Alterations in exocrine pancreatic function after acute pancreatitis.

Exocrine pancreatic dysfunction (EPD) is a malabsorptive complication of pancreatic disorders that can lead to a host of symptoms ranging from flatulence to diarrhea and contribute to weight loss and metabolic bone disease. It is increasingly recognized to occur after acute pancreatitis (AP), including episodes with mild severity. The risk of developing EPD after AP is influenced by a range of factors, including the degree of acinar cell destruction and inflammation during AP, and persistent structural derangements following AP. In this article, we discuss the epidemiology, pathophysiology, and clinical management of EPD after AP while highlighting key knowledge gaps.

Carbon-13-isotopomics and metabolomics of fatty acids from triacylglycerols: overcoming the limitations of GC-C-IRMS for short- and medium-acyl chains.

Carbon-13 isotopomics of triacylglycerol (TAG) fatty acids or free fatty acids in biological matrices holds considerable potential in food authentication, forensic investigations, metabolic studies, and medical research. However, challenges arise in the isotopic analysis of short- and medium-chain (C4 to C10) fatty acid methyl esters (SMCFAMEs) through gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS). The high volatility of these esters results in losses during their preparation, leading to isotopic fractionation. Moreover, the methoxy group added to acyl chains requires the correction of δ13C values, thereby increasing the uncertainty of the final results. Analyzing free fatty acids (FFAs) addresses both issues encountered with SMCFAMEs. To achieve this objective, we have developed a new protocol enabling the isotopomics of individual fatty acids (FAs) by GC-C-IRMS. The same experiment also provides the FA profile, i.e., the relative percentage of each FA in the TAG hydrolysate or its concentration in the studied matrix. The method exhibited high precision, as evidenced by the repeatability and within-lab reproducibility of results when tested on TAGs from both animal and vegetal origins. Compared to the analysis of FAMEs by GC-C-IRMS, the current procedure also brings several improvements in alignment with the principles of green analytical chemistry and green sample preparation. Thus, we present a two-in-one method for 13C-isotopomic and metabolomic biomarker quantitation within quasi-universal TAG compounds, encompassing the short- and medium-acyl chains.

Incident diabetes following acute pancreatitis in a multicenter prospective observational cohort.

Diabetes mellitus following an episode of acute pancreatitis (AP) is an increasingly discussed complication, but there are sparse prospective data on the incidence and risk factors. We evaluated data from a prospective, multicenter observational cohort study that enrolled adults hospitalized with AP between 2017 and 2021 and followed them for one year. Ninety-eight participants who completed 12-month follow-up were included in this analysis. Diabetes status was assessed using a combination of measured glycated hemoglobin (HbA1c) at predetermined time intervals or physician diagnosis. In 68 participants without diabetes at enrollment, the cumulative incidence of new-onset diabetes was 4.4 % (n = 3) at 3 months and 10.3 % (n = 7) at 12 months. No differences were observed in demographic or pancreatitis-related characteristics between those who did versus did not develop diabetes, in part due to small sample size. In summary, new-onset diabetes was identified in approximately 10 % within one year after an episode of AP. Larger prospective studies are needed to further define the incidence, risk factors, and mechanisms of diabetes and pre-diabetes following AP. NCT03063398.

A precise and rapid isotopomic analysis of small quantities of cholesterol at natural abundance by optimized 1H-13C 2D NMR.

Cholesterol, the principal zoosterol, is a key metabolite linked to several health complications. Studies have shown its potential as a metabolic biomarker for predicting various diseases and determining food origin. However, the existing INEPT (insensitive nuclei enhanced by polarization transfer) 13C position-specific isotope analysis method of cholesterol by NMR was not suitable for very precise analysis of small quantities due to its long acquisition time and therefore is restricted to products rich in cholesterol. In this work, a symmetric and adiabatic heteronuclear single quantum coherence (HSQC) 2D NMR sequence was developed for the high-precision (few permil) analysis of small quantities of cholesterol. Adiabatic pulses were incremented for improving precision and sensitivity. Moreover, several strategies such as the use of non-uniform sampling, linear prediction, and variable recycling time were optimized to reduce the acquisition time. The number of increments and spectral range were also adjusted. The method was developed on a system with a cryogenically cooled probe and was not tested on a room-temperature system. Our new approach allowed analyzing as low as 5 mg of cholesterol in 31 min with a long-term repeatability lower than 2‰ on the 24 non-quaternary carbon atoms of the molecule comparing to 16.2 h for the same quantity using the existing INEPT method. This result makes conceivable the isotope analysis of matrices low in cholesterol. Graphical abstract.

A strategy for simultaneous determination of fatty acid composition, fatty acid position, and position-specific isotope contents in triacylglycerol matrices by 13C-NMR.

Triacylglycerols, which are quasi-universal components of food matrices, consist of complex mixtures of molecules. Their site-specific 13C content, their fatty acid profile, and their position on the glycerol moiety may significantly vary with the geographical, botanical, or animal origin of the sample. Such variables are valuable tracers for food authentication issues. The main objective of this work was to develop a new method based on a rapid and precise 13C-NMR spectroscopy (using a polarization transfer technique) coupled with multivariate linear regression analyses in order to quantify the whole set of individual fatty acids within triacylglycerols. In this respect, olive oil samples were analyzed by means of both adiabatic 13C-INEPT sequence and gas chromatography (GC). For each fatty acid within the studied matrix and for squalene as well, a multivariate prediction model was constructed using the deconvoluted peak areas of 13C-INEPT spectra as predictors, and the data obtained by GC as response variables. This 13C-NMR-based strategy, tested on olive oil, could serve as an alternative to the gas chromatographic quantification of individual fatty acids in other matrices, while providing additional compositional and isotopic information. Graphical abstract A strategy based on the multivariate linear regression of variables obtained by a rapid 13C-NMR technique was developed for the quantification of individual fatty acids within triacylglycerol matrices. The conceived strategy was tested on olive oil.

Prevalence of exocrine pancreatic insufficiency at 12 months after acute pancreatitis: a prospective, multicentre, longitudinal cohort study.

Background: Exocrine Pancreatic insufficiency (EPI) occurs following acute pancreatitis (AP) at variably reported rates and with unclear recovery timeline. The aim of this study was to establish the prevalence and predictors of EPI at 12 months after AP in a prospective cohort. Methods: In this prospective, multicentre, longitudinal cohort study, adult participants (≥18 years) admitted to the hospital with an AP attack (defined by Revised Atlanta Classification) were enrolled in a United States multi-centre longitudinal cohort (Sites: The Ohio State University, University of Pittsburgh, and Johns Hopkins University). Patients were excluded if they had pancreatic cancer, chronic pancreatitis, or malabsorptive disease (including previously diagnosed EPI). Participant data was obtained by interview and by review of the electronic medical record. EPI was assessed by stool fecal elastase (FE-1) levels collected at baseline, 3 months, and 12 months (primary endpoint). EPI was defined by FE-1 <200 µg/g; severe FE-1 level ≤100 µg/g; mild FE-1 101-200 µg/g. Multivariable logistic regression was used to identify predictors of EPI at 12 months. This study is registered with ClinicalTrials.gov, NCT03063398. Findings: EPI was observed in 29 (34.1%) of the 85 participants [44 (51.8%) male, mean age 54.7 ± 14.1 years] who provided stool samples at 12 months. For the study overall, participants were recruited between June 22, 2017 and October 18, 2021. A total of 5794 individuals were screened, 311 of whom were eligible for the study. 112 participants provided stool samples at baseline, 79 completed stool samples at 3 months, and 85 completed samples at 12 months. 64 participants included samples at all 3 timepoints. In univariable analysis, factors significantly associated with EPI at 12 months included recurrent (versus index) AP, pre-existing diabetes, alcohol, and idiopathic etiologies, and increasing severity of AP. In multivariable analysis, the odds of having EPI at 12 months increased 4-fold with idiopathic AP etiology (Odds Ratio 4.095, 95% Confidence Interval [CI] 1.418, 11.826), and 3-fold with moderately severe or severe AP (Odds Ratio 3.166, 95% CI 1.156, 8.670), and baseline diabetes mellitus (Odds Ratio 3.217, 95% CI 1.113, 9.298). Even individuals with an index mild attack of AP (n = 39) developed severe EPI at 12 months (prevalence 12.8%). Interpretation: EPI as diagnosed by FE-1 is present in over one third of prospectively assessed patients at 12 months post-AP. Since EPI develops in patients with mild AP, investigations are needed to understand the mechanisms of injury and identify methods for tailored screening. Funding: This study was supported by an Investigator Initiated Research Grant from AbbVie, Inc.

Biomarkers for cheese authentication by detailed and fast gas chromatographic profiling of triacylglycerol fatty acids.

Unsaturated fatty acid isomers and odd- and branched-chain fatty acids (OBCFAs) in milk triacylglycerols (TAGs) can be quantitated using gas chromatography (GC), providing access to biomarkers of animal species, breeds, diet, geographic origin, and environmental conditions. Such analysis requires expensive cyanopropyl siloxane or ionic liquid columns of at least 50 m in length, which increases the elution time. Aiming to use GC for cheese authentication and characterization while keeping the experiment time short and maintaining a good separation between fatty acid (FA) isomers, we considered using a 30 m polyethylene glycol-2-nitroterephthalate column. The FAs thus quantitated allowed the discovery of specific biomarkers for the origins of cheese varieties highly consumed in several countries. In addition, the simple and multivariate correlations we found between FAs in the cheese TAG matrix were alternative means for characterization and authentication purposes.

Cheese characterization and authentication through lipid biomarkers obtained by high-resolution 1H NMR profiling.

Food quality and safety are at the heart of consumers' concerns across the world. Dairy products, because of their large consumption, are fertile ground for fraudulent acts. This fact justifies the development of effective, accessible, and rapid analytical methods for their authentication. A high-resolution spectral treatment method previously developed by our team was applied to 1H NMR spectra of cheese triacylglycerols. 178 Peaks were thus quantitated and successfully used in the construction of multivariate models for the quantitation of individual fatty acids and for the classification of cheese samples according to the producing species, to their origin and variety. Besides, several peaks related to the amount and position of anteisopentadecanoic, butyric, α-linolenic, myristoleic, rumenic, and vaccenic acids were, among others, specific biomarkers of cheese groups. For the first time in 1H NMR, we were able to identify and to quantitate signals related to minor fatty acids within cheese triacylglycerols.

Probiotics Properties: A Focus on Pregnancy Outcomes.

A healthy microbiome plays an important role in the prevention of illness and maintenance of overall health, including reproductive health. Although the therapeutic advantages of probiotics have been shown to run across multiple organ systems, their role in pregnancy is not well explored. The aim of this review is to highlight the potential advantages and adverse effects of probiotics in pregnancy. Data were collected from the literature over the past decade using PubMed, Medline, Google Scholar, Ovid, Scopus, and Science Direct. A total of 40 articles were utilized in this review. Collected data indicated that prenatal and post-natal supplementation with lactobacilli alone or lactobacilli with Bifidobacterium spp. seems to be protective. Probiotics may improve insulin resistance and consequently reduce the risk of gestational diabetes. Probiotics may also reduce anxiety and depression by influencing brain activity. Additionally, they interfere with vaginal flora to make it friendlier to beneficial bacteria, and enhance anti-inflammatory or reduce pro-inflammatory cytokines. They may also decrease eczema in breastfed infants and prevent allergic reactions by downregulating Th2 responses to specific allergens from mid to late gestation. Leveraging the cervicovaginal microbiota could promote a number of positive pregnancy-related health outcomes. Caution should be exercised in the selection, dosing, and monitoring of probiotics administration. More comprehensive randomized clinical trials are needed to reach a more meaningful evidence-based clinical knowledge.

High-resolution 1H NMR profiling of triacylglycerols as a tool for authentication of food from animal origin: Application to hen egg matrix.

Metabolomics of complex biological matrices conducted by means of 1H NMR leads to spectra suffering from severe signal overlapping. Previously, we have developed a high-resolution spectral treatment method to help solving this issue in 1H NMR of triacylglycerols. In this work, we tested the potential of the developed method in the characterization and authentication of food products from animal origin using egg yolk as a model matrix. The approach consisted in a spectral deconvolution guided by the precision obtained on the deconvoluted peaks after reference lineshape adjustment of spectra. Thus, 135 peaks were quantitated and successfully used as biomarkers of origin, of hens breed, and of farming system. This required multivariate statistical analyses for classification. The same pool of variables allowed construction of multivariate quantitation models for individual fatty acids. Furthermore, minute amounts of conjugated fatty acids were quantitated and used as fingerprints of samples from backyard and free-range farming.

Metabisotopomics of triacylglycerols from animal origin: A simultaneous metabolomic and isotopic profiling using 13C INEPT.

In previous works, we developed a 13C NMR method for analyzing triacylglycerols in olive oil using an adiabatic refocused INEPT sequence. This allowed spectral acquisition to be done in only 8 min with sufficient precision for isotopic measurements. In the present study, we made use of the same methodology to investigate the potential of triacylglycerols as source of biomarkers in animal origin matrices. To this end, egg yolk was taken as a model matrix. We called our profiling approach metabisotopomics since it was simultaneously metabolomic and isotopic profiling. Beside its ability to quantitate several fatty acids, metabisotopomics of triacylglycerols in egg yolk allowed the multivariate classification of samples according to the hen breed, to the farming system and origin. Achieved results confirmed our presumption that 13C metabisotopomics of triacylglycerols from animal sources is a powerful tool for metabolic studies as well as for food authentication processes.

Improved lipid mixtures profiling by 1H NMR using reference lineshape adjustment and deconvolution techniques.

ANALYSIS: of one-dimensional 1H NMR spectra of complex mixtures, such as lipids from natural extracts, is hampered by the small spectral width leading to a great number of overlapped signals. Additional complications including lineshape broadening and distortion may occur due to magnetic field inhomogeneity. Quantitation of such spectra is therefore challenging. We present in this work a quantitation approach based on deconvolution after correction of spectra by means of reference lineshape adjustment (RLA), also known as reference deconvolution. Spectral fit and precision obtained on deconvoluted peaks were used as indicators to iteratively improve the deconvolution process. This approach was tested on 1H NMR spectra of olive oil samples and allowed extraction of 77 peaks (available as peak intensities or areas), whereas spectral integration afforded 5 variables when only well-resolved signals were considered and 29 variables when a bucket around each discernible peak was integrated. Deconvoluted peak intensities and areas were obtained with improved precision after RLA of raw spectra. The use of these spectral variables as predictors in multivariate statistical analysis enhanced the classification of olive oil samples according to the altitude of the olive field or to the color of the olive drupes. The same variables allowed quantitation of oleic, palmitoleic, and vaccenic acids within triacylglycerols, which was not possible by 1H NMR, and improved quantitation of linoleic and linolenic acids. These results proved the high potential of the presented approach in the characterization and authentication of complex mixtures by 1H NMR spectroscopy.

Cholesterol, a powerful 13C isotopic biomarker.

Cholesterol is related to many health diseases and is considered as a metabolic disorder biomarker. This compound, present in all food products of animal origin, can also be used as food authentication biomarker. In this work and for the first time, positional 13C isotope contents were determined for such a high molecular weight compound. This was possible by means of NMR using adiabatic refocused INEPT. In order to test the potential of this approach for discrimination, hen eggs from different origins were collected. Quantitative extraction of egg yolk cholesterol was optimized, and partial reduced molar fractions of its different 13C isotopomers were used as predictors in discriminant analysis. Compared with the global 13C isotopic composition determined using isotope ratio monitoring by Mass Spectrometry, the relative content of cholesterol 13C isotopomers added valuable power to sample classifications according to their origins. This study paves the way to isotopomics of other steroids and similar molecular weight compounds.

Olive oil characterization and classification by 13C NMR with a polarization transfer technique: A comparison with gas chromatography and 1H NMR.

In a previous work, we optimized and used a fast adiabatic 13C-INEPT (Insensitive Nuclei Enhanced by Polarization Transfer) experiment for the isotopomic analysis of olive oil samples, which allowed us quantifying individual fatty acids within triacylglycerols through multivariate linear regression models. The goal of this study was to validate these models and to evaluate the power of 13C-INEPT in the authentication of olive oils relative to gas chromatography (GC) and 1H NMR. In this respect, a new set of olive oil samples was analyzed by these three techniques. The analytical variables thus obtained as well as their corresponding long-term repeatability were compared. As a result, the reliability of the fatty acid quantification models was proven and the best classification of olive oils according to the altitude of the olive grove and to the morphological aspect (color) of the olives was achieved by means of 13C-INEPT.

Geoclimatic, morphological, and temporal effects on Lebanese olive oils composition and classification: A (1)H NMR metabolomic study.

Two hundred and thirty-four Lebanese olive samples were collected from different regions and the corresponding oils were analysed by (1)H NMR spectroscopy. The variables obtained, related to fatty acids and minor components, were used as inputs in univariate and multivariate analyses aiming to characterize and classify the oils according to geographical, morphological, and temporal factors. Samples were sorted according to the colour, size, and shape of olives, which allowed statistically significant classifications to be achieved. A sequential strategy was developed to discriminate among samples from different altitudes and latitudes. Following this strategy, obvious trends and classifications were obtained at subregional level. Furthermore, the shift in the harvest date within a range of three weeks was considered and its effect on the classification models was investigated. Likewise, the harvest year effect was evaluated; the precipitation level in April and May had a significant impact on the characteristics of the oils.

Precise and rapid isotopomic analysis by (1)H-(13)C 2D NMR: Application to triacylglycerol matrices.

An optimized HSQC sequence was tested and applied to triacylglycerol matrices to determine their isotopic and metabolomic profiles. Spectral aliasing and non-uniform sampling approaches were used to decrease the experimental time and to improve the resolution, respectively. An excellent long-term repeatability of signal integrals was achieved enabling to perform isotopic measurements. Thirty-two commercial vegetable oils were analyzed by this methodology. The results show that this method can be used to classify oil samples according to their geographical and botanical origins.

A sharper characterization of the geographical origin of Lebanese wines by a new interpretation of the hydrogen isotope ratios of ethanol.

The hydrogen isotope ratios of the methyl [(D/H)I] and methylene [(D/H)II] groups in ethanol can be used as geographical origin tracers of wines. These ratios reflect not only the deuterium content of sugars but also that of water in the grape medium, and hence are influenced by the irrigation, the degree of ripeness at harvest, and other viticultural and enological practices. Thus, the isotopic redistribution coefficients between water in the grape must and the methyl and methylene sites of ethanol were determined and then used to compute an isotopic ratio [(D/H)Is] representing the contribution of the fermentable sugars to (D/H)I. To evaluate the discrimination power of (D/H)Is, the ethanol D/H ratios of 78 Lebanese wine samples from different vineyards were determined using the SNIF-NMR method. An improved classification at the subregional level was obtained using (D/H)Is which exhibits an inverse linear correlation with the annual precipitation amount. Furthermore, the variations of the ethanol D/H ratios with the degree of grape ripeness and with the juice fractions obtained from the inner and peripheral pulps of the grape berries were studied on a small sample set. These factors should be considered when using the SNIF-NMR results to characterize the geographical origin of wines.

N-tritylprolinal: an efficient building block for the stereoselective synthesis of proline-derived amino alcohols.

N-Tritylprolinal (prepared in four steps from l-proline) shows a very high Felkin diastereoselectivity in its reaction with various nucleophiles, leading to a straightforward and highly stereoselective access to syn-proline-derived amino alcohols.