ABSTRACT
Novel shelf-stable and high-protein meat products that are affordable, convenient, and healthy are hot topic in current food innovation trends. To offer technological databases for developing new functional lamb meat products, this study aimed to evaluate the technological and sensory aspects of dry-cured lamb meat snacks incorporated with the probiotic culture Lactobacillus paracasei and the prebiotic lactulose. Four formulations were analyzed: control (without prebiotic or probiotic); PREB (with 2% lactulose); PROB (with 107 CFU/g of L. paracasei); and SYMB (with 2% lactulose and 107 CFU/g of L. paracasei). Fitted curves revealed that weight-loss behavior during snack ripening was not affected (P > 0.05) by treatments. Snack moisture, water activity, pH, titratable acidity, lipid oxidation, and residual nitrite were affected (P < 0.05) only by ripening time. The target probiotic strain stood out against competitive flora and was detected at 107 CFU/g in the snack-supplemented formulations (PROB and SYMB). In snacks supplemented with prebiotics (PREB and SYMB), the lactulose content was maintained at 2.17%. Significant differences were not observed in the chemical composition, texture profiles, and CIE color indices between the proposed functional snacks and the control. In addition to texture, flavor, and overall impression evaluation, only color attributes were positively impacted (P < 0.05) in the acceptance and multiple comparison tests against the control. The proposed formulation and bench process parameters produced potential nutritionally and sensory-appreciated, microbiologically stable, and safe (multi-hurdle perspective) functional high-protein restructured lamb snacks.
Subject(s)
Meat Products , Prebiotics , Probiotics , Sheep, Domestic , Snacks , Taste , Animals , Meat Products/microbiology , Meat Products/analysis , Humans , Lactobacillus , Lactulose , Food Handling/methods , Red Meat/microbiology , Red Meat/analysis , Color , Male , FemaleABSTRACT
BACKGROUND: The general assumption that prebiotics reach the colon without any alterations has been challenged. Some in vitro and in vivo studies have demonstrated that 'non-digestible' oligosaccharides are digested to different degrees depending on their structural composition. In the present study, we compared different methods aiming to assess the digestibility of oligosaccharides synthesized by ß-galactosidase (ß-gal) of Lactobacillus delbruecki subsp. bulgaricus CRL450 (CRL450-ß-gal) from lactose, lactulose and lactitol. RESULTS: In the simulated gastrointestinal fluid method, no changes were observed. However, the oligosaccharides synthesized by CRL450-ß-gal were partially hydrolyzed in vitro, depending on their structure and composition, with rat small intestinal extract (RSIE) and small intestinal brush-border membrane vesicles (BBMV) from pig. Digestion of some oligosaccharides increased when mixtures were fed to C57BL/6 mice used as in vivo model; however, lactulose-oligosaccharides were the most resistant to the physiological conditions of mice. In general ß (1â6) linked products showed higher resistance compared to ß (1â3) oligosaccharides. CONCLUSION: In vitro digestion methods, without disaccharidases, may underestimate the importance of carbohydrates hydrolysis in the small intestine. Although BVMM and RSIE digestion assays are appropriate in vitro methods for these studies, in vivo studies remain the most reliable for understanding what actually happens in the digestion of oligosaccharides. © 2024 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Subject(s)
Digestion , Mice, Inbred C57BL , Oligosaccharides , Prebiotics , beta-Galactosidase , Prebiotics/analysis , Animals , beta-Galactosidase/metabolism , beta-Galactosidase/chemistry , Oligosaccharides/metabolism , Oligosaccharides/chemistry , Mice , Rats , Swine , Male , Lactulose/metabolism , Lactulose/chemistry , Bacterial Proteins/metabolism , Bacterial Proteins/chemistry , Intestine, Small/metabolism , Intestine, Small/enzymology , Lactobacillus/metabolism , Lactobacillus/enzymology , Hydrolysis , Lactose/metabolism , Lactose/chemistryABSTRACT
BACKGROUND: Increased intestinal permeability and dysbiosis are related to obesity. Nuts can provide nutrients and bioactive compounds that modulate gut microbiota and inflammation, enhancing the beneficial effects of weight loss. OBJECTIVES: To evaluate the effect of consuming cashew nuts (Anacardium occidentale L.) and Brazil nuts (Bertholletia excelsa H.B.K) on intestinal permeability and microbiota, fecal SCFAs and pH, inflammation, and weight loss in energy restriction condition. METHODS: In this 8-week randomized controlled trial, 40 women with overweight or obesity were assigned to energy-restricted groups (-500 kcal/d): control group (free of nuts) or Brazilian nuts group (BN: 30 g of cashew nuts and 15 g of Brazil nuts per day). Permeability was analyzed by the lactulose/mannitol test and the microbiota by sequencing the 16S gene in the V3-V4 regions. Plasma concentrations of inflammatory cytokines (TNF, IL-6, IL-10, IL-8, IL-17A) and C-reactive protein were analyzed. RESULTS: In total, 25 women completed the intervention. Both groups lost weight without statistical differences. Lactulose excretion increased only in the control group (P < 0.05). The BN consumption increased fecal propionic acid and potentially beneficial bacteria, such as Ruminococcus, Roseburia, strains NK4A214 and UCG-002 from the Ruminococcaceae family, but also Lachnospiraceae family, Bacteroides, and Lachnoclostridium, when compared to the control group. Changes in intestinal permeability were correlated to a greater reduction in body fat (kg), and IL-8, and increases in Ruminococcus abundance. CONCLUSION: Our findings demonstrate a positive impact of BN consumption within an energy-restricted context, linked to the augmentation of potentially beneficial bacteria and pathways associated with body fat reduction. Besides, BN consumption mitigated increased intestinal permeability, although its capacity to diminish permeability or enhance weight loss proved limited. This trial was registered at the Brazilian Registry of Clinical Trials as ReBEC (ID: RBR-3ntxrm).
Subject(s)
Anacardium , Bertholletia , Humans , Female , Nuts/chemistry , Anacardium/chemistry , Overweight , Brazil , Interleukin-8/analysis , Lactulose , Obesity , Inflammation , Weight LossABSTRACT
The first clinical guidelines on hepatic encephalopathy were published in 2009. Almost 14 years since that first publication, numerous advances in the field of diagnosis, treatment, and special condition care have been made. Therefore, as an initiative of the Asociación Mexicana de Gastroenterología A.C., we present a current view of those aspects. The manuscript described herein was formulated by 24 experts that participated in six working groups, analyzing, discussing, and summarizing the following topics: Definition of hepatic encephalopathy; recommended classifications; epidemiologic panorama, worldwide and in Mexico; diagnostic tools; conditions that merit a differential diagnosis; treatment; and primary and secondary prophylaxis. Likewise, these guidelines emphasize the management of certain special conditions, such as hepatic encephalopathy in acute liver failure and acute-on-chronic liver failure, as well as specific care in patients with hepatic encephalopathy, such as the use of medications and types of sedation, describing those that are permitted or recommended, and those that are not.
Subject(s)
Hepatic Encephalopathy , Lactulose , Rifaximin , Hepatic Encephalopathy/diagnosis , Hepatic Encephalopathy/drug therapy , Rifaximin/therapeutic use , Lactulose/therapeutic useABSTRACT
BACKGROUND: The accuracy of diagnosis and the safety of treatment in colonoscopy depends largely on the quality of bowel cleansing. This study aimed to compare the efficacy and adverse reactions of Polyethylene Glycol (PEG) combined with lactulose with that of PEG alone in bowel preparation before colonoscopy. METHODS: The authors searched a number of databases including EMBASE, MEDLINE, Cochrane Library, and China Academic Journals Full-text Database. The authors screened according to literature inclusion and exclusion criteria, assessed the quality of the included literature, and extracted the data. The meta-analysis of included literature used RevMan 5.3 and Stata 14.0 software. RESULTS: A total of 18 studies, including 2274 patients, were enrolled. The meta-analysis showed that PEG combined with lactulose had a better efficacy (OR = 3.87, 95% CI 3.07â4.87, p = 0.000, and I2 = 36.2% in the efficiency group; WMD = 0.86, 95% CI 0.69â1.03, p = 0.032 and I2 = 0% in the BBPS score group) in bowel preparation for patients with or without constipation. Moreover, PEG combined with lactulose had fewer adverse reactions, including abdominal pain (OR = 1.42, 95% CI 0.94â2.14, p = 0.094), nausea (OR = 1.60, 95% CI 1.13â2.28, p = 0.009) and vomiting (OR = 1.77, 95% CI 1.14â2.74, p = 0.011), than PEG alone. No significant reduction in the incidence of abdominal distention was observed. CONCLUSION: PEG combined with lactulose may be a better choice for bowel preparation before colonoscopy compared with PEG alone.
Subject(s)
Lactulose , Polyethylene Glycols , Humans , Polyethylene Glycols/adverse effects , Lactulose/therapeutic use , Cathartics/adverse effects , Constipation/chemically induced , Constipation/drug therapy , ColonoscopyABSTRACT
AIMS: We analysed intestinal permeability in patients with chronic Chagas cardiomyopathy (CCC) and evaluated its association with clinical manifestations, haemodynamic parameters measured by echocardiogram, and disease outcome. Intestinal permeability was compared between CCC patients and a group of healthy controls. BACKGROUND: Intestinal dysfunction may contribute to a more severe disease presentation with worse outcome in patients with CCC and heart failure. METHODS: Fifty patients with CCC and left ventricular ejection fraction (LVEF) of less than 55% were prospectively selected and followed for a mean period of 18 ± 8 months. A group of 27 healthy volunteers were also investigated. One patient was excluded from the analysis since he died before completing the intestinal permeability test. Intestinal permeability was evaluated with the sugar probe drink test. It consists in the urinary recovery of previously ingested sugar probes: mannitol, a monosaccharide, and lactulose, a disaccharide. RESULTS: Patient's mean age was 53.4 ± 10.4 years, and 31(63%) were male. Differential urinary excretion of lactulose/mannitol ratio did not differ significantly between healthy controls and CCC patients, regardless of clinical signs of venous congestion, haemodynamic parameters, and severity of presentation and outcome. CONCLUSIONS: The present study could not show a disturbance of the intestinal barrier in CCC patients with LVEF <55%, measured by lactulose/mannitol urinary excretion ratio. Further investigations are needed to verify if in patients with LVEF <40% intestinal permeability is increased.
Subject(s)
Heart Failure , Lactulose , Humans , Male , Adult , Middle Aged , Female , Lactulose/urine , Stroke Volume , Ventricular Function, Left , Mannitol/urine , Permeability , Heart Failure/diagnosis , Chronic DiseaseABSTRACT
Few studies have focused on nutrient-deficient diets and associated pathobiological dynamics of body composition and intestinal barrier function. This study evaluated the impact of a nutrient-deficient diet on physical development and intestinal morphofunctional barrier in mice. C57BL/6 (21 days of age) mice were fed a Northeastern Brazil regional basic diet (RBD) or a control diet for 21 d. The animals were subjected to bioimpedance analysis, lactulose test, morphometric analysis and quantitative reverse transcription-PCR to evaluate tight junctions and intestinal transporters. RBD feeding significantly reduced weight (P < 0·05) from day 5, weight gain from day 3 and tail length from day 14. The intake of RBD reduced total body water, extracellular fluid, fat mass and fat-free mass from day 7 (P < 0·05). RBD induced changes in the jejunum, with an increase in the villus:crypt ratio on day 7, followed by reduction on days 14 and 21 (P < 0·05). Lactulose:mannitol ratio increased on day 14 (P < 0·05). Changes in intestinal barrier function on day 14 were associated with reductions in claudin-1 and occludin, and on day 21, there was a reduction in the levels of claudin-2 and occludin. SGLT-1 levels decreased on day 21. RBD compromises body composition and physical development with dynamic changes in intestinal barrier morphofunctional. RBD is associated with damage to intestinal permeability, reduced levels of claudin-1 and occludin transcripts and return of bowel function in a chronic period.
Subject(s)
Diet , Lactulose , Mice , Animals , Occludin/genetics , Claudin-1/genetics , Claudin-1/metabolism , Weaning , Lactulose/metabolism , Mice, Inbred C57BL , Intestinal Mucosa/metabolism , Body CompositionABSTRACT
Context: Postoperative, critically ill, and elderly patients often have fecal loading or impaction. In a few such patients, disimpaction of fecalomas and colon cleansing are difficult. Bowel obstruction, megacolon, lower gastrointestinal bleeding, and gut perforation are complications that may ensue. Oral laxatives or enemas may only be partially effective. Surgical intervention may be needed for salvage or to treat complications. Series and Design: Fourteen hospitalized cases with defecation disorder due to fecal loading of the colon were enrolled for retrospective analysis. Colonoscopic instillation of mannitol and/or lactulose was undertaken as an intervention when the use of oral laxatives was either ineffective or unfeasible, and enema had yielded poor results. Results: Ten patients had satisfactory outcomes for fecal clearance, whereas four patients with poor or incomplete responses underwent repeat interventions or surgery. No significant complications were encountered due to this therapy. Conclusion: Colonoscopic instillation of mannitol or lactulose in fecal-loaded critically ill patients results in a safe and satisfactory fecal clearance. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Colonoscopy , Constipation/therapy , Laxatives , Retrospective Studies , Treatment Outcome , Constipation/diagnostic imaging , Lactulose/therapeutic use , Mannitol/therapeutic useABSTRACT
Altered intestinal barrier permeability has been associated with obesity and its metabolic and inflammatory complications in animal models. The purpose of this systematic review is to assess the evidence regarding the association between obesity with or without Metabolic Syndrome (MetS) and alteration of the intestinal barrier permeability in humans. A systematic search of the studies published up until April 2022 in Latin America & Caribbean Health Sciences Literature (LILACS), PubMed, Scopus, Embase, and ScienceDirect databases was conducted. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) checklist. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the quality of the evidence. Eight studies were included and classified as moderate to high quality. Alteration of intestinal barrier permeability was evaluated by zonulin, lactulose/mannitol, sucralose, sucrose, lactulose/L-rhamnose, and sucralose/erythritol. Impaired intestinal barrier permeability measured by serum and plasma zonulin concentration was positively associated with obesity with MetS. Nonetheless, the GRADE assessment indicated a very low to low level of evidence for the outcomes. Thus, clear evidence about the relationship between alteration of human intestinal barrier permeability, obesity, and MetS was not found.
Subject(s)
Metabolic Syndrome , Humans , Intestinal Mucosa/metabolism , Intestines , Lactulose/metabolism , Metabolic Syndrome/metabolism , Obesity/complications , Obesity/metabolism , PermeabilityABSTRACT
Metabolic syndrome is a cluster of risk factors for cardiovascular disease afflicting more than 1 billion people worldwide and is increasingly being identified in younger age groups and in socioeconomically disadvantaged settings in the global south. Enteropathogen exposure and environmental enteropathy in infancy may contribute to metabolic syndrome by disrupting the metabolic profile in a way that is detectable in cardiometabolic markers later in childhood. A total of 217 subjects previously enrolled in a birth cohort in Amazonian Peru were monitored annually from ages 2 to 5 years. A total of 197 blood samples collected in later childhood were analyzed for 37 cardiometabolic biomarkers, including adipokines, apolipoproteins, cytokines, which were matched to extant early-life markers of enteropathy ascertained between birth and 2 years. Multivariate and multivariable regression models were fitted to test for associations, adjusting for confounders. Fecal and urinary markers of intestinal permeability and inflammation (myeloperoxidase, lactulose, and mannitol) measured in infancy were associated with later serum concentrations of soluble CD40-ligand, a proinflammatory cytokine correlated with adverse metabolic outcomes. Fecal myeloperoxidase was also associated with later levels of omentin-1. Enteric protozoa exposure showed stronger associations with later cardiometabolic markers than viruses, bacteria, and overall diarrheal episodes. Early-life enteropathy markers were associated with altered adipokine, apolipoprotein, and cytokine profiles later in childhood consistent with an adverse cardiometabolic disease risk profile in this cohort. Markers of intestinal permeability and inflammation measured in urine (lactulose, mannitol) and stool (myeloperoxidase, protozoal infections) during infancy may predict metabolic syndrome in adulthood.
Subject(s)
Cardiovascular Diseases , Intestinal Diseases , Metabolic Syndrome , Adipokines , Apolipoproteins , Biomarkers/metabolism , Birth Cohort , Cardiovascular Diseases/epidemiology , Child, Preschool , Cytokines , Humans , Inflammation/complications , Intestinal Diseases/metabolism , Lactulose/metabolism , Ligands , Mannitol/metabolism , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Peroxidase/metabolism , Peru/epidemiologyABSTRACT
The effect of brown and golden flaxseeds on lipid profile, oxidative stress, intestinal permeability, endotoxemia, and fasting glycaemia of perimenopausal overweight women was investigated in this clinical trial. Thirty participants were divided into control (CG), brown flaxseed (BF), and golden flaxseed (GF) groups. BF and GF received 40 g of brown and golden flaxseed for 12 weeks. Venous blood samples were collected at the beginning and at the end. Intestinal permeability analysis was performed by urinary excretion of lactulose and mannitol. There was significant reduction in intestinal permeability in flaxseed groups, with delta of lactulose/mannitol ratio smaller (p ≤ 0.05). LPS levels were reduced in the flaxseed groups, whereas low-density lipoproteins (LDL) was decreased in the GF group (p ≤ 0.05). Flaxseed consumption did not change oxidative stress markers and glycaemia. Flaxseed consumption, especially golden flaxseed, reduced intestinal permeability and improved the lipid profile, showing positive effects on metabolic changes caused by menopausal transition.HIGHLIGHTSBrown and golden flaxseeds show a high content of insoluble fibre and alpha-linolenic acid, and brown flaxseed presented higher antioxidant activity.Golden flaxseed improved the lipid profile.Brown and golden flaxseeds reduced intestinal permeability and endotoxemia.Brown and golden flaxseed can be a promising alternative for the prevention of metabolic changes caused by menopausal transition, and for the improvement of the intestinal health.
Subject(s)
Endotoxemia , Flax , Endotoxemia/prevention & control , Female , Humans , Lactulose , Lipoproteins, LDL , Mannitol , Overweight , Perimenopause , PermeabilitySubject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Thyroid Hormones , Infliximab , Lactulose , Loperamide , Pancreatitis , Urticaria , Drug Hypersensitivity , Exanthema , Laxatives , Infant Health , Gastroenterology , Hypothyroidism , Milk, HumanABSTRACT
The effects of the most significant operational variables on reactor performance of fed-batch and repeated fed-batch were evaluated in the lactulose production by enzymatic transgalactosylation. Feed flowrate in the fed stage (F) and fructose to lactose molar ratio (Fr/L) were the variables that mostly affected the values ââof lactulose yield (YLu), lactulose productivity (πLu) and selectivity of transgalactosylation (SLu/TOS). Maximum YLu of 0.21â¯g lactulose per g lactose was obtained at 50% w/w inlet carbohydrates concentration (IC) of, 50⯰C, Fr/L 8, F 1â¯mLâ min-1, 200â¯IUâgLactose-1 reactor enzyme load and pH 4.5. At these conditions the selectivity was 7.4, productivity was 0.71 gLuâg-1âh-1and lactose conversion was 0.66. The operation by repeated fed batch increases the efficiency of use of the biocatalysts (EB) and the accumulated productivity compared to batch and fed batch operation with the same biocatalyst. EB obtained was 4.13 gLuâmgbiocatalyst protein-1, 10.6 times higher than in fed-batch.
Subject(s)
Lactose , Lactulose , Fructose , beta-GalactosidaseABSTRACT
OBJECTIVES: To assess whether weaning to an extensively hydrolyzed formula (EHF) decreases gut permeability and/or markers of intestinal inflammation in infants with HLA-conferred diabetes susceptibility, when compared with conventional formula. STUDY DESIGN: By analyzing 1468 expecting biological parent pairs for HLA-conferred susceptibility for type 1 diabetes, 465 couples (32 %) potentially eligible for the study were identified. After further parental consent, 332 babies to be born were randomized at 35th gestational week. HLA genotyping was performed at birth in 309 infants. Out of 87 eligible children, 73 infants participated in the intervention study: 33 in the EHF group and 40 in the control group. Clinical visits took place at 3, 6, 9, and 12 months of age. The infants were provided either EHF or conventional formula whenever breastfeeding was not available or additional feeding was required over the first 9 months of life. The main outcome was the lactulose to mannitol ratio (L/M ratio) at 9 months. The secondary outcomes were L/M ratio at 3, 6, and 12 months of age, and fecal calprotectin and human beta-defensin 2 (HBD-2) levels at each visit. RESULTS: Compared with controls, the median L/M ratio was lower in the EHF group at 9 months (.006 vs .028; P = .005). Otherwise, the levels of intestinal permeability, fecal calprotectin, and HBD-2 were comparable between the two groups, although slight differences in the age-related dynamics of these markers were observed. CONCLUSIONS: It is possible to decrease intestinal permeability in infancy through weaning to an extensively hydrolyzed formula. This may reduce the early exposure to dietary antigens. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01735123.
Subject(s)
Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/metabolism , Feeding Behavior , Genetic Predisposition to Disease/genetics , Infant Formula , Intestinal Absorption/physiology , Biomarkers/metabolism , Caseins , Diabetes Mellitus, Type 1/diagnosis , Female , Humans , Infant , Infant, Newborn , Inflammation/etiology , Inflammation/metabolism , Lactulose/metabolism , Leukocyte L1 Antigen Complex/metabolism , Male , Mannitol/metabolism , beta-Defensins/metabolismABSTRACT
Minimal hepatic encephalopathy (MHE) corresponds to the earliest stage of hepatic encephalopathy (HE). MHE does not present clinically detectable neurological-psychiatric abnormalities but is characterized by imperceptible neurocognitive alterations detected during routine clinical examination via neuropsychological or psychometrical tests. MHE may affect daily activities and reduce job performance and quality of life. MHE can increase the risk of accidents and may develop into overt encephalopathy, worsening the prognosis of patients with liver cirrhosis. Despite a lack of consensus on the therapeutic indication, interest in finding novel strategies for prevention or reversion has led to numerous clinical trials; their results are the main objective of this review. Many studies address the treatment of MHE, which is mainly based on the strategies and previous management of overt HE. Current alternatives for the management of MHE include measures to maintain nutritional status while avoiding sarcopenia, and manipulation of intestinal microbiota with non-absorbable disaccharides such as lactulose, antibiotics such as rifaximin, and administration of different probiotics. This review analyzes the results of clinical studies that evaluated the effects of different treatments for MHE.
Subject(s)
Hepatic Encephalopathy , Hepatic Encephalopathy/diagnosis , Hepatic Encephalopathy/etiology , Hepatic Encephalopathy/therapy , Humans , Lactulose/therapeutic use , Liver Cirrhosis/complications , Liver Cirrhosis/diagnosis , Liver Cirrhosis/therapy , Quality of Life , Rifaximin/therapeutic useABSTRACT
In this paper, 3 different biocatalysts of ß-galactosidase from Kluyveromyces lactis have been prepared by immobilization in chitosan activated with glutaraldehyde (Chi_Glu_Gal), glyoxyl agarose (Aga_Gly_Gal) and agarose coated with polyethylenimine (Aga_PEI_Gal). These biocatalysts have been used to catalyze the synthesis of lactulose from lactose and fructose. Aga-PEI-Gal only produces lactulose at 50 °C, and not at 25 or 37 °C, Aga_Gly_Gal was unable to produce lactulose at any of the assayed temperatures while Chi_Glu_Gal produced lactulose at all assayed temperatures, although a lower yield was obtained at 25 or 37 °C. The pre-incubation of this biocatalyst at 50 °C permitted to obtain similar yields at 25 or 37 °C than at 50 °C. The use of milk whey instead of pure lactose and fructose produced an improvement in the yields using Aga_PEI_Gal and a decrease using Chi_Glu_Gal. The operational stability also depends on the reaction medium and of biocatalyst. This study reveals how enzyme immobilization may greatly alter the performance of ß-galactosidase in a kinetically controlled manner, and how medium composition influences this performance due to the kinetic properties of ß-galactosidase.
Subject(s)
Enzymes, Immobilized/chemistry , Fungal Proteins/chemistry , Kluyveromyces/enzymology , Lactulose , beta-Galactosidase/chemistry , Biocatalysis , Kinetics , Lactulose/chemical synthesis , Lactulose/chemistryABSTRACT
A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3 months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease.
Subject(s)
Carcinoma, Squamous Cell/complications , Constipation/etiology , Gastroparesis/etiology , Lung Neoplasms/complications , Paraneoplastic Syndromes, Nervous System/etiology , Aged , Antiemetics/therapeutic use , Carcinoma, Squamous Cell/diagnostic imaging , Constipation/diagnosis , Constipation/drug therapy , Constipation/physiopathology , Gastrointestinal Agents/therapeutic use , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/drug therapy , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Motility , Gastroparesis/diagnosis , Gastroparesis/drug therapy , Gastroparesis/physiopathology , Glycerol/therapeutic use , Humans , Lactulose/therapeutic use , Lung Neoplasms/diagnostic imaging , Male , Metoclopramide/analogs & derivatives , Metoclopramide/therapeutic use , Morphine/adverse effects , Opioid-Induced Constipation/diagnosis , Palliative Care , Paraneoplastic Syndromes, Nervous System/diagnosis , Paraneoplastic Syndromes, Nervous System/physiopathology , Tramadol/adverse effectsABSTRACT
BACKGROUND: Increased intestinal permeability may be associated with certain disorders, such as obesity and small intestine bacterial overgrowth (SIBO). OBJECTIVE: This study aimed to investigate intestinal permeability and SIBO in excess weight adolescents. METHODS: This cross-sectional study included 67 adolescents with excess weight and 66 normal weight adolescents. Excess weight was defined as a body mass index for age (BMI/age) > +1 SD, which includes having excess body weight and obesity. SIBO was diagnosed by a breath test after the ingestion of lactulose according to the production of hydrogen and methane. Zonulin (haptoglobin) was considered an indicator of intestinal permeability. RESULTS: Adolescents with excess weight had a higher height/age Z-score (median [25th; 75th percentile]: +0.6 [-0.4; +1.0]) than those in the normal weight group (-0.1 [-0.6; +0.7]; P = .014). Zonulin (mg/mL) in the excess weight (2.3 [1.5; 3.8]) adolescents was higher than that in the normal weight (1.6 [1.0; 2.2]) adolescents (P < .001). SIBO was diagnosed in 23.3% (31/133) of the adolescents. The adolescents with SIBO had a lower (P < .05) BMI/age (+0.6 [-0.6; +1.9]) and height/age (-0.3 [-0.7; +0.3]) than the adolescents without SIBO (+1.3 [+0.1; +2.6] and +0.2 [-0.5; +1.0], respectively). No association was found between zonulin and SIBO. CONCLUSION: Excess weight is associated with increased intestinal permeability. No relationship was found between SIBO and intestinal permeability; however, SIBO was related to lower BMI and height for age Z-scores.
Subject(s)
Intestine, Small , Lactulose , Overweight/microbiology , Pediatric Obesity/microbiology , Adolescent , Blind Loop Syndrome , Breath Tests , Case-Control Studies , Cross-Sectional Studies , Humans , Intestine, Small/microbiology , PermeabilityABSTRACT
Aspergillus oryzae ß-galactosidase was immobilized in in-house quaternary ammonium agarose (QAA) and used for the first time in the synthesis of lactulose. A biocatalyst was obtained with a specific activity of 24,690 IUHâg-1; protein immobilization yield of 97% and enzyme immobilization yield of 76% were obtained at 30 °C in 10 mM phosphate buffer pH 7 for standard size agarose at 100 mgproteinâgsupport-1 which the maximum protein load of QAA. Highest yield and specific productivity of lactulose were 0.24 gâg-1 and 9.78 gâg-1 h-1 respectively, obtained at pH 6, 100 IUHâg lactose-1 enzyme/lactose ratio and 12 lactose/fructose molar ratio. In repeated-batch operation with the immobilized enzyme, the cumulative mass of lactulose per unit mass of contacted protein and cumulative specific productivity were higher than obtained with the soluble enzyme since the first batch. After enzyme activity exhaustion, the enzyme was desorbed and QAA support was reused without alteration in its maximum enzyme load capacity and without detriment in yield, productivity and selectivity in the batch synthesis of lactulose with the resulting biocatalyst. This significantly decreases the economic impact of the support, presenting itself as a distinctive advantage of immobilization by ionic interaction.
Subject(s)
Aspergillus oryzae/enzymology , Enzymes, Immobilized/chemistry , Lactulose/chemical synthesis , beta-Galactosidase/chemistry , Catalysis , Chromatography, High Pressure Liquid , Fructose/chemistry , Hydrogen-Ion Concentration , Lactose/chemistry , Particle Size , Sepharose/chemistry , TemperatureABSTRACT
Galactooligosaccharides (GOS) are useful dietary ingredients recognized worldwide as prebiotics. In the present study, we evaluated the ß-galactosidase (ß-gal) activity of a panel of lactic acid bacteria (LAB) in order to select strains for the synthesis of oligosaccharides from lactose (GOS) and lactulose (OsLu) with a potential prebiotic effect. Fifteen strains out of 20 were able to grow on lactose and showed ß-gal activities between 0.03 and 2.06 U mg-1, whereas eleven were able to synthesize GOS. Lactobacillus delbrueckii subsp. bulgaricus CRL450, the strain with the highest ß-gal activity, synthesized a maximum of 41.3% GOS and 21.0% OsLu from lactose and lactulose, respectively, with ß-(1 â 6) and secondary ß-(1 â 3) linkages. When these compounds were tested without purifying, as carbon sources for the development of recognized probiotics and the producer strain, high growth was observed compared to non-prebiotic sugars like glucose and lactose. When the purified oligosaccharides were tested, the bacterial growth decreased, but the microorganisms displayed metabolic activity evidenced by the consumption of carbohydrates and the production of lactic acid. Additionally, the purified oligosaccharides demonstrated a bifidogenic effect. The obtained results support the potential of L. delbrueckii subsp. bulgaricus CRL450 for the production of the prebiotics GOS and OsLu and encourage the optimization of their synthesis for the design of new functional food ingredients.