years after their intestinal surgery are reported. METHODS A retrospective review of the clinical findings of all patients diagnosed with vitamin A deficiency, as confirmed by serological testing, over the past year in a single neuro-ophthalmic practice. RESULTS Four patients with vitamin A deficiency were seen, three of whom had intestinal surgery more than 18 years before the development of visual symptoms. CONCLUSION The authors suggest that vitamin A deficiency should be suspected in patients with unexplained decreased vision and a history of intestinal surgery, regardless of the timing of the surgical procedure.
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Affiliation(s)
- T Chae
- Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA
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Abstract
Nutrition plays an important role in the pathogenesis, treatment, and morbidity of Crohn disease. Approximately two thirds to three fourths of hospitalized patients with active disease and one fourth of outpatients with Crohn disease are malnourished. Malnutrition, which can be present even when Crohn disease is in remission, can affect growth, cellular and humoral immunity, bone density, and wound healing. Decreased nutrient intake, malabsorption, drug-nutrient interactions, anorexia, and protein-losing enteropathy can all contribute to the protein-calorie malnutrition and other specific nutrient deficiencies seen in Crohn disease. Therefore, by preventing and correcting nutrient deficiencies, nutritional therapy is an important component in the overall management of patients with Crohn disease.
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Affiliation(s)
- Karen L Krok
- Center for Inflammatory Bowel Diseases, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-4283, USA
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Bousvaros A, Zurakowski D, Duggan C, Law T, Rifai N, Goldberg NE, Leichtner AM. Vitamins A and E serum levels in children and young adults with inflammatory bowel disease: effect of disease activity. J Pediatr Gastroenterol Nutr 1998; 26:129-35. [PMID: 9481625 DOI: 10.1097/00005176-199802000-00002] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hypovitaminosis and fat-soluble vitamin deficiency have been reported in adults with inflammatory bowel disease (IBD). A prospective study was undertaken to determine the prevalence of low serum levels of vitamins A and E in children and young adults with IBD. METHODS Clinical information and serum for vitamin levels was gathered prospectively from 61 patients with Crohn's disease, 36 patients with ulcerative colitis, and 23 control subjects. Disease activity and disease location were determined for IBD patients. Serum retinol and alpha-tocopherol levels were determined by high-performance liquid chromatography. RESULTS The prevalence of hypovitaminosis A (defined as serum vitamin A < 20 micrograms/dl) or hypovitaminosis E (defined as serum vitamin E < 5 mg/l) was 16% in the pediatric IBD population studied. Low vitamin A levels were more common than low vitamin E levels. Serum retinol levels correlated significantly with alpha-tocopherol levels. Hypovitaminosis was significantly more prevalent in the Crohn's disease patients who had active disease, an erythrocyte sedimentation rate of more than 25 mm/hour, or a serum albumin level less than 3 mg/dl. CONCLUSIONS Children and young adults with active IBD frequently have low serum levels of vitamin A or vitamin E. The severity of disease activity is a better predictor of risk for hypovitaminosis than is nutritional status. Further work is necessary to determine whether the hypovitaminosis seen in children with IBD reflects true deficiency.
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Affiliation(s)
- A Bousvaros
- Combined Program in Gastroenterology and Nutrition, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
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Kuroki F, Iida M, Tominaga M, Matsumoto T, Hirakawa K, Sugiyama S, Fujishima M. Multiple vitamin status in Crohn's disease. Correlation with disease activity. Dig Dis Sci 1993; 38:1614-8. [PMID: 8359072 DOI: 10.1007/bf01303168] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We measured serum, blood, or red cell concentrations of various vitamins in 24 patients with Crohn's disease who had been free from any nutritional treatment, and compared them with those in 24 healthy controls. Twelve of the patients were affected in the small bowel only, two in the large bowel only, and the remaining 10 in both the small and large bowel. The fat-soluble vitamins A and E were significantly decreased in patients with Crohn's disease compared to controls. Among the water-soluble vitamins, vitamins B1, B2 and B6 and folic acid were more depleted in patients with Crohn's disease than in the controls, whereas vitamins B12 and C, nicotinic acid, and biotin were not different between the two groups, and pantothenic acid was increased in patients with Crohn's disease. In addition, vitamin B2 and nicotinic acid showed a negative correlation with the Crohn's disease activity index. These findings suggest that there is a variety of vitamin deficiencies in Crohn's disease prior to treatment and also that concentrations of some vitamins, such as vitamin B2 and nicotinic acid, may reflect the severity of the disease.
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Affiliation(s)
- F Kuroki
- Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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