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Taneva I, Grumann D, Schmidt D, Taneva E, von Arnim U, Ansorge T, Wex T. Gene variants of the SLC2A5 gene encoding GLUT5, the major fructose transporter, do not contribute to clinical presentation of acquired fructose malabsorption. BMC Gastroenterol 2022; 22:167. [PMID: 35387598 PMCID: PMC8985300 DOI: 10.1186/s12876-022-02244-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background While role of ALDOB-related gene variants for hereditary fructose intolerance is well established, contribution of gene variants for acquired fructose malabsorption (e.g. SLC2A5, GLUT5) is not well understood. Methods Patients referred to fructose breath test were further selected to identify those having acquired fructose malabsorption. Molecular analysis of genomic DNA included (I) exclusion of 3 main ALDOB gene variants causing hereditary fructose intolerance and (II) sequencing analysis of SLC2A5 gene comprising complete coding region, at least 20 bp of adjacent intronic regions and 700 bp of proximal promoter. Results Among 494 patients, 35 individuals with acquired fructose malabsorption were identified based on pathological fructose-breath test and normal lactose-breath test. Thirty four of them (97%) had negative tissue anti-transglutaminase and/or deamidated gliadin antibodies in their medical records. Molecular analysis of SLC2A5 gene of all 35 subjects identified 5 frequent and 5 singular gene variants mostly in noncoding regions (promoter and intron). Allele frequencies of gene variants were similar to those reported in public databases strongly implying that none of them was associated with acquired fructose malabsorption. Conclusions Gene variants of coding exons, adjacent intronic regions and proximal promoter region of SLC2A5 gene are unlikely to contribute to genetic predisposition of acquired fructose malabsorption.
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Affiliation(s)
- Irina Taneva
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Dorothee Grumann
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Dietmar Schmidt
- Medical Office Internal Medicine and Gastroenterology, Olvenstedter Str. 11, 39108, Magdeburg, Germany
| | - Elina Taneva
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Ulrike von Arnim
- Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-Von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Thomas Ansorge
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany
| | - Thomas Wex
- Department of Molecular Genetics, Medical Laboratory for Clinical Chemistry, Microbiology, Infectious Diseases and Genetics "Prof. Schenk/Dr. Ansorge and Colleagues", Schwiesaustr. 11, 39124, Magdeburg, Germany. .,Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-Von-Guericke University, Leipziger Str. 44, 39120, Magdeburg, Germany.
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Kwiecień J, Hajzler W, Kosek K, Balcerowicz S, Grzanka D, Gościniak W, Górowska-Kowolik K. No Correlation between Positive Fructose Hydrogen Breath Test and Clinical Symptoms in Children with Functional Gastrointestinal Disorders: A Retrospective Single-Centre Study. Nutrients 2021; 13:2891. [PMID: 34445050 PMCID: PMC8401680 DOI: 10.3390/nu13082891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 12/04/2022] Open
Abstract
Fructose malabsorption is regarded as one of the most common types of sugar intolerance. However, the correlation between gastrointestinal symptoms and positive results in fructose hydrogen breath tests (HBTs) remains unclear. The aim of this study was to assess the clinical importance of positive fructose HBT by correlating the HBT results with clinical features in children with various gastrointestinal symptoms. Clinical features and fructose HBT results were obtained from 323 consecutive children (2-18 years old, mean 10.7 ± 4.3 years) that were referred to the Tertiary Paediatric Gastroenterology Centre and diagnosed as having functional gastrointestinal disorders. A total of 114 out of 323 children (35.3%) had positive HBT results, of which 61 patients were females (53.5%) and 53 were males (46.5%). Children with positive HBT were significantly younger than children with negative HBT (9.0 vs. 11.6 years old; p < 0.001). The most frequent symptom among children with fructose malabsorption was recurrent abdominal pain (89.5%). Other important symptoms were diarrhoea, nausea, vomiting, and flatulence. However, no correlation between positive fructose HBT results and any of the reported symptoms or general clinical features was found. In conclusion, positive fructose HBT in children with functional gastrointestinal disorders can be attributed to their younger age but not to some peculiar clinical feature of the disease.
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Affiliation(s)
- Jarosław Kwiecień
- Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland;
| | - Weronika Hajzler
- Faculty of Medical Sciences in Zabrze, Doctoral School, Medical University of Silesia, 41-800 Zabrze, Poland;
| | - Klaudia Kosek
- Faculty of Medical Sciences in Zabrze, Students’ Scientific Association of the Medical University in Silesia, 41-800 Zabrze, Poland; (K.K.); (D.G.); (W.G.)
| | - Sylwia Balcerowicz
- Clinical Hospital No 1 in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland;
| | - Dominika Grzanka
- Faculty of Medical Sciences in Zabrze, Students’ Scientific Association of the Medical University in Silesia, 41-800 Zabrze, Poland; (K.K.); (D.G.); (W.G.)
| | - Weronika Gościniak
- Faculty of Medical Sciences in Zabrze, Students’ Scientific Association of the Medical University in Silesia, 41-800 Zabrze, Poland; (K.K.); (D.G.); (W.G.)
| | - Katarzyna Górowska-Kowolik
- Department of Paediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland;
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Southwell BR. Treatment of childhood constipation: a synthesis of systematic reviews and meta-analyses. Expert Rev Gastroenterol Hepatol 2020; 14:163-174. [PMID: 32098515 DOI: 10.1080/17474124.2020.1733974] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Constipation occurs in many children and can become chronic. Many grow out of it but for one third, it continues into adulthood. For most patients, there is no identifiable organic disorder and it is classified as functional constipation.Areas covered: In 2016, treatment of childhood constipation was extensively reviewed by Rome IV. This review covers meta-analyses and evidence for treatment of paediatric constipation since 2016 and new emerging treatments.Expert opinion: Since 2016, meta-analyses conclude 1) fibre should be included in a normal diet, but further supplementation does not improve constipation; 2) probiotics may increase stool frequency in children, but evidence from larger RCTs is needed; 3) comparing laxatives, polyethylene glycol (PEG) is superior to placebo, lactulose and milk of magnesia, and 4) appendix stomas are effective and should be considered before surgery. Emerging areas of study include food intolerance, electrical stimulation and faecal microbiota transplant. For research, outcome measures need standardising to allow comparison between studies and allow meta-analyses. To assist this, validated GI instruments have been developed by Rome IV and PedsQl.
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Affiliation(s)
- Bridget R Southwell
- Murdoch Children's Research Institute, Urology Department, Royal Children's Hospital and Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
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