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Chen T, Jin M, Chen L, Cai XX, Huang Y, Shen K, Li Y, Chen X, Chen L. Rapid detection of depression by volatile organic compounds from exhalation. J Breath Res 2024; 18:046013. [PMID: 39317233 DOI: 10.1088/1752-7163/ad7eef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/24/2024] [Indexed: 09/26/2024]
Abstract
Depression is a pervasive and often undetected mental health condition, which poses significant challenges for early diagnosis due to its silent and subtle nature. To evaluate exhaled volatile organic compounds (VOCs) as non-invasive biomarkers for the detection of depression using a virtual surface acoustic wave sensors array (VSAW-SA). A total of 245 participants were recruited from the Hangzhou Community Health Service Center, including 38 individuals diagnosed with depression and 207 control subjects. Breath samples were collected from all participants and subjected to analysis using VSAW-SA. Univariate and multivariate analyses were employed to assess the relationship between VOCs and depression. The findings revealed that the responses of virtual sensor ID 14, 44, 59, and 176, which corresponded respectively to ethanol, trichloroethylene or isoleucine, octanoic acid or lysine, and an unidentified compound, were sensitive to depression. Taking into account potential confounders, these sensor responses were utilized to calculate a depression detection indicator. It has a sensitivity of 81.6% and a specificity of 81.6%, with an area under the curve of 0.870 (95% CI = 0.816-0.923). Conclusions: exhaled VOCs as non-invasive biomarkers of depression could be detected by a VSAW-SA. Large-scale cohort studies should be conducted to confirm the potential ability of the VSAW-SA to diagnose depression.
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Affiliation(s)
- Tao Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
- Jianqiao Community Health Service Center, Shangcheng District, Hangzhou 310021, People's Republic of China
| | - Mengqi Jin
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Liqing Chen
- Jianqiao Community Health Service Center, Shangcheng District, Hangzhou 310021, People's Republic of China
| | - Xi Xuan Cai
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Yilin Huang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Keqing Shen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Yi Li
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of Ministry of Education of China, Zhejiang Provincial Key Laboratory of Cardio Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, Zhejiang 310027, People's Republic of China
- Hangzhou Zillion M&C Technology Co., Ltd, Hangzhou 310051, People's Republic of China
| | - Xing Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
- Department of Biomedical Engineering, Key Laboratory of Biomedical Engineering of Ministry of Education of China, Zhejiang Provincial Key Laboratory of Cardio Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Zhejiang University, Hangzhou, Zhejiang 310027, People's Republic of China
| | - Liying Chen
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
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Ghannoum M, Waters PJ, Hovda KE, Choquette G, Elgstøen KBP, Nygaard I, Rootwelt H, Hickey D, Yazdani M, Bourque DK. Can endogenous ethylene glycol production occur in humans? A detailed investigation of adult monozygotic twin sisters. Clin Toxicol (Phila) 2024:1-9. [PMID: 39327950 DOI: 10.1080/15563650.2024.2401076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 08/23/2024] [Accepted: 08/30/2024] [Indexed: 09/28/2024]
Abstract
INTRODUCTION To the best of our knowledge, clinically significant endogenous ethylene glycol production has never been reported in humans, very seldom reported in other animals or microorganisms, and then only under rare and specific conditions. We describe the detailed investigations we undertook in two adult monozygotic twin sisters to ascertain whether they were producing endogenous ethylene glycol. METHODS Two previously healthy monozygotic adult twin sisters presented with recurrent episodes of apparent ethylene glycol poisoning beginning at age 35, requiring chronic hemodialysis to remove ethylene glycol and its metabolites as well as to restore metabolic homeostasis. The sisters denied ingestion or exposure to ethylene glycol. At their request, they were admitted to hospital under strict supervision to exclude surreptitious ingestion of ethylene glycol and to evaluate the need for treatment. Hemodialysis was withheld during this prospective study. Twin A was admitted for 14 days and twin B for 11 days. Serial biochemical analyses were performed in blood and urine. Clinical exome sequencing and mitochondrial deoxyribonucleic acid sequencing were also completed. RESULTS In both twins, ethylene glycol was detected in urine, along with intermittent increases in concentrations of lactate, glycolate, and glycine in blood and/or urine. Blood ethylene glycol concentrations, however, remained <62 mg/L (<1 mmol/L) but became positive soon after discharge. The oxalate concentration remained normal in blood and urine. Plasma and urine amino acid profiles showed intermittent small increases in glycine, serine, taurine, proline, and/or alanine concentrations. Exome sequencing and mitochondrial deoxyribonucleic acid sequencing were non-diagnostic. Neither twin has been admitted with metabolic acidosis nor ethylene glycol poisoning since chronic hemodialysis was started. Twin A developed a calcium oxalate dihydrate lithiasis. DISCUSSION Mitochondrial disease, methylmalonic/propionic/isovaleric aciduria, primary hyperoxaluria, and analyte error were all excluded in these twins, as were obvious common environmental exposures. CONCLUSION Detailed investigations were performed in adult monozygotic twin sisters to ascertain whether they were producing endogenous ethylene glycol. Alternative explanations were excluded to the very best of our efforts and knowledge. Global metabolomics, gut microbiome analyses, and whole genome sequencing are pending.
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Affiliation(s)
- Marc Ghannoum
- National Poisons Information Centre, Utrecht University Medical Center, Utrecht, the Netherlands
- Department of Nephrology, Bathurst hospital, Bathurst, NB, Canada
| | - Paula J Waters
- Division of Medical Genetics, University of Sherbrooke Hospital Centre (CHUS), Sherbrooke, QC, Canada
| | - Knut Erik Hovda
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- National Poison Information Centre, Institute of Public Health, Oslo, Norway
| | | | | | - Ilah Nygaard
- Department of Pharmacology, Oslo University Hospital, Oslo, Norway
| | - Helge Rootwelt
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Dean Hickey
- Department of Nephrology, Bathurst hospital, Bathurst, NB, Canada
| | - Mazyar Yazdani
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Danielle K Bourque
- Division of Metabolics and Newborn Screening, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada
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3
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Mbaye B, Wasfy RM, Alou MT, Borentain P, Gerolami R, Dufour JC, Million M. A catalog of ethanol-producing microbes in humans. Future Microbiol 2024; 19:697-714. [PMID: 38700288 PMCID: PMC11259083 DOI: 10.2217/fmb-2023-0250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/13/2024] [Indexed: 05/05/2024] Open
Abstract
Aim: Endogenous ethanol production emerges as a mechanism of nonalcoholic steatohepatitis, obesity, diabetes and auto-brewery syndrome. Methods: To identify ethanol-producing microbes in humans, we used the NCBI taxonomy browser and the PubMed database with an automatic query and manual verification. Results: 85 ethanol-producing microbes in human were identified. Saccharomyces cerevisiae, Candida and Pichia were the most represented fungi. Enterobacteriaceae was the most represented bacterial family with mainly Escherichia coli and Klebsiella pneumoniae. Species of the Lachnospiraceae and Clostridiaceae family, of the Lactobacillales order and of the Bifidobacterium genus were also identified. Conclusion: This catalog will help the study of ethanol-producing microbes in human in the pathophysiology, diagnosis, prevention and management of human diseases associated with endogenous ethanol production.
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Affiliation(s)
- Babacar Mbaye
- Aix Marseille Université, AP-HM, MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Reham Magdy Wasfy
- Aix Marseille Université, AP-HM, MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Maryam Tidjani Alou
- Aix Marseille Université, AP-HM, MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
| | - Patrick Borentain
- Department of Hepatology, La Timone University Hospital, AP-HM, Marseille, France
| | - Rene Gerolami
- Aix Marseille Université, AP-HM, MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
- Department of Hepatology, La Timone University Hospital, AP-HM, Marseille, France
| | - Jean-Charles Dufour
- INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Aix Marseille University, 13385 Marseille, France
- APHM, Hôpital de la Timone, Service Biostatistique et Technologies de l'Information et de la Communication, 13385 Marseille, France
| | - Matthieu Million
- Aix Marseille Université, AP-HM, MEPHI, Institut Hospitalo-Universitaire Méditerranée Infection, Marseille, France
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4
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Patel P, Patel D, Gutlapalli SD, Okorie IJ, Onana AE, Ugwendum D, Arrey Agbor DB, Munoh Kenne F, Otterbeck P, Nfonoyim J. The Associations of Auto-Brewery Syndrome and Diabetes Mellitus: A Literature Review and Clinical Perspective. Cureus 2023; 15:e41924. [PMID: 37588335 PMCID: PMC10425700 DOI: 10.7759/cureus.41924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/15/2023] [Indexed: 08/18/2023] Open
Abstract
Endogenous production of alcohol without the external intake of alcohol is called auto-brewery syndrome (ABS), and to get its levels to rise to a level that it has physical symptoms of alcohol intake is rare. The most common cause of ABS is the metabolism of ingested carbohydrates by intestinal microflora. This occurrence does not happen in all normal individuals but only in some high-risk individuals. Patients with diabetes mellitus (DM) have been hypothesized to be at high risk for ABS. We searched databases, such as PubMed, Medline, and PubMed Central, to search for existing literature with relevant keywords. In the finalized review, we have included 30 relevant articles. Alcohol formed in the gut gets absorbed in the bloodstream and immediately gets metabolized, so usually it does not achieve a level in blood high enough to cause symptoms. In high-risk patients, there is an increase in the level of bloodstream alcohol above a certain level, so it shows symptoms. Because there is higher blood glucose in DM, the patients have been shown to be at increased risk for developing ABS. Similarly, obesity is also a risk factor for DM, making it a high-risk condition for ABS. The most involved pathogens are Candida and Saccharomyces.
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Affiliation(s)
- Priyansh Patel
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Department of Internal Medicine, Baroda Medical College, Vadodara, IND
| | - Diya Patel
- Department of Internal Medicine, Gujarat Medical Education & Research Society, Sola, Ahmedabad, IND
| | - Sai Dheeraj Gutlapalli
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
- Department of Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ikpechukwu J Okorie
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
| | - Arnold E Onana
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
| | - Derek Ugwendum
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
| | | | - Foma Munoh Kenne
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
| | - Philip Otterbeck
- Department of Internal Medicine, Richmond University Medical Center, New York, USA
| | - Jay Nfonoyim
- Department of Pulmonary and Critical Care Medicine, Richmond University Medical Center, New York, USA
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5
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Paramsothy J, Gutlapalli SD, Ganipineni VDP, Okorie IJ, Ugwendum D, Piccione G, Ducey J, Kouyate G, Onana A, Emmer L, Arulthasan V, Otterbeck P, Nfonoyim J. Understanding Auto-Brewery Syndrome in 2023: A Clinical and Comprehensive Review of a Rare Medical Condition. Cureus 2023; 15:e37678. [PMID: 37206535 PMCID: PMC10189828 DOI: 10.7759/cureus.37678] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/21/2023] Open
Abstract
Auto-brewery syndrome (ABS) occurs when the gastrointestinal tract produces excessive endogenous ethanol. This article examines various aspects of ABS such as its epidemiology, underlying etiology, diagnostic difficulties, management strategies, and social implications. By synthesizing the existing medical literature, we hope to identify understanding gaps, pave the way for further research, and ultimately improve detection, treatment, and awareness. The databases we used are PubMed, PubMed Central, and Google Scholar. We carefully screened all published articles from inception till date and narrowed down 24 relevant articles. We at Richmond University Medical Center and Mount Sinai are one of the leading medical centers for diagnosing and treating this rare condition in the United States.
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Affiliation(s)
- Jananthan Paramsothy
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Sai Dheeraj Gutlapalli
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
- Internal Medicine Clinical Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Vijay Durga Pradeep Ganipineni
- General Medicine, SRM Medical College Hospital and Research Center, Chennai, IND
- General Medicine, Andhra Medical College/King George Hospital, Visakhapatnam, IND
- Internal Medicine, Thomas Hospital Infirmary Health, Fairhope, USA
| | - Ikpechukwu J Okorie
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Derek Ugwendum
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - GianPaolo Piccione
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - James Ducey
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Gnama Kouyate
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Arnold Onana
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Louis Emmer
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Vaithilingam Arulthasan
- Internal Medicine, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Philip Otterbeck
- Endocrinology, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
| | - Jay Nfonoyim
- Pulmonary and Critical Care, Richmond University Medical Center Affiliated with Mount Sinai Health System and Icahn School of Medicine at Mount Sinai, Staten Island, USA
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6
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Ser MH, Calikusu FZ, Erener N, Destanoğlu O, Siva A. Auto brewery syndrome from the perspective of the neurologist. J Forensic Leg Med 2023; 96:102514. [PMID: 37004374 DOI: 10.1016/j.jflm.2023.102514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 03/04/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND AND PURPOSE Auto-brewery syndrome (ABS) is a rare condition that causes the digestive system to produce intoxicating amounts of alcohol due to abnormal growth of the gut microbiota. Medicolegal inferences of ABS have two distinct edges. First, malingering in drunk-driving and abusing the syndrome as a factitious disorder may occur. Second, patients suffering from the syndrome may face medicolegal and social problems. Moreover, chronic exposure to alcohol due to undiagnosed ABS might result in cognitive and behavioral disturbances. Here, we present a patient with recurrent encephalopathy episodes and chronic cognitive disturbances, who was diagnosed with the auto-brewery syndrome, to emphasize the neurocognitive consequences of the syndrome. CASE PRESENTATION A 58 years old female presented with mild cognitive impairment, behavioral disturbances, and recurrent encephalopathy episodes. The history of hemicolectomy, an odd smell on her breath, and cravings for high carbohydrate meals during the paroxysmal episodes raised the suspicion of ABS. Her blood ethanol concentration reached 315 mg/dL following an oral glucose tolerance test (OGTT), and stool analysis revealed increased colonization with C. krusei and C. parapsilosis. She was free of the acute episodes, cognitive and behavioral disturbances improved, and C. krusei and C. parapsilosis were eliminated from the intestinal flora with dietary recommendations and nystatin treatment. CONCLUSION The auto brewery syndrome is a rare disorder of dysbiosis leading to a disturbed gut-brain axis. Being a treatable and relatively benign diagnosis, presentation of the ABS with neurocognitive disturbances necessitates highlighting.
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7
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Smędra A, Trzmielak M, Góralska K, Dzikowiec M, Brzeziańska-Lasota E, Berent J. Oral form of auto-brewery syndrome. J Forensic Leg Med 2022; 87:102333. [DOI: 10.1016/j.jflm.2022.102333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
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8
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Sukul P, Grzegorzewski S, Broderius C, Trefz P, Mittlmeier T, Fischer DC, Miekisch W, Schubert JK. Physiological and metabolic effects of healthy female aging on exhaled breath biomarkers. iScience 2022; 25:103739. [PMID: 35141500 PMCID: PMC8810402 DOI: 10.1016/j.isci.2022.103739] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/12/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Abstract
Healthy aging driven physio-metabolic events in females hold the key to complex in vivo mechanistic links and systemic cross talks. Effects from basic changes at genome, proteome, metabolome, and lipidome levels are often reflected at the upstream phenome (e.g., breath volatome) cascades. Here, we have analyzed exhaled volatile metabolites (measured via real time mass spectrometry based breathomics) data from 204 healthy females, aged between 07 and 80 years. Age related substance-specific differences were observed in breath biomarkers. Exhalation of blood-borne endogenous organosulfur, short-chain fatty acids, alcohols, aldehydes, alkene, ketones and exogenous nitriles, terpenes, and aromatics have denominated interplay between endocrine differences, energy homeostasis, systemic microbial diversity, oxidative stress, and lifestyle. Overall marker expressions were suppressed under daily oral contraception. Young homosexual/lesbian adults turned out as breathomic outliers. Previously proposed disease-specific breath biomarkers should be reevaluated upon aging effects. Breathomics offers a noninvasive window toward system-wide understanding and personalized monitoring of aging i.e., translatable to gerontology.
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Affiliation(s)
- Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Simon Grzegorzewski
- Department of Traumatology, Hand and Reconstructive Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Celine Broderius
- Department of Traumatology, Hand and Reconstructive Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Phillip Trefz
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Thomas Mittlmeier
- Department of Traumatology, Hand and Reconstructive Surgery, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Dagmar-Christiane Fischer
- Department of Pediatrics, University Medicine Rostock, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Wolfram Miekisch
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Jochen K. Schubert
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Schillingallee 35, 18057 Rostock, Germany
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9
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Sukul P, Bartels J, Fuchs P, Trefz P, Remy R, Rührmund L, Kamysek S, Schubert JK, Miekisch W. Effects of COVID-19 protective face-masks and wearing durations onto respiratory-haemodynamic physiology and exhaled breath constituents. Eur Respir J 2022; 60:13993003.00009-2022. [PMID: 35169028 PMCID: PMC9492982 DOI: 10.1183/13993003.00009-2022] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 02/03/2022] [Indexed: 11/28/2022]
Abstract
Background While assumed to protect against coronavirus transmission, face masks may have effects on respiratory–haemodynamic parameters. Within this pilot study, we investigated immediate and progressive effects of FFP2 and surgical masks on exhaled breath constituents and physiological attributes in 30 adults at rest. Methods We continuously monitored exhaled breath profiles within mask space in older (age 60–80 years) and young to middle-aged (age 20–59 years) adults over the period of 15 and 30 min by high-resolution real-time mass-spectrometry. Peripheral oxygen saturation (SpO2) and respiratory and haemodynamic parameters were measured (noninvasively) simultaneously. Results Profound, consistent and significant (p≤0.001) changes in SpO2 (≥60_FFP2-15 min: 5.8±1.3%↓, ≥60_surgical-15 min: 3.6±0.9%↓, <60_FFP2-30 min: 1.9±1.0%↓, <60_surgical-30 min: 0.9±0.6%↓) and end-tidal carbon dioxide tension (PETCO2) (≥60_FFP2-15 min: 19.1±8.0%↑, ≥60_surgical-15 min: 11.6±7.6%↑, <60_FFP2- 30 min: 12.1±4.5%↑, <60_surgical- 30 min: 9.3±4.1%↑) indicate ascending deoxygenation and hypercarbia. Secondary changes (p≤0.005) to haemodynamic parameters (e.g. mean arterial pressure (MAP) ≥60_FFP2-15 min: 9.8±10.4%↑) were found. Exhalation of bloodborne volatile metabolites, e.g. aldehydes, hemiterpene, organosulfur, short-chain fatty acids, alcohols, ketone, aromatics, nitrile and monoterpene mirrored behaviour of cardiac output, MAP, SpO2, respiratory rate and PETCO2. Exhaled humidity (e.g. ≥60_FFP2-15 min: 7.1±5.8%↑) and exhaled oxygen (e.g. ≥60_FFP2-15 min: 6.1±10.0%↓) changed significantly (p≤0.005) over time. Conclusions Breathomics allows unique physiometabolic insights into immediate and transient effects of face mask wearing. Physiological parameters and breath profiles of endogenous and/or exogenous volatile metabolites indicated putative cross-talk between transient hypoxaemia, oxidative stress, hypercarbia, vasoconstriction, altered systemic microbial activity, energy homeostasis, compartmental storage and washout. FFP2 masks had a more pronounced effect than surgical masks. Older adults were more vulnerable to FFP2 mask-induced hypercarbia, arterial oxygen decline, blood pressure fluctuations and concomitant physiological and metabolic effects. While assumed to protect against SARS-CoV-2 transmission, face masks cause various physiometabolic side-effects and changes in exhaled VOC profiles. Effects are more pronounced in FFP2 masks and are profound at age ≥60 years.https://bit.ly/33fzOMA
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Affiliation(s)
- Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Julia Bartels
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Patricia Fuchs
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Phillip Trefz
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Rasmus Remy
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Leo Rührmund
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Svend Kamysek
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Jochen K Schubert
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Wolfram Miekisch
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Dept. of Anaesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
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10
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Chiarello E, Di Nunzio M, Picone G, Antonelli G, Capozzi F, Bordoni A. Insight on Glucose and Fructose Absorption and Relevance in the Enterocyte Milieu. Nutrients 2022; 14:517. [PMID: 35276876 PMCID: PMC8839622 DOI: 10.3390/nu14030517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/10/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Although epidemiological studies indicate a strong correlation between high sugar intake and metabolic diseases, the biological mechanisms underlying this link are still controversial. To further examine the modification and crosstalk occurring in enterocyte metabolism during sugar absorption, in this study we evaluate the diffusion and intestinal metabolism of glucose, fructose and sucrose, which were supplemented in equimolar concentration to Caco-2 cells grown on polyester membrane inserts. At different time points after supplementation, changes in metabolite concentration were evaluated in the apical and basolateral chambers by nuclear magnetic resonance (NMR) and gas-chromatography (GC). Sucrose was only minimally hydrolyzed by Caco-2 cells. Upon supplementation, we observed a faster uptake of fructose than glucose, the pentose sugar being also faster catabolized. Monosaccharide absorption was concomitant to the synthesis/transport of other metabolites, which occurred differently in glucose and fructose supplemented cells. Our results confirm the prominent role of intestinal cells in fructose metabolism and clearance after absorption, representing a further step forward in the understanding of the role of dietary sugars. Future research, including targeted analysis on specific transporters/enzymes and the use of labeled substrates, will be helpful to confirm the present results and their interpretation.
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Affiliation(s)
- Elena Chiarello
- Department of Agri-Food Sciences and Technologies (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy; (E.C.); (G.P.); (G.A.); (F.C.)
| | - Mattia Di Nunzio
- Department of Food, Environmental and Nutritional Sciences (Defens), University of Milan, via Celoria 2, 20133 Milan, Italy;
| | - Gianfranco Picone
- Department of Agri-Food Sciences and Technologies (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy; (E.C.); (G.P.); (G.A.); (F.C.)
| | - Giorgia Antonelli
- Department of Agri-Food Sciences and Technologies (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy; (E.C.); (G.P.); (G.A.); (F.C.)
| | - Francesco Capozzi
- Department of Agri-Food Sciences and Technologies (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy; (E.C.); (G.P.); (G.A.); (F.C.)
- Interdepartmental Centre for Industrial Agri-Food Research (CIRI), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy
| | - Alessandra Bordoni
- Department of Agri-Food Sciences and Technologies (DISTAL), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy; (E.C.); (G.P.); (G.A.); (F.C.)
- Interdepartmental Centre for Industrial Agri-Food Research (CIRI), University of Bologna, Piazza Goidanich 60, 47521 Cesena, Italy
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11
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Gbaoui L, Fachet M, Lüno M, Meyer-Lotz G, Frodl T, Hoeschen C. Breathomics profiling of metabolic pathways affected by major depression: Possibilities and limitations. Front Psychiatry 2022; 13:1061326. [PMID: 36590606 PMCID: PMC9795849 DOI: 10.3389/fpsyt.2022.1061326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the most common psychiatric disorders with multifactorial etiologies. Metabolomics has recently emerged as a particularly potential quantitative tool that provides a multi-parametric signature specific to several mechanisms underlying the heterogeneous pathophysiology of MDD. The main purpose of the present study was to investigate possibilities and limitations of breath-based metabolomics, breathomics patterns to discriminate MDD patients from healthy controls (HCs) and identify the altered metabolic pathways in MDD. METHODS Breath samples were collected in Tedlar bags at awakening, 30 and 60 min after awakening from 26 patients with MDD and 25 HCs. The non-targeted breathomics analysis was carried out by proton transfer reaction mass spectrometry. The univariate analysis was first performed by T-test to rank potential biomarkers. The metabolomic pathway analysis and hierarchical clustering analysis (HCA) were performed to group the significant metabolites involved in the same metabolic pathways or networks. Moreover, a support vector machine (SVM) predictive model was built to identify the potential metabolites in the altered pathways and clusters. The accuracy of the SVM model was evaluated by receiver operating characteristics (ROC) analysis. RESULTS A total of 23 differential exhaled breath metabolites were significantly altered in patients with MDD compared with HCs and mapped in five significant metabolic pathways including aminoacyl-tRNA biosynthesis (p = 0.0055), branched chain amino acids valine, leucine and isoleucine biosynthesis (p = 0.0060), glycolysis and gluconeogenesis (p = 0.0067), nicotinate and nicotinamide metabolism (p = 0.0213) and pyruvate metabolism (p = 0.0440). Moreover, the SVM predictive model showed that butylamine (p = 0.0005, pFDR=0.0006), 3-methylpyridine (p = 0.0002, pFDR = 0.0012), endogenous aliphatic ethanol isotope (p = 0.0073, pFDR = 0.0174), valeric acid (p = 0.005, pFDR = 0.0162) and isoprene (p = 0.038, pFDR = 0.045) were potential metabolites within identified clusters with HCA and altered pathways, and discriminated between patients with MDD and non-depressed ones with high sensitivity (0.88), specificity (0.96) and area under curve of ROC (0.96). CONCLUSION According to the results of this study, the non-targeted breathomics analysis with high-throughput sensitive analytical technologies coupled to advanced computational tools approaches offer completely new insights into peripheral biochemical changes in MDD.
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Affiliation(s)
- Laila Gbaoui
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
| | - Melanie Fachet
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
| | - Marian Lüno
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Gabriele Meyer-Lotz
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Thomas Frodl
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen, Aachen, Germany
| | - Christoph Hoeschen
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
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12
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Piacentino D, Grant-Beurmann S, Vizioli C, Li X, Moore CF, Ruiz-Rodado V, Lee MR, Joseph PV, Fraser CM, Weerts EM, Leggio L. Gut microbiome and metabolome in a non-human primate model of chronic excessive alcohol drinking. Transl Psychiatry 2021; 11:609. [PMID: 34853299 PMCID: PMC8636625 DOI: 10.1038/s41398-021-01728-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/27/2021] [Accepted: 11/05/2021] [Indexed: 02/08/2023] Open
Abstract
A relationship between the gut microbiome and alcohol use disorder has been suggested. Excessive alcohol use produces changes in the fecal microbiome and metabolome in both rodents and humans. Yet, these changes can be observed only in a subgroup of the studied populations, and reversal does not always occur after abstinence. We aimed to analyze fecal microbial composition and function in a translationally relevant baboon model of chronic heavy drinking that also meets binge criteria (drinking too much, too fast, and too often), i.e., alcohol ~1 g/kg and blood alcohol levels (BALs) ≥ 0.08 g/dL in a 2-hour period, daily, for years. We compared three groups of male baboons (Papio anubis): L = Long-term alcohol drinking group (12.1 years); S = Short-term alcohol drinking group (2.7 years); and C = Control group, drinking a non-alcoholic reinforcer (Tang®) (8.2 years). Fecal collection took place during 3 days of Drinking (D), followed by a short period (3 days) of Abstinence (A). Fecal microbial alpha- and beta-diversity were significantly lower in L vs. S and C (p's < 0.05). Members of the commensal families Lachnospiraceae and Prevotellaceae showed a relative decrease, whereas the opportunistic pathogen Streptococcus genus showed a relative increase in L vs. S and C (p's < 0.05). Microbiota-related metabolites of aromatic amino acids, tricarboxylic acid cycle, and pentose increased in L vs. S and C (FDR-corrected p < 0.01), with the latter two suggesting high energy metabolism and enhanced glycolysis in the gut lumen in response to alcohol. Consistent with the long-term alcohol exposure, mucosal damage and oxidative stress markers (N-acetylated amino acids, 2-hydroxybutyrate, and metabolites of the methionine cycle) increased in L vs. S and C (FDR-corrected p < 0.01). Overall, S showed few differences vs. C, possibly due to the long-term, chronic alcohol exposure needed to alter the normal gut microbiota. In the three groups, the fecal microbiome barely differed between conditions D and A, whereas the metabolome shifted in the transition from condition D to A. In conclusion, changes in the fecal microbiome and metabolome occur after significant long-term excessive drinking and are only partially affected by acute forced abstinence from alcohol. These results provide novel information on the relationship between the fecal microbiome and metabolome in a controlled experimental setting and using a unique non-human primate model of chronic excessive alcohol drinking.
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Affiliation(s)
- Daria Piacentino
- grid.94365.3d0000 0001 2297 5165Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD 21224 USA ,grid.94365.3d0000 0001 2297 5165Center on Compulsive Behaviors, National Institutes of Health, 10 Center Dr, Bethesda, MD 20892 USA
| | - Silvia Grant-Beurmann
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD USA
| | - Carlotta Vizioli
- grid.420085.b0000 0004 0481 4802Sensory Science and Metabolism Unit, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute of Nursing Research Division of Intramural Research, 10 Center Dr, Bethesda, MD 20892 USA
| | - Xiaobai Li
- grid.94365.3d0000 0001 2297 5165Biostatistics and Clinical Epidemiology Services, National Institutes of Health, Bethesda, MD USA
| | - Catherine F. Moore
- grid.21107.350000 0001 2171 9311Division of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Victor Ruiz-Rodado
- grid.94365.3d0000 0001 2297 5165Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, 10 Center Dr, Bethesda, MD 20892 USA
| | - Mary R. Lee
- grid.94365.3d0000 0001 2297 5165Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD 21224 USA
| | - Paule V. Joseph
- grid.420085.b0000 0004 0481 4802Sensory Science and Metabolism Unit, National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research and National Institute of Nursing Research Division of Intramural Research, 10 Center Dr, Bethesda, MD 20892 USA
| | - Claire M. Fraser
- grid.411024.20000 0001 2175 4264Institute for Genome Sciences, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD USA
| | - Elise M. Weerts
- grid.21107.350000 0001 2171 9311Division of Behavioral Biology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Nathan Shock Drive, Baltimore, MD 21224 USA
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, 21224, USA. .,Center on Compulsive Behaviors, National Institutes of Health, 10 Center Dr, Bethesda, MD, 20892, USA. .,Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, 251 Bayview Blvd, Baltimore, MD, 21224, USA. .,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA. .,Division of Addiction Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA. .,Department of Neuroscience, Georgetown University Medical Center, 3970 Reservoir Rd NW, Washington, DC, 20007, USA.
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13
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Jones AW. Comment on "Estimates of Non-Alcoholic Food-Derived Ethanol and Methanol in Human". J Anal Toxicol 2021; 46:e48-e51. [PMID: 34698859 DOI: 10.1093/jat/bkab112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 10/12/2021] [Accepted: 10/25/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alan Wayne Jones
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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14
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Dinis-Oliveira RJ. The Auto-Brewery Syndrome: A Perfect Metabolic "Storm" with Clinical and Forensic Implications. J Clin Med 2021; 10:4637. [PMID: 34682761 PMCID: PMC8537665 DOI: 10.3390/jcm10204637] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 12/29/2022] Open
Abstract
Auto-brewery syndrome (ABS) is a rare, unstudied, unknown, and underreported phenomenon in modern medicine. Patients with this syndrome become inebriated and may suffer the medical and social implications of alcoholism, including arrest for inebriated driving. The pathophysiology of ABS is reportedly due to a fungal type dysbiosis of the gut that ferments some carbohydrates into ethanol and may mimic a food allergy or intolerance. This syndrome should be considered in patients with chronic obstruction or hypomotility presenting with elevated breath and blood alcohol concentrations, especially after a high carbohydrate intake. A glucose challenge test should be performed as the confirmatory test. Treatment typically includes antifungal drugs combined with changes in lifestyle and nutrition. Additional studies are particularly needed on the human microbiome to shed light on how imbalances of commensal bacteria in the gut allow yeast to colonize on a pathological level.
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Affiliation(s)
- Ricardo Jorge Dinis-Oliveira
- TOXRUN—Toxicology Research Unit, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal; or or ; Tel.: +351-224-157-216
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- UCIBIO-Applied Molecular Biosciences Unit, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira nº 228, 4050-313 Porto, Portugal
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15
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Birková A, Hubková B, Čižmárová B, Bolerázska B. Current View on the Mechanisms of Alcohol-Mediated Toxicity. Int J Mol Sci 2021; 22:9686. [PMID: 34575850 PMCID: PMC8472195 DOI: 10.3390/ijms22189686] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023] Open
Abstract
Alcohol is a psychoactive substance that is widely used and, unfortunately, often abused. In addition to acute effects such as intoxication, it may cause many chronic pathological conditions. Some of the effects are very well described and explained, but there are still gaps in the explanation of empirically co-founded dysfunction in many alcohol-related conditions. This work focuses on reviewing actual knowledge about the toxic effects of ethanol and its degradation products.
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Affiliation(s)
- Anna Birková
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia
| | - Beáta Hubková
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia
| | - Beáta Čižmárová
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia
| | - Beáta Bolerázska
- 1st Department of Stomatology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia
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16
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Disease Differentiation and Monitoring of Anti-TNF Treatment in Rheumatoid Arthritis and Spondyloarthropathies. Int J Mol Sci 2021; 22:ijms22147389. [PMID: 34299006 PMCID: PMC8307996 DOI: 10.3390/ijms22147389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/03/2021] [Accepted: 07/07/2021] [Indexed: 01/16/2023] Open
Abstract
Rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) are comprehensive immunological disorders. The treatment of these disorders is limited to ameliorating the symptoms and improving the quality of life of patients. In this study, serum samples from RA, AS, and PsA patients were analyzed with metabolomic tools employing the 1H NMR method in combination with univariate and multivariate analyses. The results obtained in this study showed that the changes in metabolites were the highest for AS > RA > PsA. The study demonstrated that the time until remission or until low disease activity is achieved is shortest (approximately three months) for AS, longer for RA and longest for PsA. The statistically common metabolite that was found to be negatively correlated with the healing processes of these disorders is ethanol, which may indicate the involvement of the gut microflora and/or the breakdown of malondialdehyde as a cell membrane lipid peroxide product.
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17
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Bayoumy AB, Mulder CJJ, Mol JJ, Tushuizen ME. Gut fermentation syndrome: A systematic review of case reports. United European Gastroenterol J 2021; 9:332-342. [PMID: 33887125 PMCID: PMC8259373 DOI: 10.1002/ueg2.12062] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/02/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The gut fermentation syndrome (GFS), also known as the endogenous alcohol fermentation syndrome or auto brewery syndrome, is a rare and underdiagnosed medical condition where consumed carbohydrates are converted to alcohol by the microbiota in the gastrointestinal or urinary tract. The symptoms of GFS can have severe impact on patients' wellbeing and can have social and legal consequences. Unfortunately, not much is reported about GFS. The aim of this systematic review was to assess the evidence for GFS, causal micro-organisms, diagnostics, and possible treatments. METHODS A protocol was developed prior to initiation of the systematic review (PROSPERO 207182). We performed a literature search for clinical studies on 1 September 2020 using PubMed and Embase. We included all clinical studies, including case reports that described the GFS. RESULTS In total, 17 case reports were included, consisting of 20 patients diagnosed with GFS. The species that caused the GFS included Klebsiella pneumoniae, Candida albicans, C. glabrata, Saccharomyces cerevisiae, C. intermedia, C. parapsilosis, and C. kefyr. CONCLUSIONS GFS is a rare but underdiagnosed disease in daily practice. The disease is mostly reported by Saccharomyces and Candida genera, and some cases were previously treated with antibiotics. Studies in Nonalcoholic Fatty Liver disease suggest a bacterial origin of endogenous alcohol-production, which might also be causal micro-organisms in GFS. Current treatments for GFS include antibiotics, antifungal medication, low carbohydrate diet, and probiotics. There might be a potential role of fecal microbiota transplant in the treatment of GFS.
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Affiliation(s)
- Ahmed B Bayoumy
- Division of Human Nutrition, Wageningen University and Research Centre, Wageningen, The Netherlands
| | - Chris J J Mulder
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jaap J Mol
- Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - Maarten E Tushuizen
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
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18
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Rodda LN, Pearring S, Harper CE, Tiscione NB, Jones AW. Inferences and Legal Considerations Following a Blood Collection Tube Recall. J Anal Toxicol 2021; 45:211-214. [PMID: 32442269 DOI: 10.1093/jat/bkaa056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/10/2020] [Accepted: 05/17/2020] [Indexed: 11/13/2022] Open
Abstract
In mid-2019, medical, forensic and legal communities were notified that a certain shipment of evacuated blood sampling tubes were recalled by the manufacturer. This recall order described that the preservative sodium fluoride (100 mg) and anticoagulant potassium oxalate (20 mg) were missing from a small batch of 10-mL evacuated tubes. This gave cause for concern for possible implications in criminal justice (e.g., in drink-driving offenses) when blood-alcohol concentrations are interpreted. In reality, the lack of an anticoagulant would have been immediately obvious during sample preparation, owing to the formation of a large clot in the tube when received. Certain impairing drugs (e.g., cocaine and 6-acetylmorphine) are unstable in blood and tend to degrade without an enzyme inhibitor, such as sodium fluoride, present. In reviewing available literature related to current practices and the stability of ethanol in stored blood samples, there does not appear to be a clear consensus regarding the amount of sodium fluoride preservative necessary, if any at all, when blood is taken from living subjects under sterile conditions for typical forensic ethanol analysis.
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Affiliation(s)
- Luke N Rodda
- Forensic Laboratory Division, Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, USA.,Department of Laboratory Medicine, University of California, San Francisco, CA 94143, USA
| | - Sue Pearring
- Forensic Laboratory Division, Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, USA
| | - Curt E Harper
- Alabama Department of Forensic Sciences, 2026 Valleydale Rd, Hoover, AL 35244, USA
| | | | - Alan Wayne Jones
- Division of Drug Research, Department of Biomedical and Clinical Sciences, Linköping University, SE-581 85 Linköping, Sweden
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19
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Tameez Ud Din A, Alam F, Tameez-Ud-Din A, Chaudhary FMD. Auto-Brewery Syndrome: A Clinical Dilemma. Cureus 2020; 12:e10983. [PMID: 33209539 PMCID: PMC7667719 DOI: 10.7759/cureus.10983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2020] [Indexed: 12/13/2022] Open
Abstract
Auto-brewery syndrome (ABS), also known as gut fermentation syndrome, is a very rare disorder. It is characterized by the endogenous production of alcohol. It typically presents with the signs of alcohol intoxication, such as staggering gait, slurred speech, gastrointestinal distress, and state of confusion. Due to the nonspecific symptoms, it is necessary to rule out other etiologies before reaching a diagnosis of ABS. The confirmatory test for this syndrome is the raised levels of blood or breath ethanol after a glucose challenge test. The management includes the use of antifungal drugs and avoidance of a carbohydrate-rich diet. In this review, we summarize the etiology, clinical presentation, diagnostic tests, management, and medicolegal aspects of ABS.
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Affiliation(s)
| | - Faran Alam
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | | | - Farooq Mohyud Din Chaudhary
- Gastroenterology, Buch International Hospital, Multan, PAK
- Gastroenterology, Mohyud Din Clinic, Multan, PAK
- Gastroenterology, Nishtar Hospital, Multan, PAK
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20
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Martin M, Alvarez JC. Ethanolémie positive sans consommation d’alcool chez le sujet vivant : le syndrome d’auto-brasserie. Conséquences cliniques et médico-judiciaires. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2020. [DOI: 10.1016/j.toxac.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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The Effects of Prebiotic Supplementation with OMNi-LOGiC ® FIBRE on Fecal Microbiome, Fecal Volatile Organic Compounds, and Gut Permeability in Murine Neuroblastoma-Induced Tumor-Associated Cachexia. Nutrients 2020; 12:nu12072029. [PMID: 32650568 PMCID: PMC7400931 DOI: 10.3390/nu12072029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/26/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023] Open
Abstract
Malignant diseases can cause tumor-associated cachexia (TAC). Supplementation with prebiotic non-digestible carbohydrates exerts positive metabolic effects in experimental oncologic diseases. The aim of this project was to assess the effect of prebiotic supplementation with OMNi-LOGiC® FIBRE on intestinal microbiome, bacterial metabolism, gut permeability, and inflammation in a murine model of neuroblastoma (NB)-associated TAC. For this study, 2,000,000 NB cells (MHH-NB11) were implanted into athymic mice followed by daily supplementation with water or 200 mg prebiotic oligosaccharide (POS) OMNi-LOGiC® FIBRE (NB-Aqua, n = 12; NB-POS, n = 12). Three animals of each tumor group did not develop NB. The median time of tumor growth (first visibility to euthanasia) was 37 days (IQR 12.5 days) in the NB-Aqua group and 37 days (IQR 36.5 days) in the NB-POS group (p = 0.791). At euthanasia, fecal microbiome and volatile organic compounds (VOCs), gut permeability (fluorescein isothiocyanate-dextran (FITC-dextran), and gut barrier markers were measured. Values were compared to sham animals following injection of culture medium and gavage of either water or OMNi-LOGiC® FIBRE (SH-Aqua, n = 10; SH-POS, n = 10). Alpha diversity did not differ significantly between the groups. Principal coordinate analysis (PCoA) revealed clustering differences between Aqua and POS animals. Both NB and POS supplementation led to taxonomic alterations of the fecal microbiome. Of 49 VOCs, 22 showed significant differences between the groups. NB animals had significantly higher gut permeability than Aqua animals; POS did not ameliorate these changes. The pore and leak pathways of tight junctions did not differ between groups. In conclusion, our results suggest that NB-induced TAC causes increased gut permeability coupled with compositional changes in the fecal microbiome and VOC profile. Prebiotic supplementation with OMNi-LOGiC® FIBRE seemed to induce modifications of the fecal microbiome and VOC profile but did not improve gut permeability.
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Kruckenberg KM, DiMartini AF, Rymer JA, Pasculle AW, Tamama K. Urinary Auto-brewery Syndrome: A Case Report. Ann Intern Med 2020; 172:702-704. [PMID: 32092761 DOI: 10.7326/l19-0661] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Andrea F DiMartini
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (K.M.K., A.F.D.)
| | - Jacqueline A Rymer
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, Pennsylvania (J.A.R.)
| | - A William Pasculle
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (A.W.P.)
| | - Kenichi Tamama
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, University of Pittsburgh School of Medicine, McGowan Institute for Regenerative Medicine, University of Pittsburgh, and Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania (K.T.)
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23
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Akbaba M. A medicolegal approach to the very rare Auto-Brewery (endogenous alcohol fermentation) syndrome. TRAFFIC INJURY PREVENTION 2020; 21:295-297. [PMID: 32255712 DOI: 10.1080/15389588.2020.1740688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
Objective: Auto-Brewery Syndrome is defined as the production of ethanol by microorganisms becoming dominant when inhabiting the gastrointestinal system or through the impairment of flora because of carbohydrate-rich nutrition, and the elevation of levels of measured ethanol. This study aimed to consider medicolegal approaches to individuals with Auto-Brewery Syndrome.Methods: A 38-year-old male patient who was involved in a traffic accident about two months ago and whose driving license was taken away due to his blood alcohol level measuring above the legal limits was referred to our department for the detection of any condition which might cause the elevation of blood alcohol levels without alcohol intake, in consequence of his objection submitted to the judicial authorities claiming that he had not drunk alcohol on the day of the event.Results: After the informed consent of the individual was obtained, he was admitted under supervision to an inpatient unit with a visitor ban in a manner which inhibited his intake of alcohol, and during admission his blood alcohol levels were measured at intervals. His blood alcohol level was measured as 160 mg/dl at the time of admission for monitoring and as 141 mg/dl, 322 mg/dl, 208 mg/dl and 279 mg/dl after two hours, six hours, 12 hours and 20 hours, respectively. His liver function test results were high and neurological examination was normal. The individual was diagnosed with Auto-Brewery Syndrome.Conclusion: Various gastrointestinal system abnormalities such as through laparotomy, gastrectomy are reported in most of Auto-Brewery syndrome cases. There are cases, although rare, where gastrointestinal disorders are not detected and secondary disorders of normal intestinal flora due to frequent antibiotic use seem to be a factor. Such a condition is present in the current case. Those who are aware of this condition may falsely rely on it as a method to avoid penalties. On the other hand, genuine patients suffering from this condition may be caught by traffic control and become victims of the condition. For that reason, a meticulous and planned approach should be taken to verify the condition and to ensure that it is not overlooked.
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Affiliation(s)
- Murat Akbaba
- Faculty of Medicine, Department of Forensic Medicine, Gaziantep University, Gaziantep, Turkey
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More SL, Thornton SA, Maskrey JR, Sharma A, de Gandiaga E, Cheng TJ, Fung ES, Bernal AJ, Madl AK. PBPK modeling characterization of potential acute impairment effects from inhalation of ethanol during e-cigarette use. Inhal Toxicol 2020; 32:14-23. [PMID: 32013640 DOI: 10.1080/08958378.2020.1720867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Ethanol is used as a solvent for flavoring chemicals in some electronic cigarette (e-cigarette) liquids (e-liquids). However, there are limited data available regarding the effects of inhalation of ethanol on blood alcohol concentration (BAC) during e-cigarette use. In this study, a modified physiologically based pharmacokinetic (PBPK) model for inhalation of ethanol was used to estimate the BAC time-profile of e-cigarette users who puffed an e-liquid containing 23.5% ethanol. Materials and Methods: A modified PBPK model for inhalation of ethanol was developed. Use characteristics were estimated based on first-generation and second-generation e-cigarette topography parameters. Three representative use-case puffing profiles were modeled: a user that took many, short puffs; a typical user with intermediate puff counts and puff durations; and a user that took fewer, long puffs. Results and Discussion: The estimated peak BACs for these three user profiles were 0.22, 0.22, and 0.30 mg/L for first-generation devices, respectively, and 0.85, 0.58, and 0.34 mg/L for second-generation devices, respectively. Additionally, peak BACs for individual first-generation users with directly measured puffing parameters were estimated to range from 0.06 to 0.67 mg/L. None of the scenarios modeled predicted a peak BAC result that approached toxicological or regulatory thresholds that would be associated with physiological impairment (roughly 0.01% or 100 mg/L). Conclusions: The approach used in this study, combining a validated PBPK model for a toxicant with peer-reviewed topographical parameters, can serve as a screening-level exposure assessment useful for evaluation of the safety of e-liquid formulations. Abbreviations: BAC: blood alcohol concentration; e-cigarette: electronic cigarette; e-liquid: e-cigarette liquid or propylene glycol and/or vegetable glycerin-based liquid; HS-GC-FID: headspace gas chromatography with flame-ionization detection; HS-GC-MS: headspace gas chromatography-mass spectrometry; PBPK: physiologically based pharmacokinetic; Cair: puff concentration expressed as ppm; Cair,mass: ethanol air concentration expressed on a mass basis; Cv: ethanol concentration in the venous blood; ρ: density; EC: ethanol concentration in the liquid; PLC: liquid consumption per puff; PAV: air volume of the puff; Cair,mass: puff concentration expressed as ppm; MW: molecular weight; P: pressure; T: temperature; PK: pharmacokinetic.
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Non-Invasive Assessment of Metabolic Adaptation in Paediatric Patients Suffering from Type 1 Diabetes Mellitus. J Clin Med 2019; 8:jcm8111797. [PMID: 31717811 PMCID: PMC6912469 DOI: 10.3390/jcm8111797] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
An analysis of exhaled volatile organic compounds (VOC) may deliver systemic information quicker than available invasive techniques. Metabolic aberrations in pediatric type 1 diabetes (T1DM) are of high clinical importance and could be addressed via breathomics. Real-time breath analysis was combined with continuous glucose monitoring (CGM) and blood tests in children suffering from T1DM and age-matched healthy controls in a highly standardized setting. CGM and breath-resolved VOC analysis were performed every 5 minutes for 9 hours and blood was sampled at pre-defined time points. Per participant (n = 44) food intake and physical activity were identical and a total of 22 blood samples and 93 minutes of breath samples were investigated. The inter-individual variability of glucose, insulin, glucagon, leptin, and soluble leptin receptor relative to food intake differed distinctly between patients and controls. In T1DM patients, the exhaled amounts of acetone, 2-propanol, and pentanal correlated to glucose concentrations. Of note, the strength of these correlations strongly depended on the interval between food intake and breath sampling. Our data suggests that metabolic adaptation through postprandial hyperglycemia and related oxidative stress is immediately reflected in exhaled breath VOC concentrations. Clinical translations of our findings may enable point-of-care applicability of online breath analysis towards personalized medicine.
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Saverimuttu J, Malik F, Arulthasan M, Wickremesinghe P. A Case of Auto-brewery Syndrome Treated with Micafungin. Cureus 2019; 11:e5904. [PMID: 31777691 PMCID: PMC6853272 DOI: 10.7759/cureus.5904] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Auto-brewery syndrome is caused by alcohol brewing inside the human body; it is a rare clinical condition where the patient becomes inebriated without exogenous alcohol use. Yeast is responsible, and treatment requires an appropriate antifungal agent. If undiagnosed, the patient's life becomes a misery. We present a case of a 45-year-old male who suffered from this condition for over three years with two arrests for driving under the influence prior to being diagnosed. The patient stated that he felt the episodes were related to his meal intakes; therefore, he would skip most meals of the day. The patient visited several centers where he was told there was not much they could offer him and he was left without a diagnosis. A carbohydrate challenge test in a monitored setting showed elevated blood alcohol levels. He was treated with antifungals and a low carbohydrate diet which resulted in the resolution of his symptoms. Hence the importance of awareness among physicians is necessary along with a high index of suspicion.
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Affiliation(s)
- Jessie Saverimuttu
- Infectious Disease, Richmond University Medical Center, Staten Island, USA
| | - Fahad Malik
- Internal Medicine, University of Alabama at Birmingham, Montgomery, USA
| | - Marutha Arulthasan
- Internal Medicine, Richmond University Medical Center, Staten Island, USA
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Teschke R. Alcoholic Liver Disease: Current Mechanistic Aspects with Focus on Their Clinical Relevance. Biomedicines 2019; 7:E68. [PMID: 31491888 PMCID: PMC6783919 DOI: 10.3390/biomedicines7030068] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 09/03/2019] [Indexed: 12/11/2022] Open
Abstract
The spectrum of alcoholic liver disease (ALD) is broad and includes alcoholic fatty liver, alcoholic steatohepatitis, alcoholic hepatitis, alcoholic fibrosis, alcoholic cirrhosis, and alcoholic hepatocellular carcinoma, best explained as a five-hit sequelae of injurious steps. ALD is not primarily the result of malnutrition as assumed for many decades but due to the ingested alcohol and its metabolic consequences although malnutrition may marginally contribute to disease aggravation. Ethanol is metabolized in the liver to the heavily reactive acetaldehyde via the alcohol dehydrogenase (ADH) and the cytochrome P450 isoform 2E1 of the microsomal ethanol-oxidizing system (MEOS). The resulting disturbances modify not only the liver parenchymal cells but also non-parenchymal cells such as Kupffer cells (KCs), hepatic stellate cells (HSCs), and liver sinusoidal endothelial cells (LSECs). These are activated by acetaldehyde, reactive oxygen species (ROS), and endotoxins, which are produced from bacteria in the gut and reach the liver due to gut leakage. A variety of intrahepatic signaling pathways and innate or acquired immune reactions are under discussion contributing to the pathogenesis of ALD via the five injurious hits responsible for disease aggravation. As some of the mechanistic steps are based on studies with in vitro cell systems or animal models, respective proposals for humans may be considered as tentative. However, sufficient evidence is provided for clinical risk factors that include the amount of alcohol used daily for more than a decade, gender differences with higher susceptibility of women, genetic predisposition, and preexisting liver disease. In essence, efforts within the last years were devoted to shed more light in the pathogenesis of ALD, much has been achieved but issues remain to what extent results obtained from experimental studies can be transferred to humans.
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Affiliation(s)
- Rolf Teschke
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, D-63450 Hanau, Academic Teaching Hospital of the Medical Faculty, Goethe University Frankfurt/Main, Frankfurt/Main, Germany.
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Akhavan BJ, Ostrosky-Zeichner L, Thomas EJ. Drunk Without Drinking: A Case of Auto-Brewery Syndrome. ACG Case Rep J 2019; 6:e00208. [PMID: 31750376 PMCID: PMC6831150 DOI: 10.14309/crj.0000000000000208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/23/2019] [Indexed: 02/07/2023] Open
Abstract
Information on auto-brewery syndrome is limited in the medical literature. This rare syndrome occurs when yeast overgrowth leads to ethanol fermentation in the gut. We present a patient presenting with symptoms of alcohol intoxication with objective laboratory data of elevated blood ethanol levels without a history of alcohol consumption. We reviewed the literature and have discussed the current diagnostic and therapeutic options.
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Affiliation(s)
- Bobak J. Akhavan
- Division of General Internal Medicine, Department of Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Luis Ostrosky-Zeichner
- Division of Infectious Diseases, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
| | - Eric J. Thomas
- Division of General Internal Medicine, Department of Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX
- The University of Texas at Houston, Memorial Hermann Center of Healthcare Quality and Safety, Houston, TX
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Jones AW. Alcohol, its absorption, distribution, metabolism, and excretion in the body and pharmacokinetic calculations. ACTA ACUST UNITED AC 2019. [DOI: 10.1002/wfs2.1340] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Alan W. Jones
- Department of Clinical Pharmacology University of Linköping Linköping Sweden
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Woźniak MK, Wiergowski M, Namieśnik J, Biziuk M. Biomarkers of Alcohol Consumption in Body Fluids - Possibilities and Limitations of Application in Toxicological Analysis. Curr Med Chem 2019; 26:177-196. [PMID: 28982313 DOI: 10.2174/0929867324666171005111911] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 08/08/2016] [Accepted: 09/05/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Ethyl alcohol is the most popular legal drug, but its excessive consumption causes social problems. Despite many public campaigns against alcohol use, car accidents, instances of aggressive behaviour, sexual assaults and deterioration in labor productivity caused by inebriated people is still commonplace. Fast and easy diagnosis of alcohol consumption is required in order to introduce proper and effective therapy, and is crucial in forensic toxicology analysis. The easiest method to prove alcohol intake is determination of ethanol in body fluids or in breath. However, since ethanol is rapidly metabolized in the human organism, only recent consumption can be detected using this method. Because of that, the determination of alcohol biomarkers was introduced for monitoring alcohol consumption over a wider range of time. OBJECTIVE The objective of this study was to review published studies focusing on the sample preparation methods and chromatographic or biochemical techniques for the determination of alcohol biomarkers in whole blood, plasma, serum and urine. METHODS An electronic literature search was performed to discuss possibilities and limitations of application of alcohol biomarkers in toxicological analysis. RESULTS Authors described the markers of alcohol consumption such as: ethanol, its nonoxidative metabolites (ethyl glucuronide, ethyl sulfate, phosphatidylethanol, ethyl phosphate, fatty acid ethyl esters) and oxidative metabolites (acetaldehyde and acetaldehyde adducts). We also discussed issues concerning the detection window of these biomarkers, and possibilities and limitations of their use in routine analytical toxicology for monitoring alcohol consumption or sobriety during alcohol therapy.
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Affiliation(s)
- Mateusz Kacper Woźniak
- Department of Analytical Chemistry, Faculty of Chemistry, Gdansk University of Technology (GUT), 11/12 Narutowicza Str., Gdansk 80-233, Poland
| | - Marek Wiergowski
- Chair & Department of Forensic Medicine, Faculty of Medicine, Medical University of Gdansk (MUG), 3a M. Skłodowskiej-Curie Str., Gdansk 80-210, Poland
| | - Jacek Namieśnik
- Department of Analytical Chemistry, Faculty of Chemistry, Gdansk University of Technology (GUT), 11/12 Narutowicza Str., Gdansk 80-233, Poland
| | - Marek Biziuk
- Department of Analytical Chemistry, Faculty of Chemistry, Gdansk University of Technology (GUT), 11/12 Narutowicza Str., Gdansk 80-233, Poland
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Ruzsányi V, Péter Kalapos M, Schmidl C, Karall D, Scholl-Bürgi S, Baumann M. Breath profiles of children on ketogenic therapy. J Breath Res 2018; 12:036021. [PMID: 29760294 DOI: 10.1088/1752-7163/aac4ab] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Ketogenic diets (KDs) were initially introduced to clinical practices as alimentary approaches with the aim to control drug-resistant epilepsies. Over the decades, a large and growing body of research has addressed the antiseizure effect of various KDs, and worked out KD-based dietary regimens, including their acting factors and modes of action. KDs have also appeared in weight loss therapies. Therapy control, particularly at initiation, happens through regular blood analysis and control of urine ketone levels. However, there is a lack of fast, reliable, and preferably non-invasive methods to accomplish this. The detection of exhaled breath constituents may offer a solution. The exhaled breath contains hundreds of volatile organic compounds (VOCs), which can be modified by diet. VOC detection technology has resulted in low-cost sensors that can facilitate the self-monitoring of patients in the future if reliable breath markers are available. Therefore, it is of interest to investigate the composition of exhaled breath in children on KDs. Twenty-two pediatric patients between 4 and 18 years of age were recruited in this study. Eleven of them received a KD and suffered from epilepsy, with the exception of one child, who was admitted to a weight-reduction therapy. The control group involved 11 patients with neurological disorders but not on KD. Breath volatiles were analyzed using gas chromatography mass spectrometry (GC-MS) after preconcentration of the analytes on needle traps (NTs). We found that the breath concentrations of a number of VOCs, namely acetaldehyde, acetone, 2-methylfuran, methyl-vinyl-ketone, and 2-pentanone were significantly elevated in the breath of children on a KD in comparison to their control counterparts. Interestingly, breath ethanol was lower in patients on a KD than in non-KD patients. Association studies revealed an interrelationship among (i) lipid parameters and ketone bodies, (ii) methacrolein, methyl-vinyl-ketone, and high-density lipoprotein, as well as (iii) methyl-vinyl-ketone, acetone, and 2-pentanone, thus raising the possibility of a common metabolic source. The duration of diet was positively and negatively associated with breath acetone and breath ethanol, respectively. Some of the changes were linked to β-oxidation, but there are uncertainties in regard to metabolic sources of other metabolites. Lipid peroxidation and alteration of intestinal microbial composition may also be involved in the changes of VOC profiles during KD. Since lipids used for metabolism during KD originate from external sources, the processes occurring cannot simply be compared to and deduced from changes appearing in starvation; however, lipid mobilization is also evident in starvation. To find reliable and sensitive VOC markers that are linked to the respective ketogenic regimen, further investigations are needed to reveal the metabolic background.
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Affiliation(s)
- Veronika Ruzsányi
- Breath Research Institute, University of Innsbruck, Innrain 66, 6020 Innsbruck, Austria. Department of Anesthesia and Intensive Care, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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Nguyen VL, Haber PS, Seth D. Applications and Challenges for the Use of Phosphatidylethanol Testing in Liver Disease Patients (Mini Review). Alcohol Clin Exp Res 2017; 42:238-243. [DOI: 10.1111/acer.13558] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 11/10/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Van Long Nguyen
- Department of Chemical Pathology; Royal Prince Alfred Hospital; Camperdown New South Wales Australia
- Faculty of Medicine; The University of Sydney; Sydney New South Wales Australia
| | - Paul S. Haber
- Faculty of Medicine; The University of Sydney; Sydney New South Wales Australia
- Drug Health Services; Royal Prince Alfred Hospital; Camperdown New South Wales Australia
| | - Devanshi Seth
- Faculty of Medicine; The University of Sydney; Sydney New South Wales Australia
- Drug Health Services; Royal Prince Alfred Hospital; Camperdown New South Wales Australia
- Centenary Institute of Cancer Medicine and Cell Biology; Camperdown New South Wales Australia
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Welch BT, Coelho Prabhu N, Walkoff L, Trenkner SW. Auto-brewery Syndrome in the Setting of Long-standing Crohn's Disease: A Case Report and Review of the Literature. J Crohns Colitis 2016; 10:1448-1450. [PMID: 27161390 DOI: 10.1093/ecco-jcc/jjw098] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 05/04/2016] [Indexed: 02/08/2023]
Abstract
CLINICAL BACKGROUND A 71-year-old male with 50-year history of Crohn's disease was evaluated for acute onset of dizziness and slurred speech. Blood ethanol levels were elevated despite abstinence from alcohol for over 30 years. CT enterography demonstrated massive dilation of the small bowel with anastomotic stricture. DISCUSSION Auto-brewery syndrome may be considered in a patient with chronic obstruction or hypomotility presenting with elevated serum ethanol levels in the setting of high carbohydrate intake. Although treatment algorithms lack validation, judicious use of antibiotic therapy, carbohydrate control, and short courses of antifungal therapy have all been reported in the literature. Importantly, clinical consideration of 'auto-brewery' should be undertaken with substantial caution, given the lack of validated mechanisms linking endogenous ethanol production to peripheral blood ethanol.
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Affiliation(s)
- B T Welch
- Mayo Clinic Department of Radiology, Rochester, MN, USA
| | - N Coelho Prabhu
- Mayo Clinic Department of Gastroenterology and Hepatology, Rochester, MN, USA
| | - L Walkoff
- Mayo Clinic Department of Radiology, Rochester, MN, USA
| | - S W Trenkner
- Mayo Clinic Department of Radiology, Rochester, MN, USA
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Hafez EM, Hamad MA, Fouad M, Abdel-Lateff A. Auto-brewery syndrome: Ethanol pseudo-toxicity in diabetic and hepatic patients. Hum Exp Toxicol 2016; 36:445-450. [PMID: 27492480 DOI: 10.1177/0960327116661400] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endogenous alcohol has been applied for spontaneous ethanol production via different metabolic pathways of the human body. Auto-brewery syndrome describes the patients with alcohol intoxication after ingesting carbohydrate-rich meals. The main objective of this study is to investigate the effect of diabetes mellitus (DM), liver cirrhosis (LC) and presence of both (DM and LC) on blood alcohol concentration (BAC) especially after carbohydrate ingestion. BAC has been measured by headspace gas chromatography-mass spectrometry in three groups of humans namely control, DM, LC and both (DM and LC) groups. The results showed that BAC in control group was 0.01-.3 mg/dL with mean 0.3 ± 0.41 mg/dL. In patients with DM, BAC is significantly higher than that of control group 4.85 ± 3.96 mg/dL. In patients with LC, BAC was 3.45 ± 2.65 mg/dL. In patients with both DM and LC, BAC increases to reach 10.88 ± 5.36 mg/dL. Endogenous ethanol production appears to increase in DM and LC. Also, it increased much more in patients with both diseases, but it did not reach toxic levels. On comparing BAC and blood glucose level in each group, all groups show insignificant correlations ( p > 0.05).
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Affiliation(s)
- E M Hafez
- 1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Minia University, Minia, Egypt
| | - M A Hamad
- 1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Minia University, Minia, Egypt
| | - M Fouad
- 2 Department of Tropical medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - A Abdel-Lateff
- 3 Department of Pharmacognosy, Faculty of Pharmacy, Minia University, Minia, Egypt.,4 Department of Natural Products and Alternative Medicine, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
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Pandya HC, Mulla H, Hubbard M, Cordell RL, Monks PS, Yakkundi S, McElnay JC, Nunn AJ, Turner MA. Essential medicines containing ethanol elevate blood acetaldehyde concentrations in neonates. Eur J Pediatr 2016; 175:841-7. [PMID: 26997167 PMCID: PMC4868857 DOI: 10.1007/s00431-016-2714-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/03/2016] [Accepted: 03/08/2016] [Indexed: 01/15/2023]
Abstract
UNLABELLED Neonates administered ethanol-containing medicines are potentially at risk of dose-dependent injury through exposure to ethanol and its metabolite, acetaldehyde. Here, we determine blood ethanol and acetaldehyde concentrations in 49 preterm infants (median birth weight = 1190 g) dosed with iron or furosemide, medicines that contain different amounts of ethanol, and in 11 control group infants (median birth weight = 1920 g) who were not on any medications. Median ethanol concentrations in neonates administered iron or furosemide were 0.33 (range = 0-4.92) mg/L, 0.39 (range = 0-72.77) mg/L and in control group infants were 0.15 (range = 0.03-5.4) mg/L. Median acetaldehyde concentrations in neonates administered iron or furosemide were 0.16 (range = 0-8.89) mg/L, 0.21 (range = 0-2.43) mg/L and in control group infants were 0.01 (range = 0-0.14) mg/L. There was no discernible relationship between blood ethanol or acetaldehyde concentrations and time after medication dose. CONCLUSION Although infants dosed with iron or furosemide had low blood ethanol concentrations, blood acetaldehyde concentrations were consistent with moderate alcohol exposure. The data suggest the need to account for the effects of acetaldehyde in the benefit-risk analysis of administering ethanol-containing medicines to neonates. WHAT IS KNOWN • Neonates are commonly treated with ethanol-containing medicines, such as iron and furosemide. • However, there is no data on whether this leads to appreciable increases in blood concentrations of ethanol or its metabolite, acetaldehyde. What is New: • In this study, we find low blood ethanol concentrations in neonates administered iron and/or furosemide but markedly elevated blood acetaldehyde concentrations in some infants receiving these medicines. • Our data suggest that ethanol in drugs may cause elevation of blood acetaldehyde, a potentially toxic metabolite.
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Affiliation(s)
- H. C. Pandya
- />Department of Infection, Immunity and Inflammation, University of Leicester, University Road, Leicester, LE1 9HN UK
| | - H. Mulla
- />Department of Pharmacy, University of Hospitals Leicester NHS Trust, Leicester, UK
| | - M. Hubbard
- />Neonatal Unit University of Hospitals Leicester NHS Trust, Leicester, UK
| | - R. L. Cordell
- />Department of Chemistry, University of Leicester, Leicester, UK
| | - P. S. Monks
- />Department of Chemistry, University of Leicester, Leicester, UK
| | - S. Yakkundi
- />Department of Pharmacy, Queen’s University Belfast, Belfast, UK
| | - J. C. McElnay
- />Department of Pharmacy, Queen’s University Belfast, Belfast, UK
| | - A. J. Nunn
- />Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
| | - M. A. Turner
- />Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
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Yang JY, Kwak HS, Han JY, Choi JS, Ahn HK, Oh YJ, Velázquez-Armenta EY, Nava-Ocampo AA. Linear Versus Non-Linear Dose-Response Relationship Between Prenatal Alcohol Exposure and Meconium Concentration of Nine Different Fatty Acid Ethyl Esters. Dose Response 2015; 13:10.2203_dose-response.14-056_Yang. [PMID: 26691866 PMCID: PMC4679215 DOI: 10.2203/dose-response.14-056_yang] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Presence of individual fatty acid ethyl esters (FAEEs) in meconium is considered to be a reliable biomarker of prenatal alcohol exposure, and their concentration has been found to be linearly associated with poor postnatal development, supporting the widely extended idea that ethanol is a non-threshold teratogen. However, a growing number of epidemiological studies have consistently found a lack of adverse short- and long-term fetal outcomes at low exposure levels. We therefore aimed to investigate the relationship between the concentration of individual FAEEs and prenatal alcohol exposure in meconium samples collected within the first 6 to 12?h after birth from 182 babies born to abstainer mothers and from 54 babies born to women who self-reported either light or moderate alcohol ingestion in the second or third trimester of pregnancy. In most cases, the individual FAEE concentrations were negligible and not significantly different (P >0.05) between exposed and control babies. The concentrations appeared to increase linearly with the dose only in the few babies born to mothers who reported >3 drinks/week. These results provide evidence that the correlation between prenatal alcohol exposure and individual FAEE concentrations in meconium is non-linear shape, with a threshold probably at 3 drinks/week.
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Affiliation(s)
- J Y Yang
- National Institute of of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Seoul, Republic of Korea ; Department of Systems Biology, Yonsei University, Seoul, Republic of Korea
| | - H S Kwak
- Department of Laboratory Medicine, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine, Seoul, Republic of Korea
| | - J Y Han
- The Korean Motherisk Program, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine, Seoul, Republic of Korea
| | - J S Choi
- The Korean Motherisk Program, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine, Seoul, Republic of Korea
| | - H K Ahn
- The Korean Motherisk Program, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine, Seoul, Republic of Korea
| | - Y J Oh
- Department of Systems Biology, Yonsei University, Seoul, Republic of Korea
| | - E Y Velázquez-Armenta
- PharmaReasons - Pharmacological Research & Applied Solutions, Toronto, Ontario, Canada
| | - A A Nava-Ocampo
- PharmaReasons - Pharmacological Research & Applied Solutions, Toronto, Ontario, Canada ; Department of Pharmacology & Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada ; Division of Clinical Pharmacology & Toxicology, Hospital for Sick Children, Toronto, Ontario, Canada
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Zamengo L, Frison G, Tedeschi G, Frasson S, Zancanaro F, Sciarrone R. Variability of blood alcohol content (BAC) determinations: The role of measurement uncertainty, significant figures, and decision rules for compliance assessment in the frame of a multiple BAC threshold law. Drug Test Anal 2014; 6:1028-37. [DOI: 10.1002/dta.1614] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 11/27/2013] [Accepted: 12/23/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Luca Zamengo
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
| | - Giampietro Frison
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
| | - Gianpaola Tedeschi
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
| | - Samuela Frasson
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
| | - Flavio Zancanaro
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
| | - Rocco Sciarrone
- Laboratory of Environmental Hygiene and Forensic Toxicology, Department of Prevention; ULSS12 Veneziana; Regione Veneto, Venezia Mestre Venezia Italy
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Paranjpe A, Zhang R, Ali-Osman F, Bobustuc GC, Srivenugopal KS. Disulfiram is a direct and potent inhibitor of human O6-methylguanine-DNA methyltransferase (MGMT) in brain tumor cells and mouse brain and markedly increases the alkylating DNA damage. Carcinogenesis 2013; 35:692-702. [PMID: 24193513 DOI: 10.1093/carcin/bgt366] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The alcohol aversion drug disulfiram (DSF) reacts and conjugates with the protein-bound nucleophilic cysteines and is known to elicit anticancer effects alone or improve the efficacy of many cancer drugs. We investigated the effects of DSF on human O(6)-methylguanine-DNA methyltransferase (MGMT), a DNA repair protein and chemotherapy target that removes the mutagenic O(6)-akyl groups from guanines, and thus confers resistance to alkylating agents in brain tumors. We used DSF, copper-chelated DSF or CuCl2-DSF combination and found that all treatments inhibited the MGMT activity in two brain tumor cell lines in a rapid and dose-dependent manner. The drug treatments resulted in the loss of MGMT protein from tumor cells through the ubiquitin-proteasome pathway. Evidence showed that Cys145, a reactive cysteine, critical for DNA repair was the sole site of DSF modification in the MGMT protein. DSF was a weaker inhibitor of MGMT, compared with the established O(6)-benzylguanine; nevertheless, the 24-36h suppression of MGMT activity in cell cultures vastly increased the alkylation-induced DNA interstrand cross-linking, G2/M cell cycle blockade, cytotoxicity and the levels of apoptotic markers. Normal mice treated with DSF showed significantly attenuated levels of MGMT activity and protein in the liver and brain tissues. In nude mice bearing T98 glioblastoma xenografts, there was a preferential inhibition of tumor MGMT. Our studies demonstrate a strong and direct inhibition of MGMT by DSF and support the repurposing of this brain penetrating drug for glioma therapy. The findings also imply an increased risk for alkylation damage in alcoholic patients taking DSF.
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Parnell JA, Raman M, Rioux KP, Reimer RA. The potential role of prebiotic fibre for treatment and management of non-alcoholic fatty liver disease and associated obesity and insulin resistance. Liver Int 2012; 32:701-11. [PMID: 22221818 DOI: 10.1111/j.1478-3231.2011.02730.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 11/23/2011] [Indexed: 12/28/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) and the more severe non-alcoholic steatohepatitis (NASH) represent a spectrum of diseases involving hepatic fat accumulation and histological features essentially identical to alcoholic liver disease; however, they occur in the absence of excessive alcohol intake. They typically arise in conjunction with one or more features of the metabolic syndrome. Lifestyle mediated weight loss remains the primary mode of therapy for NAFLD and NASH, but this is often ineffective and adjunctive medical and surgical treatments are presently lacking. Prebiotic fibres are a group of non-digestible carbohydrates that modulate the human microbiota in a manner that is advantageous to host health. Rodent studies suggest that dietary supplementation with prebiotic fibres positively impacts NAFLD by modifying the gut microbiota, reducing body fat, and improving glucoregulation. Future research should focus on placebo-controlled, human, clinical trials using histological endpoints to address the effects of prebiotics on NAFLD and NASH. The aim of this review is to summarize current knowledge about prebiotics as an emerging therapeutic target for NAFLD.
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Affiliation(s)
- Jill A Parnell
- Department of Physical Education and Recreation Studies, Faculty of Health and Community Studies, Mount Royal University, Calgary, Alberta, Canada.
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40
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Scientific Opinion on the evaluation of the substances currently on the list in the Annex to Commission Directive 96/3/EC as acceptable previous cargoes for edible fats and oils - Part I of III. EFSA J 2011. [DOI: 10.2903/j.efsa.2011.2482] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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41
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Hernández-Tobías A, Julián-Sánchez A, Piña E, Riveros-Rosas H. Natural alcohol exposure: Is ethanol the main substrate for alcohol dehydrogenases in animals? Chem Biol Interact 2011; 191:14-25. [DOI: 10.1016/j.cbi.2011.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 02/01/2011] [Accepted: 02/01/2011] [Indexed: 01/30/2023]
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Haub S, Kanuri G, Volynets V, Brune T, Bischoff SC, Bergheim I. Serotonin reuptake transporter (SERT) plays a critical role in the onset of fructose-induced hepatic steatosis in mice. Am J Physiol Gastrointest Liver Physiol 2010; 298:G335-44. [PMID: 19713474 DOI: 10.1152/ajpgi.00088.2009] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Elevated dietary fructose intake, altered intestinal motility, and barrier function may be involved in the development of nonalcoholic fatty liver disease (NAFLD). Because intestinal motility and permeability are also regulated through the bioavailability of serotonin (5-HT), we assessed markers of hepatic injury in serotonin reuptake transporter knockout (SERT(-/-)) and wild-type mice chronically exposed to different monosaccharide solutions (30% glucose or fructose solution) or water for 8 wk. The significant increase in hepatic triglyceride, TNF-alpha, and 4-hydroxynonenal adduct as well as portal endotoxin levels found in fructose-fed mice was associated with a significant decrease of SERT and the tight-junction occludin in the duodenum. Similar effects were not found in mice fed glucose. In contrast, in SERT(-/-) mice fed glucose, portal endotoxin levels, concentration of occludin, and indices of hepatic damage were similar to those found in wild-type and SERT(-/-) mice fed fructose. In fructose-fed mice treated with a 5-HT3 receptor antagonist, hepatic steatosis was significantly attenuated. Our data suggest that a loss of intestinal SERT is a critical factor in fructose-induced impairment of intestinal barrier function and subsequently the development of steatosis.
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Affiliation(s)
- Synia Haub
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Spruss A, Bergheim I. Dietary fructose and intestinal barrier: potential risk factor in the pathogenesis of nonalcoholic fatty liver disease. J Nutr Biochem 2009; 20:657-62. [PMID: 19679262 DOI: 10.1016/j.jnutbio.2009.05.006] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 04/17/2009] [Accepted: 05/14/2009] [Indexed: 12/11/2022]
Abstract
Worldwide, not only the prevalence of obesity has increased dramatically throughout the last three decades but also the incidences of co-morbid conditions such as diabetes type 2 and liver disease have increased. The 'hepatic manifestation of the metabolic syndrome' is called nonalcoholic fatty liver disease (NAFLD) and comprises a wide spectrum of stages of liver disease ranging from simple steatosis to liver cirrhosis. NAFLD of different stages is found in approximately 30% of adults and approximately 20% in the US population. Not just a general overnutrition but also an elevated intake of certain macronutrients such as fat and carbohydrates and herein particularly fructose has been claimed to be risk factors for the development for NAFLD; however, the etiology of this disease is still unknown. The present review outlines some of the potential mechanisms associated with the development of NAFLD and fructose intake with a particular focus on the role of the intestinal barrier functions.
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Affiliation(s)
- Astrid Spruss
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Helander A, Hagelberg CA, Beck O, Petrini B. Unreliable alcohol testing in a shipping safety programme. Forensic Sci Int 2009; 189:e45-7. [DOI: 10.1016/j.forsciint.2009.04.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Revised: 04/20/2009] [Accepted: 04/23/2009] [Indexed: 11/17/2022]
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Petković S, Savić S, Zgonjanin D, Samojlik I. Ethanol Concentrations in Antemortem Blood Samples Under Controlled Conditions. Alcohol Alcohol 2008; 43:658-60. [DOI: 10.1093/alcalc/agn072] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Helander A, Beck O. Chapter 17 Analytical markers of acute and chronic alcohol consumption. HANDBOOK OF ANALYTICAL SEPARATIONS 2008. [DOI: 10.1016/s1567-7192(06)06017-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Accurate interpretation of the blood ethanol (EtOH) concentration at the time of death presents a difficult task since the origin of detected EtOH in postmortem cases (either in corpses or in specimens after sample collection) may vary. Headspace gas chromatography is the choice method for detecting EtOH in blood or other specimens, due to the accuracy and sensitivity it provides. Possible sources of postmortem EtOH have been the ante-mortem ingestion, the ante-mortem endogenous production and the postmortem microbial neo-formation, which has been considered the most critical factor that could complicate the results. It has been reported that EtOH could be formed postmortem in variable and non-predictable amounts, as a function of the type and number of microorganisms present either in corpses or specimens collected at autopsy. The presence of other volatiles-mostly n-propanol-has been correlated to microbial EtOH production, although the quantitative pattern between them and EtOH still remains obscure. The factors most frequently implicated in the mechanism of postmortem EtOH production in corpses have been considered the number and nature of microbes present, the availability of various types of substrates, the temperature and the time. Complication in the interpretation of blood alcohol concentration could arise due to the atypical distribution of EtOH in the body compartments after death. Specimens to blood EtOH ratios reported in the literature are presented. All the aforementioned aspects are discussed in a comprehensive way, providing a deep insight into this essential problem.
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Affiliation(s)
- Kallirroe Ziavrou
- Department of Forensic Medicine and Toxicology, Medical School, University of Ioannina, Ioannina, Greece
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Gruszecki AC, Robinson CA, Kloda S, Brissie RM. High Urine Ethanol and Negative Blood and Vitreous Ethanol in a Diabetic Woman. Am J Forensic Med Pathol 2005; 26:96-8. [PMID: 15725786 DOI: 10.1097/01.paf.0000154266.15884.84] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Several studies have shown that ethanol can be produced in urine infected with yeast or bacteria in vitro. We present the unusual case of a diabetic woman in whom ethanol was produced in her urine in vivo. The decedent was a 19-year-old woman who was noncompliant with her diabetes treatment. She presented to a local hospital in severe diabetic ketoacidosis and died shortly thereafter. Upon arrival at the hospital, a blood glucose of 553 mg/dL was detected. A urinalysis was positive for ketones (> 80 mg/dL), glucose (> 1000 mg/dL), and large budding yeast forms. A drug screen performed on the urine was positive for ethanol. At the coroner/medical examiner office, an autopsy was negative for significant anatomic findings. Toxicology analysis revealed a urine ethanol level 0.32 g/dL, although no ethanol was detected in blood or vitreous samples. A urine gram stain and culture identified Candida glabrata. A retrospective case review of all deaths related to diabetes examined at the coroner/medical examiner office from 1986 to 2003 did not reveal other cases with similar findings. This case of a noncompliant, juvenile-diabetic woman illustrates a rare finding of apparent in vivo glucose fermentation by C. glabrata to form ethanol in the urine. This case also highlights a potential difficulty in toxicologic analysis and interpretation using urine only.
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Affiliation(s)
- Amy C Gruszecki
- Department of Pathology and Laboratory Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
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Galassetti PR, Novak B, Nemet D, Rose-Gottron C, Cooper DM, Meinardi S, Newcomb R, Zaldivar F, Blake DR. Breath ethanol and acetone as indicators of serum glucose levels: an initial report. Diabetes Technol Ther 2005; 7:115-23. [PMID: 15738709 DOI: 10.1089/dia.2005.7.115] [Citation(s) in RCA: 156] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Many volatile organic compounds are present in exhaled breath and may represent by-products of endogenous biological processes. Ethanol is produced via alcoholic fermentation of glucose by gut bacteria and yeast, while acetone derives from oxidations of free fatty acids, influenced by glucose metabolism. We hypothesized that the integrated analysis of breath ethanol and acetone would provide a good approximation of the blood glucose profile during a glucose load. METHODS We collected simultaneous exhaled breath gas, ambient air, and serum glucose and insulin samples from 10 healthy volunteers at baseline and during an oral glucose tolerance test (OGTT) (ingestion of 75 g of glucose followed by 120 min of sampling). Gas samples were analyzed by gas chromatography/mass spectrometry. RESULTS Mean glucose values displayed a typical OGTT pattern (rapid increase, peak values at 30-60 min, and gradual return to near baseline by 120 min). Breath ethanol displayed a similar pattern early in the test, with peak values at 30 min; this was followed by a fast return to basal levels by 60 min. Breath acetone decreased progressively below basal levels, with lowest readings obtained at 120 min. A multiple regression analysis of glucose, ethanol, and acetone was used to estimate glucose profiles that correlated with measured glucose values with an average individual correlation coefficient of 0.70, and not lower than 0.41 in any subject. CONCLUSION The integrated analysis of multiple exhaled gases may serve as a marker of blood glucose levels. Further studies are needed to assess the usefulness of this method in different populations.
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Affiliation(s)
- Pietro R Galassetti
- Center for the Study of Health Effects of Exercise in Children, University of California, Irvine, College of Medicine, Orange, California 92868, USA.
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Al-Awadhi A, Wasfi IA, Al Reyami F, Al-Hatali Z. Autobrewing revisited: endogenous concentrations of blood ethanol in residents of the United Arab Emirates. Sci Justice 2004; 44:149-52. [PMID: 15270453 DOI: 10.1016/s1355-0306(04)71707-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Endogenous ethanol concentrations in blood were determined by sensitive headspace gas chromatography/mass spectrometry in 1557 residents of the United Arab Emirates. The subjects were from 13 nationalities, of both sexes and of different age groups. There was no significant difference in blood ethanol concentration between nationalities or between sexes within and between nationalities. The data was pooled and the overall median, minimum, maximum, 25% percentile and 75% percentile were 0.04, 0.00, 3.52, 0.01 and 0.09 mg/dl respectively. The values of blood ethanol concentration as reported in this study indicate that they are far too low to have any forensic significance.
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Affiliation(s)
- A Al-Awadhi
- Forensic Science Laboratory, PO Box 253, Abu Dhab, United Arab Emirates
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