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Shinn LM, Mansharamani A, Baer DJ, Novotny JA, Charron CS, Khan NA, Zhu R, Holscher HD. Fecal Metabolites as Biomarkers for Predicting Food Intake by Healthy Adults. J Nutr 2023; 152:2956-2965. [PMID: 36040343 PMCID: PMC9840004 DOI: 10.1093/jn/nxac195] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/01/2022] [Accepted: 08/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The fecal metabolome is affected by diet and includes metabolites generated by human and microbial metabolism. Advances in -omics technologies and analytic approaches have allowed researchers to identify metabolites and better utilize large data sets to generate usable information. One promising aspect of these advancements is the ability to determine objective biomarkers of food intake. OBJECTIVES We aimed to utilize a multivariate, machine learning approach to identify metabolite biomarkers that accurately predict food intake. METHODS Data were aggregated from 5 controlled feeding studies in adults that tested the impact of specific foods (almonds, avocados, broccoli, walnuts, barley, and oats) on the gastrointestinal microbiota. Fecal samples underwent GC-MS metabolomic analysis; 344 metabolites were detected in preintervention samples, whereas 307 metabolites were detected postintervention. After removing metabolites that were only detected in either pre- or postintervention and those undetectable in ≥80% of samples in all study groups, changes in 96 metabolites relative concentrations (treatment postintervention minus preintervention) were utilized in random forest models to 1) examine the relation between food consumption and fecal metabolome changes and 2) rank the fecal metabolites by their predictive power (i.e., feature importance score). RESULTS Using the change in relative concentration of 96 fecal metabolites, 6 single-food random forest models for almond, avocado, broccoli, walnuts, whole-grain barley, and whole-grain oats revealed prediction accuracies between 47% and 89%. When comparing foods with one another, almond intake was differentiated from walnut intake with 91% classification accuracy. CONCLUSIONS Our findings reveal promise in utilizing fecal metabolites as objective complements to certain self-reported food intake estimates. Future research on other foods at different doses and dietary patterns is needed to identify biomarkers that can be applied in feeding study compliance and clinical settings.
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Affiliation(s)
- Leila M Shinn
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Aditya Mansharamani
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David J Baer
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - Janet A Novotny
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - Craig S Charron
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
| | - Naiman A Khan
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Hannah D Holscher
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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2
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Quantification of 5-Hydroxyindoleacetic Acid in Urine by Ultra-performance Liquid Chromatography Tandem Mass Spectrometry. Methods Mol Biol 2022; 2546:195-204. [PMID: 36127590 DOI: 10.1007/978-1-0716-2565-1_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Serotonin (5-hydroxytryptamine) is a neurotransmitter produced in excess by carcinoid tumors, which develop from enterochromaffin cells. 5-Hydroxyindoleacetic acid (5-HIAA) is the primary urinary metabolite of serotonin, making measurement of 5-HIAA useful in the diagnosis and management of carcinoid tumors. Here we describe a simple, inexpensive, and fast method for the detection and quantification of 5-HIAA in urine. Samples are prepared by simple 1:1 dilution. The instrumental analysis is performed by chromatographic separation on a reverse-phase analytical column followed by detection using a triple quadrupole mass spectrometer with electrospray ionization in positive ion mode. Data are acquired by multiple reaction monitoring (MRM).
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3
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Levy J, Silva AM, De Carli E, Cacau LT, de Alvarenga JFR, Fiamoncini J, Benseñor IM, Lotufo PA, Marchioni DM. Biomarkers of Fruit Intake Using a Targeted Metabolomics Approach: an Observational Cross-Sectional Analysis of the ELSA-Brasil Study. J Nutr 2022; 152:2023-2030. [PMID: 35641174 DOI: 10.1093/jn/nxac115] [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: 12/06/2021] [Revised: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Advances in technology have led to the identification of a greater number of metabolites related to diet. Although fruit intake biomarkers have been reported in some studies, these findings require further replication, considering the relevance of fruits for diet quality and health. OBJECTIVES The aim of this study was to explore the associations of a set of potential urinary biomarkers of diet, assessed using a targeted metabolomics approach, with self-reported fruit intake data in participants of a computer-assisted 24-h dietary recall (GloboDiet software) validation study. METHODS A total of 93 individuals aged 43-72 y, 54% female, participated in this study. The subjects were a subsample of the Longitudinal Study of Adult Health (ELSA-Brasil). A 24-h dietary recall was obtained with the aid of GloboDiet software matching a 24-h urine sample from each participant. Candidate biomarkers were selected in a literature search and identified in urine by LC coupled to high-resolution MS. Spearman correlation analyses were performed between fruit intake and each biomarker. RESULTS Spearman correlation analysis showed that total fruits intake was significantly correlated with citric acid (ρ = 0.213, P = 0.041), ferulic acid sulfate I (ρ = 0.240, P = 0.020), hesperetin glucuronide/homoeriodictyol glucuronide (ρ = 0.303, P = 0.003), hydroxyhippuric acid (ρ = 0.239, P = 0.021), homovanillic alcohol sulfate (ρ = 0.339, P = 0.001), methylgallic acid sulfate (ρ = 0.268, P = 0.009), naringenin glucuronide (NG; ρ = 0.278, P = 0.007), proline betaine (PB; ρ = 0.305, P = 0.003), syringic acid sulfate (ρ = 0.210, P = 0.044), and sinapic acid sulfate (ρ = 0.412, P < 0.001). Among them, 3 have been described in literature as promising biomarkers for intake of total fruit, oranges, and citrus fruit: NG, hesperetin glucuronide, and PB. CONCLUSIONS Associations of total fruits intake with urinary measurements indicate the potential usefulness of dietary biomarkers in the Brazilian population as a complement to self-reported dietary assessments.
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Affiliation(s)
- Jessica Levy
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Alexsandro Macedo Silva
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Eduardo De Carli
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Leandro Teixeira Cacau
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - José Fernando Rinaldi de Alvarenga
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Jarlei Fiamoncini
- Food Research Center (FoRC), Department of Food and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Isabela Martins Benseñor
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Paulo Andrade Lotufo
- Clinical and Epidemiological Research Center, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Dirce Maria Marchioni
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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4
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Gudra D, Dejus S, Bartkevics V, Roga A, Kalnina I, Strods M, Rayan A, Kokina K, Zajakina A, Dumpis U, Ikkere LE, Arhipova I, Berzins G, Erglis A, Binde J, Ansonska E, Berzins A, Juhna T, Fridmanis D. Detection of SARS-CoV-2 RNA in wastewater and importance of population size assessment in smaller cities: An exploratory case study from two municipalities in Latvia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 823:153775. [PMID: 35151738 PMCID: PMC8830921 DOI: 10.1016/j.scitotenv.2022.153775] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/20/2022] [Accepted: 02/06/2022] [Indexed: 05/05/2023]
Abstract
Wastewater-based epidemiology (WBE) has regained global importance during the COVID-19 pandemic. The mobility of people and other factors, such as precipitation and irregular inflow of industrial wastewater, are complicating the estimation of the disease prevalence through WBE, which is crucial for proper crisis management. These estimations are particularly challenging in urban areas with moderate or low numbers of inhabitants in situations where movement restrictions are not adopted (as in the case of Latvia) because residents of smaller municipalities tend to be more mobile and less strict in following the rules and measures of disease containment. Thus, population movement can influence the outcome of WBE measurements significantly and may not reflect the actual epidemiological situation in the respective area. Here, we demonstrate that by combining the data of detected SARS-CoV-2 RNA copy number, 5-hydroxyindoleacetic acid (5-HIAA) analyses in wastewater and mobile call detail records it was possible to provide an accurate assessment of the COVID-19 epidemiological situation in towns that are small (COVID-19 28-day cumulative incidence r = 0.609 and 35-day cumulative incidence r = 0.89, p < 0.05) and medium-sized towns (COVID-19 21-day cumulative incidence r = 0.997, 28-day cumulative incidence r = 0.98 and 35-day cumulative incidence r = 0.997, p < 0.05). This is the first study demonstrating WBE for monitoring COVID-19 outbreaks in Latvia. We demonstrate that the application of population size estimation measurements such as total 5-HIAA and call detail record data improve the accuracy of the WBE approach.
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Affiliation(s)
- Dita Gudra
- Latvian Biomedical Research and Study Centre, Ratsupites iela 1, Riga LV-1067, Latvia
| | - Sandis Dejus
- Riga Technical University, Laboratory of Water Research and Environmental Biotechnology, Kipsalas iela 6a/6b, Riga LV-1048, Latvia
| | - Vadims Bartkevics
- Institute of Food Safety, Animal Health and Environment BIOR, Lejupes iela 3, Riga LV-1067, Latvia.
| | - Ance Roga
- Latvian Biomedical Research and Study Centre, Ratsupites iela 1, Riga LV-1067, Latvia
| | - Ineta Kalnina
- Latvian Biomedical Research and Study Centre, Ratsupites iela 1, Riga LV-1067, Latvia
| | - Martins Strods
- Riga Technical University, Laboratory of Water Research and Environmental Biotechnology, Kipsalas iela 6a/6b, Riga LV-1048, Latvia
| | - Anton Rayan
- Riga Technical University, Laboratory of Water Research and Environmental Biotechnology, Kipsalas iela 6a/6b, Riga LV-1048, Latvia
| | - Kristina Kokina
- Riga Technical University, Laboratory of Water Research and Environmental Biotechnology, Kipsalas iela 6a/6b, Riga LV-1048, Latvia
| | - Anna Zajakina
- Latvian Biomedical Research and Study Centre, Ratsupites iela 1, Riga LV-1067, Latvia
| | - Uga Dumpis
- University of Latvia, Aspazijas bulvaris 5, Riga LV-1050, Latvia
| | - Laura Elina Ikkere
- Institute of Food Safety, Animal Health and Environment BIOR, Lejupes iela 3, Riga LV-1067, Latvia
| | - Irina Arhipova
- Latvia University of Life Sciences and Technologies, Liela iela 2, Jelgava LV-3001, Latvia
| | - Gundars Berzins
- University of Latvia, Aspazijas bulvaris 5, Riga LV-1050, Latvia
| | - Aldis Erglis
- University of Latvia, Aspazijas bulvaris 5, Riga LV-1050, Latvia
| | - Juris Binde
- LLC "Latvian Mobile Telephone", Ropazu iela 6, Riga LV-1039, Latvia
| | - Evija Ansonska
- University of Latvia, Aspazijas bulvaris 5, Riga LV-1050, Latvia
| | - Aivars Berzins
- Institute of Food Safety, Animal Health and Environment BIOR, Lejupes iela 3, Riga LV-1067, Latvia
| | - Talis Juhna
- Riga Technical University, Laboratory of Water Research and Environmental Biotechnology, Kipsalas iela 6a/6b, Riga LV-1048, Latvia.
| | - Davids Fridmanis
- Latvian Biomedical Research and Study Centre, Ratsupites iela 1, Riga LV-1067, Latvia.
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5
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Ciobanu OA, Martin S, Fica S. Perspectives on the diagnostic, predictive and prognostic markers of neuroendocrine neoplasms (Review). Exp Ther Med 2021; 22:1479. [PMID: 34765020 PMCID: PMC8576627 DOI: 10.3892/etm.2021.10914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/23/2021] [Indexed: 12/15/2022] Open
Abstract
Neuroendocrine neoplasms (NENs) are a heterogeneous group of rare tumors with different types of physiology and prognosis. Therefore, prognostic information, including morphological differentiation, grade, tumor stage and primary location, are invaluable and contribute to the formulation of treatment decisions. Biomarkers that are currently used, including chromogranin A (CgA), serotonin and neuron-specific enolase, are singular parameters that cannot be used to accurately predict variables associated with tumor growth, including proliferation, metabolic rate and metastatic potential. In addition, site-specific biomarkers, such as insulin and gastrin, cannot be applied to all types of NENs. The clinical application of broad-spectrum markers, as it is the case for CgA, remains controversial despite being widely used. Due to limitations of the currently available mono-analyte biomarkers, recent studies were conducted to explore novel parameters for NEN diagnosis, prognosis, therapy stratification and evaluation of treatment response. Identification of prognostic factors for predicting NEN outcome is a critical requirement for the planning of adequate clinical management. Advances in ‘liquid’ biopsies and genomic analysis techniques, including microRNA, circulating tumor DNA or circulating tumor cells and sophisticated biomathematical analysis techniques, such as NETest or molecular image-based biomarkers, are currently under investigation as potentially novel tools for the management of NENs in the future. Despite these recent findings yielding promising observations, further research is necessary. The present review therefore summarizes the existing knowledge and recent advancements in the exploration of biochemical markers for NENs, with focus on gastroenteropancreatic-neuroendocrine tumors.
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Affiliation(s)
- Oana Alexandra Ciobanu
- Department of Endocrinology and Diabetes, Elias Hospital, 011461 Bucharest, Romania.,Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 20021 Bucharest, Romania
| | - Sorina Martin
- Department of Endocrinology and Diabetes, Elias Hospital, 011461 Bucharest, Romania.,Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 20021 Bucharest, Romania
| | - Simona Fica
- Department of Endocrinology and Diabetes, Elias Hospital, 011461 Bucharest, Romania.,Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 20021 Bucharest, Romania
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6
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Pandopulos AJ, Bade R, Tscharke BJ, O'Brien JW, Simpson BS, White JM, Gerber C. Application of catecholamine metabolites as endogenous population biomarkers for wastewater-based epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 763:142992. [PMID: 33498117 DOI: 10.1016/j.scitotenv.2020.142992] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 05/24/2023]
Abstract
Wastewater-based epidemiology studies use catchment populations to normalise chemical marker mass loads in 24-h composite wastewater samples. However, one of the biggest uncertainties within the field is the accuracy of the population used. A population marker in wastewater may significantly reduce the uncertainty. This study evaluated the catecholamine metabolites - homovanillic acid (HVA) and vanillylmandelic acid (VMA) - as potential population biomarkers. Influent wastewater 24-h composite samples were collected from 38 wastewater catchments from around Australia (representing ~33% of Australia's population), extracted and analysed by liquid chromatography tandem mass spectrometry. Measured mass loads were compared to population sizes determined by mapping catchment maps against high-resolution census data. Both biomarkers correlated with coefficient of determinations (r2) of 0.908 and 0.922 for HVA and VMA, respectively. From the regression analysis, a slope (i.e. the daily per-capita excretion) of 1.241 and 1.067 mg.day-1.person-1 was obtained for HVA and VMA, respectively. The mass load ratio between VMA:HVA were very similar to that reported in literature for urinary analysis among all catchments. Overall, this study provided further evidence that catecholamine metabolites are suitable candidates as population biomarkers for future studies.
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Affiliation(s)
- Aaron J Pandopulos
- University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia
| | - Richard Bade
- University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia
| | - Benjamin J Tscharke
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, Queensland 4102, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street Woolloongabba, Queensland 4102, Australia
| | - Bradley S Simpson
- University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia
| | - Jason M White
- University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia
| | - Cobus Gerber
- University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia.
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7
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Vázquez-Manjarrez N, Ulaszewska M, Garcia-Aloy M, Mattivi F, Praticò G, Dragsted LO, Manach C. Biomarkers of intake for tropical fruits. GENES AND NUTRITION 2020; 15:11. [PMID: 32560627 PMCID: PMC7304196 DOI: 10.1186/s12263-020-00670-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022]
Abstract
Consumption of fruit and vegetable is a key component of a healthy and sustainable diet. However, their accurate dietary assessment remains a challenge. Due to errors in self-reporting methods, the available dietary information is usually biased. Biomarkers of intake constitute objective tools to better reflect the usual or recent consumption of different foods, including fruits and vegetables. Partners of The Food Biomarker Alliance (FoodBall) Project have undertaken the task of reviewing the available literature on putative biomarkers of tropical fruit intake. The identified candidate biomarkers were subject to validation evaluation using eight biological and chemical criteria. This publication presents the current knowledge on intake biomarkers for 17 tropical fruits including banana, mango, and avocado as the most widely consumed ones. Candidate biomarkers were found only for banana, avocado, and watermelon. An array of banana-derived metabolites has been reported in human biofluids, among which 5-hydroxyindole-acetic acid, dopamine sulfate, methoxyeugenol glucuronide, salsolinol sulfate, 6-hydroxy-1-methyl-1,2,3,4-tetrahydro-β-carboline-sulfate, and other catecholamine metabolites. Their validation is still at an early stage, with insufficient data on dose-response relationship. Perseitol and mannoheptulose have recently been reported as candidate biomarkers for avocado intake, while the amino acid citrulline has been associated with watermelon intake. Additionally, the examination of food composition data revealed some highly specific phytochemicals, which metabolites after absorption may be further studied as putative BFI for one or several tropical fruits. To make the field move forward, untargeted metabolomics, as a data-driven explorative approach, will have to be applied in both intervention and observational studies to discover putative BFIs, while their full validation and the establishment of dose-response calibration curves will require quantification methods at a later stage.
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Affiliation(s)
- N Vázquez-Manjarrez
- Human Nutrition Unit, Université Clermont Auvergne, INRAE, F-63000, Clermont-Ferrand, France.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - M Ulaszewska
- Research and Innovation Centre Food Quality and Nutrition, Fondazione Edmund Mach, Via Mach 1, 38010, San Michele all'Adige, Italy
| | - M Garcia-Aloy
- Biomarkers and Nutrimetabolomic Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, Campus Torribera, University of Barcelona, Barcelona, Spain.,CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Barcelona, Spain
| | - F Mattivi
- Research and Innovation Centre Food Quality and Nutrition, Fondazione Edmund Mach, Via Mach 1, 38010, San Michele all'Adige, Italy.,Department of Cellular, Computational and Integrative Biology, CIBIO, University of Trento, San Michele all'Adige, Italy
| | - G Praticò
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - L O Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - C Manach
- Human Nutrition Unit, Université Clermont Auvergne, INRAE, F-63000, Clermont-Ferrand, France.
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8
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Pandopulos AJ, Gerber C, Tscharke BJ, O'Brien J, White JM, Bade R. A sensitive analytical method for the measurement of neurotransmitter metabolites as potential population biomarkers in wastewater. J Chromatogr A 2020; 1612:460623. [DOI: 10.1016/j.chroma.2019.460623] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/09/2019] [Accepted: 10/13/2019] [Indexed: 12/17/2022]
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9
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Ewang-Emukowhate M, Nair D, Caplin M. The role of 5-hydroxyindoleacetic acid in neuroendocrine tumors: the journey so far. INTERNATIONAL JOURNAL OF ENDOCRINE ONCOLOGY 2019. [DOI: 10.2217/ije-2019-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
5-Hydroxyindole acetic acid (5-HIAA) is a surrogate marker for serotonin measurement and one of the first biochemical markers used in neuroendocrine tumors. In this review, we give a brief history of 5-HIAA and its precursor serotonin. We discuss its clinical utility and diagnostic performance in small intestinal neuroendocrine tumor and describe the challenges encountered during its analysis, historically performed in urine. The introduction of blood-based assays will help overcome some of the issues associated with its measurement in urine. The diagnostic performance of serum and plasma 5-HIAA has been shown to be comparable to that of urine 5-HIAA. Thus, analysis in either serum or plasma will provide a practical and convenient alternative to urine.
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Affiliation(s)
- Mfon Ewang-Emukowhate
- Neuroendocrine Tumour Unit, Royal Free NHS Foundation Trust, London, NW3 2QG, UK
- Department of Clinical Biochemistry, Royal Free NHS Foundation Trust, London, UK, NW3 2QG, UK
| | - Devaki Nair
- Department of Clinical Biochemistry, Royal Free NHS Foundation Trust, London, UK, NW3 2QG, UK
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Royal Free NHS Foundation Trust, London, NW3 2QG, UK
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10
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Sansone A, Lauretta R, Vottari S, Chiefari A, Barnabei A, Romanelli F, Appetecchia M. Specific and Non-Specific Biomarkers in Neuroendocrine Gastroenteropancreatic Tumors. Cancers (Basel) 2019; 11:E1113. [PMID: 31382663 PMCID: PMC6721814 DOI: 10.3390/cancers11081113] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 12/11/2022] Open
Abstract
The diagnosis of neuroendocrine tumors (NETs) is a challenging task: Symptoms are rarely specific, and clinical manifestations are often evident only when metastases are already present. However, several bioactive substances secreted by NETs can be included for diagnostic, prognostic, and predictive purposes. Expression of these substances differs between different NETs according to the tumor hormone production. Gastroenteropancreatic (GEP) NETs originate from the diffuse neuroendocrine system of the gastrointestinal tract and pancreatic islets cells: These tumors may produce many non-specific and specific substances, such as chromogranin A, insulin, gastrin, glucagon, and serotonin, which shape the clinical manifestations of the NETs. To provide an up-to-date reference concerning the different biomarkers, as well as their main limitations, we reviewed and summarized existing literature.
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Affiliation(s)
- Andrea Sansone
- Section of Medical Pathophysiology, Food Science and Endocrinology, Dept. of Experimental Medicine, Sapienza University of Rome, 00165 Rome, Italy
| | - Rosa Lauretta
- Internal Medicine, Angioloni Hospital, San Piero in Bagno, 47026 Forlì-Cesena, Italy
| | - Sebastiano Vottari
- Endocrinology Unit, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy
| | - Alfonsina Chiefari
- Endocrinology Unit, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy
| | - Agnese Barnabei
- Endocrinology Unit, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy
| | - Francesco Romanelli
- Section of Medical Pathophysiology, Food Science and Endocrinology, Dept. of Experimental Medicine, Sapienza University of Rome, 00165 Rome, Italy
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11
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Calanchini M, Tadman M, Krogh J, Fabbri A, Grossman A, Shine B. Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection. Endocr Connect 2019; 8:1082-1088. [PMID: 31265996 PMCID: PMC6652243 DOI: 10.1530/ec-19-0269] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions. AIM To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection. METHODS Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration. RESULTS We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P < 0.001) and r = +0.840 (P < 0.001) including only NEN patients. Using the 24-h urinary 5-HIAA as reference method, the AUC on ROC analysis for spot urinary 5-HIAA was 0.948 (95% CI, 0.914-0.983; P < 0.001), attaining a sensitivity of 83% and specificity of 95% using 5.3 mol/mmol as cut-off for the spot urine. The AUC among NEN patients alone was 0.945 (95% CI, 0.904-0.987; P < 0.001). CONCLUSIONS The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.
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Affiliation(s)
- Matilde Calanchini
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
- Endocrinology & Metabolism Unit, CTO A. Alesini Hospital ASL Roma 2, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Correspondence should be addressed to M Calanchini:
| | - Michael Tadman
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Jesper Krogh
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Andrea Fabbri
- Endocrinology & Metabolism Unit, CTO A. Alesini Hospital ASL Roma 2, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ashley Grossman
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
| | - Brian Shine
- Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
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Garcia-Aloy M, Hulshof PJM, Estruel-Amades S, Osté MCJ, Lankinen M, Geleijnse JM, de Goede J, Ulaszewska M, Mattivi F, Bakker SJL, Schwab U, Andres-Lacueva C. Biomarkers of food intake for nuts and vegetable oils: an extensive literature search. GENES & NUTRITION 2019; 14:7. [PMID: 30923582 PMCID: PMC6423890 DOI: 10.1186/s12263-019-0628-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/25/2019] [Indexed: 01/09/2023]
Abstract
Nuts and vegetable oils are important sources of fat and of a wide variety of micronutrients and phytochemicals. Following their intake, several of their constituents, as well as their derived metabolites, are found in blood circulation and in urine. As a consequence, these could be used to assess the compliance to a dietary intervention or to determine habitual intake of nuts and vegetable oils. However, before these metabolites can be widely used as biomarkers of food intake (BFIs), several characteristics have to be considered, including specificity, dose response, time response, stability, and analytical performance. We have, therefore, conducted an extensive literature search to evaluate current knowledge about potential BFIs of nuts and vegetable oils. Once identified, the strengths and weaknesses of the most promising candidate BFIs have been summarized. Results from selected studies have provided a variety of compounds mainly derived from the fatty fraction of these foods, but also other components and derived metabolites related to their nutritional composition. In particular, α-linolenic acid, urolithins, and 5-hydroxyindole-3-acetic acid seem to be the most plausible candidate BFIs for walnuts, whereas for almonds they could be α-tocopherol and some catechin-derived metabolites. Similarly, several studies have reported a strong association between selenium levels and consumption of Brazil nuts. Intake of vegetable oils has been mainly assessed through the measurement of specific fatty acids in different blood fractions, such as oleic acid for olive oil, α-linolenic acid for flaxseed (linseed) and rapeseed (canola) oils, and linoleic acid for sunflower oil. Additionally, hydroxytyrosol and its metabolites were the most promising distinctive BFIs for (extra) virgin olive oil. However, most of these components lack sufficient specificity to serve as BFIs. Therefore, additional studies are necessary to discover new candidate BFIs, as well as to further evaluate the specificity, sensitivity, dose-response relationships, and reproducibility of these candidate biomarkers and to eventually validate them in other populations. For the discovery of new candidate BFIs, an untargeted metabolomics approach may be the most effective strategy, whereas for increasing the specificity of the evaluation of food consumption, this could be a combination of different metabolites.
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Affiliation(s)
- Mar Garcia-Aloy
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, Campus Torribera, University of Barcelona, Barcelona, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Barcelona, Spain
| | - Paul J. M. Hulshof
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Sheila Estruel-Amades
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, Campus Torribera, University of Barcelona, Barcelona, Spain
| | - Maryse C. J. Osté
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Maria Lankinen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Johanna M. Geleijnse
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Janette de Goede
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Marynka Ulaszewska
- Department of Food Quality and Nutrition, Research Innovation Center, Fondazione Edmund Mach, Via Mach 1, 38010 San Michele all’Adige, TN Italy
| | - Fulvio Mattivi
- Department of Food Quality and Nutrition, Research Innovation Center, Fondazione Edmund Mach, Via Mach 1, 38010 San Michele all’Adige, TN Italy
- Center Agriculture Food Environment, University of Trento, San Michele all’Adige, Italy
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Ursula Schwab
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, Campus Torribera, University of Barcelona, Barcelona, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Barcelona, Spain
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Flynn N, LeFebvre A, Messahel B, Hogg SL. Olive ingestion causing a false suspicion of relapsed neuroblastoma: A case of "oliveblastoma?". Pediatr Blood Cancer 2018; 65:e27248. [PMID: 29923309 DOI: 10.1002/pbc.27248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/29/2018] [Accepted: 04/30/2018] [Indexed: 11/10/2022]
Abstract
Measurement of the urine catecholamine metabolites homovanillic acid (HVA) and vanillylmandelic acid (VMA) are the standard method for detecting disease recurrence in neuroblastoma. We present a case of abnormal concentrations of catecholamine metabolites that prompted investigations for relapsed neuroblastoma. However, further study revealed that the abnormal biochemistry was likely due to ingestion of olives. Olive ingestion should be considered when interpreting urine HVA and VMA results, and excluded if concentrations are unexpectedly abnormal.
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Affiliation(s)
- Nick Flynn
- Biochemical Genetics Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Amanda LeFebvre
- Department of Paediatric Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Boo Messahel
- Department of Paediatric Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
| | - Sarah L Hogg
- Biochemical Genetics Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge, UK
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Corcuff JB, Chardon L, El Hajji Ridah I, Brossaud J. Urinary sampling for 5HIAA and metanephrines determination: revisiting the recommendations. Endocr Connect 2017; 6:R87-R98. [PMID: 28566493 PMCID: PMC5527357 DOI: 10.1530/ec-17-0071] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 05/30/2017] [Indexed: 01/01/2023]
Abstract
CONTEXT Biogenic amines such as 5-hydroxy-indole acetic acid (5HIAA) the main metabolite of serotonin or metanephrines (catecholamines metabolites) are used as biomarkers of neuroendocrine tumours. OBJECTIVE To re-evaluate the recommendations for urinary sampling (preservatives, diet, drugs, etc.) as many of the reported analytical interferences supporting these recommendations are related to obsolete assays. METHODS Bibliographic analysis of old and modern assays concerning preservation, extraction, assay and interferences. RESULTS 5HIAA may degrade as soon as urine is excreted. Thus, acids as preservatives (hydrochloric or acetic acid) have to be immediately added. Care should be taken not to decrease the pH under 2. Urine preservative for metanephrine assays is not mandatory. Diets including serotonin-, tryptophan- and dopamine-rich foods have to be avoided depending on the biomarkers investigated (bananas, plantain, nuts, etc.). Tryptophan-rich over-the-counter formulas have to be prohibited when 5HIAA has to be assayed. Acetaminophen may interfere with electrochemical detection depending on high-pressure liquid chromatography (HPLC) parameters. No interference is known with mass spectrometric assays but with the one described for metanephrines determination. Some drugs interfere however with serotonin and catecholamines secretion and/or metabolism (monoamine oxidase inhibitors, serotonin or dopamine recapture inhibitors, etc.). CONCLUSION Revisited recommendations are provided for the diet, the drugs and the preservatives before HPLC coupled with electrochemical and mass spectrometry assays.
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Affiliation(s)
- Jean-Benoît Corcuff
- Department of Nuclear MedicineHaut Lévêque Hospital, Pessac, France
- Nutrition et Neurobiologie intégréeUMR 1286, University of Bordeaux, Bordeaux, France
- Groupe de Biologie SpécialiséeSociété Française de Médecine Nucléaire, Paris, France
| | - Laurence Chardon
- Department of BiochemistryEdouard Herriot Hospital, Lyon, France
| | | | - Julie Brossaud
- Department of Nuclear MedicineHaut Lévêque Hospital, Pessac, France
- Nutrition et Neurobiologie intégréeUMR 1286, University of Bordeaux, Bordeaux, France
- Groupe de Biologie SpécialiséeSociété Française de Médecine Nucléaire, Paris, France
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Grimaldi F, Fazio N, Attanasio R, Frasoldati A, Papini E, Angelini F, Baldelli R, Berretti D, Bianchetti S, Bizzarri G, Caputo M, Castello R, Cremonini N, Crescenzi A, Davì MV, D’Elia AV, Faggiano A, Pizzolitto S, Versari A, Zini M, Rindi G, Öberg K. Italian Association of Clinical Endocrinologists (AME) position statement: a stepwise clinical approach to the diagnosis of gastroenteropancreatic neuroendocrine neoplasms. J Endocrinol Invest 2014; 37:875-909. [PMID: 25038902 PMCID: PMC4159596 DOI: 10.1007/s40618-014-0119-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 03/29/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Franco Grimaldi
- Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, P.le S.M. della Misericordia, 15-33100, Udine, Italy
| | - Nicola Fazio
- Unit of Gastrointestinal and Neuroendocrine Tumors, European Institute of Oncology, Milan, Italy
| | | | - Andrea Frasoldati
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Enrico Papini
- Endocrinology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Francesco Angelini
- Oncology and Hematology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Roberto Baldelli
- Endocrinology Section, Regina Elena National Cancer Institute, Rome, Italy
| | - Debora Berretti
- Gastroenterology Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Sara Bianchetti
- Oncology and Hematology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Giancarlo Bizzarri
- Diagnostic Imaging Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Marco Caputo
- Dipartimento Servizi di Diagnosi e Cura, AUSL 22 Regione Veneto, Bussolengo, VR Italy
| | - Roberto Castello
- Medicina Interna ad indirizzo Endocrinologico, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nadia Cremonini
- Endocrinology Unit, Maggiore and Bellaria Hospital, Bologna, Italy
| | - Anna Crescenzi
- Pathology Unit, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - Maria Vittoria Davì
- Medicina Interna D, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Angela Valentina D’Elia
- Genetic Service, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Antongiulio Faggiano
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Stefano Pizzolitto
- Pathology Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy
| | - Annibale Versari
- Nuclear Medicine Service, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Michele Zini
- Endocrinology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy
| | - Guido Rindi
- Institute of Pathology, Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Kjell Öberg
- Department of Endocrine Oncology, University Hospital, Uppsala, Sweden
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Molero-Luis M, Serrano M, Ormazábal A, Pérez-Dueñas B, García-Cazorla A, Pons R, Artuch R. Homovanillic acid in cerebrospinal fluid of 1388 children with neurological disorders. Dev Med Child Neurol 2013; 55:559-66. [PMID: 23480488 DOI: 10.1111/dmcn.12116] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 11/29/2022]
Abstract
AIM To determine the prevalence of dopaminergic abnormalities in 1388 children with neurological disorders, and to analyse their clinical, neuroradiological, and electrophysiological characteristics. METHOD We studied biogenic amines in 1388 cerebrospinal fluid (CSF) samples from children with neurological disorders (mean age 3y 10mo, SD 4y 5mo; 712 males, 676 females. Correlations among CSF homovanillic acid (HVA) values and other biochemical, clinical, neuroradiological, and electrophysiological parameters were analysed. RESULTS Twenty-one patients with primary dopaminergic deficiencies were identified. Of the whole sample, 20% showed altered HVA. We report neurological diseases with abnormal CSF HVA values such as pontocerebellar hypoplasia, perinatal asphyxia, central nervous system infections, mitochondrial disorders, and other genetic diseases. Overlapping HVA levels between primary and secondary dopamine deficiencies were observed. Prevalence of low CSF HVA levels was significantly higher in neonatal patients (χ(2) =84.8, p<0.001). Abnormalities in white matter were associated with low CSF HVA (odds ratio 2.3, 95% confidence interval 1.5-3.5). INTERPRETATION HVA abnormalities are observed in various neurological diseases, but some are probably an unspecific finding. No clear limits for CSF HVA values pointing towards primary diseases can be stated. We report several neurological diseases showing HVA alterations. No neuroimaging traits were associated with low HVA values, except for white matter abnormalities.
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Affiliation(s)
- Marta Molero-Luis
- Neurometabolic Unit, Hospital Sant Joan de Déu and Centre for Biomedical Network Research on Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
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Ost DE, Jim Yeung SC, Tanoue LT, Gould MK. Clinical and organizational factors in the initial evaluation of patients with lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e121S-e141S. [PMID: 23649435 PMCID: PMC4694609 DOI: 10.1378/chest.12-2352] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 11/30/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This guideline is intended to provide an evidence-based approach to the initial evaluation of patients with known or suspected lung cancer. It also includes an assessment of the impact of timeliness of care and multidisciplinary teams on outcome. METHODS The applicable current medical literature was identified by a computerized search and evaluated using standardized methods. Recommendations were framed using the approach described by the Guidelines Oversight Committee of the American College of Chest Physicians. Data sources included MEDLINE and the Cochrane Database of Systematic Reviews. RESULTS Initial evaluation should include a thorough history and physical examination; CT imaging; pulmonary function tests; and hemoglobin, electrolyte, liver function, and calcium levels. Additional testing for distant metastases and paraneoplastic syndromes should be determined on the basis of these results. Paraneoplastic syndromes may have an adverse impact on cancer treatment, so they should be controlled rapidly with the goal of proceeding with definitive cancer treatment in a timely manner. Although the relationship between timeliness of care and survival is difficult to quantify, efforts to deliver timely care are reasonable and should be balanced with the need to attend to other dimensions of health-care quality (eg, safety, effectiveness, efficiency, equality, consistency with patient values and preferences). Quality care will require multiple disciplines. Although it is difficult to assess the impact, we suggest that a multidisciplinary team approach to care be used, particularly for patients requiring multimodality therapy. CONCLUSIONS The initial evaluation of patients with lung cancer should include a thorough history and physical examination, pulmonary function tests, CT imaging, basic laboratory tests, and selective testing for distant metastases and paraneoplastic syndromes.
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Affiliation(s)
- David E Ost
- Department of Pulmonary Medicine, MD Anderson Cancer Center, The University of Texas, Houston, TX.
| | - Sai-Ching Jim Yeung
- Department of Emergency Medicine, MD Anderson Cancer Center, The University of Texas, Houston, TX; Department of Endocrine, Neoplasia & Hormonal Disorders, MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - Lynn T Tanoue
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Yale University, New Haven, CT
| | - Michael K Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
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Grès S, Canteiro S, Mercader J, Carpéné C. Oxidation of high doses of serotonin favors lipid accumulation in mouse and human fat cells. Mol Nutr Food Res 2013; 57:1089-99. [DOI: 10.1002/mnfr.201200681] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 12/04/2012] [Accepted: 12/21/2012] [Indexed: 01/25/2023]
Affiliation(s)
| | - Sarah Canteiro
- Institut des Maladies Métaboliques et Cardiovasculaires (I2MC); Université de Toulouse; UPS; Toulouse; France
| | - Josep Mercader
- Institut National de la Santé et de la Recherche Médicale; INSERM U1048; Toulouse; France
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Biochemical markers for gastroenteropancreatic neuroendocrine tumours (GEP-NETs). Best Pract Res Clin Gastroenterol 2012; 26:791-802. [PMID: 23582919 DOI: 10.1016/j.bpg.2012.12.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 12/27/2012] [Indexed: 01/31/2023]
Abstract
Biochemical markers are applied in gastroenteropancreatic neuroendocrine tumours (GEP-NETs) for diagnostic, prognostic or predictive purposes. Chromogranin A is the most important general marker and it is recommended to be measured in every patient with a suspected NET, whereas Neuron Specific Enolase is elevated mainly in poorly differentiated NETs. Pancreatic Polypeptide is used in the diagnosis of pancreatic non-functioning NETs, whereas Chorionic Gonadotrophin has an adjunctive role. In the case of functioning tumours, specific markers should be sought and monitored during follow up. Endogenous hyperinsulinemia is suggested in the presence of non-suppressible insulin and proinsulin levels during hypoglycemia, whereas high fasting or stimulated gastrin levels along with elevated gastric acid output are diagnostic for the Zollinger-Ellison syndrome. Glucagon, vasoactive intestinal polypeptide (VIP) and somatostatin are markers for glucagonoma, VIP-oma and somatostatinoma syndromes respectively. In case of ectopic paraneoplastic syndrome, the relevant hormone serves as a diagnostic and prognostic marker.
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21
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Lin JW, Shih CM, Chen YC, Lin CM, Tsai JT, Chiang YH, Shih R, Chiu PL, Hung KS, Yeh YS, Wei L, Chiu WT, Yang LY. Biochemical alteration in cerebrospinal fluid precedes behavioral deficits in Parkinsonian rats induced by 6-hydroxydopamine. ACTA ACUST UNITED AC 2009; 72 Suppl 2:S55-65; discussion S65. [DOI: 10.1016/j.wneu.2009.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 09/06/2009] [Indexed: 12/25/2022]
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Anderson GM, Czarkowski K, Ravski N, Epperson CN. Platelet serotonin in newborns and infants: ontogeny, heritability, and effect of in utero exposure to selective serotonin reuptake inhibitors. Pediatr Res 2004; 56:418-22. [PMID: 15240861 DOI: 10.1203/01.pdr.0000136278.23672.a0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Ontogeny of platelet serotonin (5-hydroxytryptamine, 5-HT) during the first year of life was examined in newborns and infants. The effects of in utero exposure to selective serotonin reuptake inhibitors (SSRI, including fluoxetine, sertraline, and citalopram) were examined by comparing cord blood 5-HT levels in exposed and unexposed newborns. Heritability was assessed by correlation of the platelet 5-HT values observed for mother-infant pairs. No age effect was observed in 1-49 wk-old infants (r = 0.13, p = 0.49) and mean platelet 5-HT levels in infants (241 +/- 102 ng/mL, n = 33; 615 +/- 320 ng/10(9) platelets, n = 32) were similar to those reported for older children and adults. However, significantly lower blood 5-HT levels were observed in newborns (81.3 +/- 32.5 ng/mL, n = 16, p < 0.0001; 297 +/- 101 ng/10(9) platelets, n = 11, p = 0.0007) compared with the 1-49 wk-old infants. The mean cord blood 5-HT concentrations in newborns exposed in utero to SSRI (n = 8) were substantially lower than that seen in unexposed (n = 16) newborns (20.6 +/- 14.4 versus. 81.3 +/- 32.5 ng/mL, p = 0.0001; 90.7 +/- 55.4 versus. 297 +/- 101 ng/10(9) platelets, p = 0.0005). Platelet serotonin levels (ng/10(9) platelets) in mother-child pairs (n = 32) were significantly correlated (r = 0.415, p = 0.018). The results indicate that, although platelet 5-HT is low at birth, values quickly increase and stabilize at near-adult levels by 1 mo of age. Gestational exposure to SSRI appears to substantially reduce platelet 5-HT uptake in the fetus, strongly suggesting that such exposure has important physiologic effects. The observed mother-infant correlation agrees with a previous report of high heritability in a large adult population.
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Affiliation(s)
- George M Anderson
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
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Taşdemir HA, Cetinkaya MC, Polat C, Belet U, Kalayci AG, Akbaş S. Gallbladder motility in children with Down syndrome. J Pediatr Gastroenterol Nutr 2004; 39:187-91. [PMID: 15269626 DOI: 10.1097/00005176-200408000-00012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE The aim of this study was to investigate gallbladder motility in children with Down syndrome by measuring gall-bladder volume and contraction index. METHODS This study, performed between January 2001 and December 2002 at the Ondokuz Mayis University, School of Medicine, Department of Paediatric Neurology, Samsun, Turkey, included 21 patients with Down syndrome (study group) and 22 healthy children (control group). After an 8-hour fast, gallbladder diameters in both groups were measured in length, width, and height by ultrasonography before and 30 minutes after a test meal. The volume of gallbladder before and after a test meal was determined, and the contraction index was calculated. Blood triglyceride and cholesterol levels were measured, and 5-hydroxyindoleacetic acid (5-HIAA) levels in urine were determined. RESULTS Mean gallbladder volume before test meal in the study group and controls was 8,412.4 +/- 5,174 mm and 16,516.8 +/- 6,796.1 mm (P < 0.001), respectively. The mean contraction index of the study group was 41.2% +/- 19.4% and of controls, 75.0% +/- 12.3% (P < 0.001). The mean triglyceride level of the study group was significantly higher than controls (P < 0.05). The mean urine 5-HIAA level of the study group was lower than controls (P < 0.05). CONCLUSION CI was lower in patients with Down syndrome, suggesting gallbladder hypomotility. Hypomotility may be a feature associated with the high prevalence of gallstones in Down syndrome.
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Weldin J, Jack R, Dugaw K, Kapur RP. Quercetin, an over-the-counter supplement, causes neuroblastoma-like elevation of plasma homovanillic acid. Pediatr Dev Pathol 2003; 6:547-51. [PMID: 15018454 DOI: 10.1007/s10024-003-5061-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A 22-month-old boy, who regularly consumed the oral dietary supplement, quercetin, was suspected erroneously of having a catecholamine-producing tumor, based on elevated serum and urine levels of the dopamine metabolite, homovanillic acid (HVA). Subsequent studies of healthy adult volunteers showed that significant elevations in plasma HVA are a consequence of quercetin ingestion.
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Affiliation(s)
- Josh Weldin
- Department of Pediatrics, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98195, USA
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Kroll CA, Magera MJ, Helgeson JK, Matern D, Rinaldo P. Liquid Chromatographic–Tandem Mass Spectrometric Method for the Determination of 5-Hydroxyindole-3-acetic Acid in Urine. Clin Chem 2002. [DOI: 10.1093/clinchem/48.11.2049] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Charles A Kroll
- Biochemical Genetics Laboratory, Department of Laboratory Medicine & Pathology, Mayo Clinic and Foundation, Rochester, MN 55905
| | - Mark J Magera
- Biochemical Genetics Laboratory, Department of Laboratory Medicine & Pathology, Mayo Clinic and Foundation, Rochester, MN 55905
| | - Janice K Helgeson
- Biochemical Genetics Laboratory, Department of Laboratory Medicine & Pathology, Mayo Clinic and Foundation, Rochester, MN 55905
| | - Dietrich Matern
- Biochemical Genetics Laboratory, Department of Laboratory Medicine & Pathology, Mayo Clinic and Foundation, Rochester, MN 55905
| | - Piero Rinaldo
- Biochemical Genetics Laboratory, Department of Laboratory Medicine & Pathology, Mayo Clinic and Foundation, Rochester, MN 55905
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26
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Wevers RA, de Rijk-van Andel JF, Bräutigam C, Geurtz B, van den Heuvel LP, Steenbergen-Spanjers GC, Smeitink JA, Hoffmann GF, Gabreëls FJ. A review of biochemical and molecular genetic aspects of tyrosine hydroxylase deficiency including a novel mutation (291delC). J Inherit Metab Dis 1999; 22:364-73. [PMID: 10407773 DOI: 10.1023/a:1005539803576] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
An overview is given of the current knowledge on the human tyrosine hydroxylase gene and on the biochemical aspects of diagnosing defects in this gene. Diagnostic biochemical findings are described in four cases of genetically confirmed tyrosine hydroxylase deficiency. Decreased CSF levels of homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG), together with normal pterin and CSF tyrosine and 5-hydroxyindoleacetic acid (5-HIAA) concentrations are the diagnostic hallmarks of tyrosine hydroxylase deficiency. At the metabolite level the diagnosis can only be made reliably in CSF. Strict adherence to a standardized lumbar puncture protocol and adequate reference values are essential for diagnosis of this 'new' treatable neurometabolic disorder. Measurements of HVA, vanillylmandelic acid (VMA) or catecholamines in urine are not relevant for diagnosing tyrosine hydroxylase deficiency. The diagnosis should be considered in all children with unexplained hypokinesia and other extrapyramidal symptoms. Three of our patients are homozygous for a mutation in exon 6 (698G > A) of the tyrosine hydroxylase gene and one patient was compound heterozygous for the same mutation and a novel truncating mutation in exon 3 (291delC).
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Affiliation(s)
- R A Wevers
- Institute of Neurology, University Hospital Nijmegen, The Netherlands.
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Bräutigam C, Wevers RA, Jansen RJT, Smeitink JAM, Andel JFDRV, Gabreëls FJM, Hoffmann GF. Biochemical hallmarks of tyrosine hydroxylase deficiency. Clin Chem 1998. [DOI: 10.1093/clinchem/44.9.1897] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
We report the biochemical hallmarks of tyrosine hydroxylase deficiency with emphasis on reliable diagnostic strategies of four new cases of an inborn error of tyrosine hydroxylase (TH). Three of our patients from different parts of the Netherlands were found homozygous for a mutation in exon 6 (G698A) of the TH gene, and one patient was found compound heterozygous for the same mutation and an additional mutation in exon 3. The first clinical symptoms of hypokinesia, rigidity of arms and legs and axial hypotonia, developed between 3 and 7 months of age. Cerebrospinal fluid investigations revealed a characteristic metabolite constellation in every case: low homovanillic acid (HVA) and 3-methoxy-4-hydroxy-phenylethyleneglycol concentrations in the presence of normal reference range 5-hydroxyindolacetic acid concentrations. Strict adherence to a standardized lumbar puncture protocol and adequate age-related reference values are essential for diagnosis of this “new” treatable neurometabolic disorder. Urinary measurements of HVA, vanillylmandelic acid, and catecholamines can lead to false-negative conclusions. All patients showed a remarkable clinical improvement on a low dose of l-dihydroxyphenylalanine/(S)-2-(3,4-dihydroxybenzyl)-2-hydrazinpropionic acid. During treatment, cerebrospinal fluid HVA, and 3-methoxy-4-hydroxy-phenylethyleneglycol increased substantially.
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Affiliation(s)
- Christa Bräutigam
- Department of Neuropaediatrics and Metabolic Diseases, University Hospital, D-35037 Marburg, Germany
| | - Ron A Wevers
- Department of Neurology, University Hospital Nijmegen, 6525 GC Nijmegen, The Netherlands
| | - Riet J T Jansen
- Department of Neurology, University Hospital Nijmegen, 6525 GC Nijmegen, The Netherlands
| | - Jan A M Smeitink
- Department of Neurology, University Hospital Nijmegen, 6525 GC Nijmegen, The Netherlands
| | | | - Fons J M Gabreëls
- Department of Neurology, University Hospital Nijmegen, 6525 GC Nijmegen, The Netherlands
| | - Georg F Hoffmann
- Department of Neuropaediatrics and Metabolic Diseases, University Hospital, D-35037 Marburg, Germany
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