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1.
Clin Nutr ; 40(3): 1413-1419, 2021 03.
Article in English | MEDLINE | ID: mdl-32948350

ABSTRACT

BACKGROUND & AIMS: Experimental (nutritional) interventions in preterm infants frequently focus on intestinal maturation, as improving tolerance to enteral nutrition is a major goal. Intestinal permeability and lactase activity serve as markers for intestinal maturation. We aimed to develop a protocol for the simultaneous assessment of both markers in human-milk-fed preterm infants by a sugar absorption test. In addition, we developed a new gas chromatography-mass spectrometry (GC-MS) method for the analysis of lactulose, lactose, and mannitol in urine and milk collected during the sugar absorption test. METHODS: The sugar absorption test was performed on days 4, 7, and 14 postpartum in 12 preterm infants (gestational age of 26-32 weeks). Human milk was collected, pooled, and divided into equal portions to provide a stable lactose intake for 24 h. Urine was collected in the last 6 h of this 24 h period, after administration of a bolus test sugar solution. Samples were analyzed by GC-MS after derivatization by oxime formation combined with acetylation. RESULTS: The GC-MS method was validated and used for the accurate measurement of lactulose, lactose, and mannitol concentrations. The urinary lactulose/mannitol ratio declined with time, suggesting a decreased intestinal permeability. The urine-to-milk-lactulose/lactose ratio increased as a result of increased lactase activity with time. CONCLUSIONS: The developed protocol for simultaneous assessment of intestinal permeability and lactase activity can be used to monitor the effect of experimental (nutritional) interventions in human-milk-fed preterm infants. Urine and milk samples obtained during the sugar absorption test can be accurately analyzed by GC-MS.


Subject(s)
Infant, Premature/metabolism , Intestinal Absorption/physiology , Intestinal Mucosa/metabolism , Lactase/metabolism , Milk, Human , Double-Blind Method , Gas Chromatography-Mass Spectrometry/methods , Gestational Age , Humans , Infant, Newborn , Lactose/administration & dosage , Lactose/analysis , Lactose/urine , Lactulose/administration & dosage , Lactulose/analysis , Lactulose/urine , Mannitol/administration & dosage , Mannitol/urine , Milk, Human/chemistry , Permeability , Placebos , Reproducibility of Results
2.
J Dairy Res ; 86(2): 188-192, 2019 May.
Article in English | MEDLINE | ID: mdl-31118111

ABSTRACT

The aim of this study was to investigate the effect of 17ß-estradiol on mammary tight junctions in cows in late lactation. The experiment included five non-pregnant cows around day 290 in lactation. The cows received injections of 17ß-estradiol for six days. The effect of exogenous 17ß-estradiol on milk yield, milk composition and lactose in plasma and lactose in urine was investigated before, during and after the treatment. Milk yield decreased after 17ß-estradiol injections and lactose in plasma and urine increased, showing an effect on the integrity of the mammary tight junctions. However, there was a delay between hormone injections and the decrease in milk yield and opening of tight junctions, indicating that other factors are involved. A high correlation between lactose in urine and blood plasma was found. More than 30% of the total lactose production was lost in urine after 17ß-estradiol treatment.


Subject(s)
Cattle/blood , Estradiol/pharmacology , Lactation/blood , Lactose/blood , Lactose/urine , Tight Junctions/drug effects , Animals , Female , Milk/chemistry , Milk/cytology
3.
Drug Test Anal ; 11(9): 1412-1418, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31140750

ABSTRACT

Urine samples were analyzed for lactose to investigate if elevated lactose concentrations indicate recent (< 48 hours) intravenous abuse of substances containing lactose as an excipient. Elevated lactose levels were found in samples given by patients who had recently injected substances intravenously, verified by fresh injection marks. Urine lactose assay can support clinical and toxicological findings when assessing substance abuse.


Subject(s)
Buprenorphine/urine , Lactose/urine , Narcotics/urine , Substance Abuse, Intravenous/urine , Adult , Enzyme Assays/methods , Excipients/analysis , Female , Humans , Male , Middle Aged , Substance Abuse Detection/methods , Young Adult
4.
Am J Clin Nutr ; 109(2): 470-477, 2019 02 01.
Article in English | MEDLINE | ID: mdl-30721917

ABSTRACT

Background: Lactase is an enzyme that hydrolyzes lactose into glucose and galactose in the small intestine, where they are absorbed. Hypolactasia is a common condition, primarily caused by genetic programming, that leads to lactose maldigestion and, in certain cases, lactose intolerance. Galactitol and galactonate are 2 products of hepatic galactose metabolism that are candidate markers for the intake of lactose-containing foods. Objectives: The primary objective of the study was to explore the changes in serum and urine metabolomes during postprandial dairy product tests through the association between lactase persistence genotype and the postprandial dynamics of lactose-derived metabolites. Methods: We characterized the 6-h postprandial serum kinetics and urinary excretion of lactose, galactose, galactitol, and galactonate in 14 healthy men who had consumed a single dose of acidified milk (800 g) which contained 38.8 g lactose. Genotyping of LCT-13910 C/T (rs4988235) was performed to assess primary lactase persistence. Results: There were 2 distinct postprandial responses, classified as high and low metabolite responses, observed for galactose, and its metabolites galactitol and galactonate, in serum and urine. In all but 1 subject, there was a concordance between the high metabolite responses and genetic lactase persistence and between the low metabolite responses and genetic lactase nonpersistence (accuracy 0.92), galactitol and galactonate being more discriminative than galactose. Conclusions: Postprandial galactitol and galactonate after lactose overload appear to be good proxies for genetically determined lactase activity. The development of a noninvasive lactose digestion test based on the measurement of these metabolites in urine could be clinically useful. This trial was registered at clinicaltrials.gov as NCT02230345.


Subject(s)
Galactitol/metabolism , Lactase/metabolism , Lactose Intolerance , Lactose/metabolism , Milk/adverse effects , Nutrition Assessment , Sugar Acids/metabolism , Adult , Animals , Biomarkers/metabolism , Dairy Products/adverse effects , Digestion/genetics , Galactitol/blood , Galactitol/urine , Galactose/blood , Galactose/metabolism , Galactose/urine , Genotype , Humans , Lactase/deficiency , Lactase/genetics , Lactose/blood , Lactose/urine , Lactose Intolerance/genetics , Lactose Intolerance/metabolism , Liver , Male , Milk/chemistry , Polymorphism, Single Nucleotide , Postprandial Period , Sugar Acids/blood , Sugar Acids/urine , Young Adult
5.
J Proteome Res ; 16(9): 3321-3335, 2017 09 01.
Article in English | MEDLINE | ID: mdl-28753012

ABSTRACT

The measurement of food intake biomarkers (FIBs) in biofluids represents an objective tool for dietary assessment. FIBs of milk and cheese still need more investigation due to the absence of candidate markers. Thus, an acute intervention study has been performed to sensitively and specifically identify candidate FIBs. Eleven healthy male and female volunteers participated in the randomized, controlled crossover study that tested a single intake of milk and cheese as test products, and soy-based drink as a control. Urine samples were collected at baseline and up to 24 h at distinct time intervals (0-1, 1-2, 2-4, 4-6, 6-12, and 12-24 h) and were analyzed using an untargeted multiplatform approach (GC-MS and 1H NMR). Lactose, galactose, and galactonate were identified exclusively after milk intake while for other metabolites (allantoin, hippurate, galactitol, and galactono-1,5-lactone) a significant increase has been observed. Urinary 3-phenyllactic acid was the only compound specifically reflecting cheese intake although alanine, proline, and pyroglutamic acid were found at significantly higher levels after cheese consumption. In addition, several novel candidate markers for soy drink were identified, such as pinitol and trigonelline. Together, these candidate FIBs of dairy intake could serve as a basis for future validation studies under free-living conditions.


Subject(s)
Cheese/analysis , Eating/physiology , Metabolome , Milk/metabolism , Soy Milk/metabolism , Adult , Alkaloids/urine , Allantoin/urine , Animals , Biomarkers/urine , Cross-Over Studies , Female , Galactose/urine , Gas Chromatography-Mass Spectrometry , Healthy Volunteers , Hippurates/urine , Humans , Inositol/analogs & derivatives , Inositol/urine , Lactates/urine , Lactose/urine , Magnetic Resonance Spectroscopy , Male , Milk/chemistry , Soy Milk/administration & dosage
6.
Br J Nutr ; 117(2): 237-247, 2017 01.
Article in English | MEDLINE | ID: mdl-28179042

ABSTRACT

Human milk oligosaccharides (HMO) are involved in many biological functions influencing infant health. Although HMO act locally at the intestine, recent evidence has demonstrated that HMO are partially incorporated into the systemic circulation of breast-fed infants. In the last few years, a large amount of research has been conducted using preclinical models to uncover new biological functions of HMO. The aim of this study was to evaluate the absorption and urine excretion of HMO in rats. We administered a single oral dose of the following HMO: 2'-fucosyllactose (2'-FL), 6'-sialyllactose and lacto-N-neotetraose at different concentrations to adult rats. The time course of absorption of HMO into the bloodstream and their appearance in urine was studied. Our results showed that rats, similar to human infants, are able to effectively absorb a portion of HMO from the intestine into plasma and to excrete them in urine. On the basis of this, we also conducted a specific kinetic absorption study with 2'-FL, the most predominant HMO in human milk, in 9-11-d-old rat pups. Our results confirmed that a significant amount of 2'-FL was absorbed into the systemic circulation and subsequently excreted in urine during lactation in rats in a dose-depended manner. We also found basal levels of these HMO in plasma and urine of adult rats as well as rat pups as a natural result of nursing. Our data suggest that the rat may be a useful preclinical model that provides new insights into the metabolism and functions of HMO.


Subject(s)
Breast Feeding , Intestinal Absorption , Lactation , Lactose/analogs & derivatives , Milk, Human/chemistry , Oligosaccharides/pharmacokinetics , Trisaccharides/pharmacokinetics , Administration, Oral , Animals , Diet , Dietary Carbohydrates/blood , Dietary Carbohydrates/pharmacokinetics , Dietary Carbohydrates/urine , Female , Intestines , Lactose/blood , Lactose/pharmacokinetics , Lactose/urine , Male , Oligosaccharides/blood , Oligosaccharides/urine , Rats, Sprague-Dawley , Trisaccharides/blood , Trisaccharides/urine
7.
J Anal Toxicol ; 41(1): 22-31, 2017 Jan.
Article in English | MEDLINE | ID: mdl-28130543

ABSTRACT

The detection of disaccharides in urine is under investigation to act as a marker for intravenous abuse of disaccharide formulations, like liquid methadone with syrup (sucrose), methadone tablets (lactose and sucrose), or buprenorphine tablets (lactose). As the detection time in urine has not yet been investigated and a routine method for detecting disaccharides is still lacking, a study was performed to estimate the window of detection in urine after intravenous consumption of disaccharides. Furthermore, an analytical LC-MSMS method for the quantification of sucrose and lactose in urine was validated. The method was applied to urine samples of intravenous substitute consumers, with urine being sampled before intravenous use of substitutes and approximately 30 minutes later. Twenty users provided information regarding their most recent prior intravenous consumption. Disaccharides were detectable in all 20 urine samples about 30 minutes after consumption. A cut off for both disaccharides of 40mg/L was used. Based on these conditions 81% of the persons who consumed in a time frame of 24 hours ago showed positive results for disaccharides. The study showed that the validated LC-MSMS method with an easy and fast workup is usable for daily routine in the laboratory. It might be helpful for methadone and buprenorphine prescribing physicians to check whether the opiate maintenance treatment patient takes his or her substitution medicines orally as intended, or continues with intravenous misuse by injecting substitution medicines instead of heroin.


Subject(s)
Buprenorphine/urine , Lactose/urine , Methadone/urine , Opiate Alkaloids/urine , Substance Abuse Detection/methods , Substance Abuse, Intravenous/urine , Sucrose/urine , Adult , Biomarkers/urine , Carbonated Beverages , Case-Control Studies , Chocolate , Chromatography, Liquid , Female , Humans , Limit of Detection , Male , Middle Aged , Reproducibility of Results , Tandem Mass Spectrometry , Young Adult
8.
Drug Test Anal ; 9(6): 949-952, 2017 Jun.
Article in English | MEDLINE | ID: mdl-27504930

ABSTRACT

Buprenorphine and methadone are commonly used medications for opioid maintenance treatment (OMT), using sublingual and oral administration, respectively. Although beneficial for OMT, these drugs can also be abused by intravenous administration. In intravenous abuse cases, the adjuvants lactose and sucrose are excreted in urine without hydrolysis to monosaccharides, since there are no disaccharidases in the blood. We validated enzymatic methods for the analysis of lactose and sucrose in urine. The analytical performance of both assays was considered appropriate for detecting intravenous drug abuse. The principle was proven by analyzing 93 postmortem (PM) urine samples for lactose, following comprehensive toxicological drug screening. In addition, 32 clinical urine samples from potential drug abusers were analyzed to assess the effect of PM changes on the assay. The mean level of lactose was low in clinical samples and relatively low in PM samples in which no drugs were found. Markedly elevated levels were seen in many of the buprenorphine positive samples, suggesting intravenous administration. Enzymatic methods could provide a simple and cost effective way to assess the intravenous administration of OMT drugs or drugs of abuse. Very high levels of glucose in urine may interfere with the assays. Furthermore, other causes for elevated urine disaccharides, such as hypolactasia and increased intestinal permeability, need to be considered in the interpretation of the results. Copyright © 2016 John Wiley & Sons, Ltd.


Subject(s)
Analgesics, Opioid/urine , Buprenorphine/urine , Lactose/urine , Substance Abuse Detection/methods , Substance Abuse, Intravenous/urine , Sucrose/urine , Analgesics, Opioid/administration & dosage , Buprenorphine/administration & dosage , Enzyme Assays/methods , Humans , Limit of Detection , Opiate Substitution Treatment
9.
Isotopes Environ Health Stud ; 51(4): 488-96, 2015.
Article in English | MEDLINE | ID: mdl-26499512

ABSTRACT

Three resistant starches (RSs), namely fibre of potatoes (FP), wrinkle pea starch (WPS), and high amylose maize starch (HAMS) with different dietary fibre contents, were supplemented in adults to evaluate their effects on urinary nitrogen and ammonia excretion as well as on faecal nitrogen excretion by means of lactose-[(15)N2]ureide ((15)N-LU) degradation. Twenty subjects received a regular diet either without or with the supplementation of FP, WPS, and HAMS in a randomized order. After administration of (15)N-LU, urine and faeces were collected over 48 and 72 h, respectively, whereas blood was collected after 6 h. The (15)N-abundances were measured by isotope ratio mass spectrometry. In comparison to the dry run, supplementation with RS significantly lowered renal (15)N-excretion (dry run: 43.2%, FP: 34.6%, WPS: 37.9%, HAMS: 36.4%) as well as the corresponding (15)NH3-excretion (dry run: 0.08%, FP: 0.06%, HAMS: 0.05%), clearly indicating a reduced colonic nitrogen generation at high dietary fibre intake.


Subject(s)
Ammonia/metabolism , Dietary Carbohydrates/metabolism , Pisum sativum/chemistry , Solanum tuberosum/chemistry , Zea mays/chemistry , Adult , Ammonia/blood , Ammonia/urine , Colon/metabolism , Dietary Carbohydrates/administration & dosage , Dietary Fiber/administration & dosage , Dietary Fiber/metabolism , Dietary Supplements/analysis , Feces/chemistry , Female , Humans , Lactose/analysis , Lactose/blood , Lactose/urine , Male , Nitrogen/blood , Nitrogen/metabolism , Nitrogen/urine , Nitrogen Isotopes/analysis , Nitrogen Isotopes/blood , Nitrogen Isotopes/urine , Urea/analogs & derivatives , Urea/analysis , Urea/blood , Urea/urine , Young Adult
10.
Analyst ; 140(8): 2834-41, 2015 Apr 21.
Article in English | MEDLINE | ID: mdl-25730398

ABSTRACT

Urinary tract infection (UTI) is among the most common bacterial infections worldwide. The understanding of the physiological mechanisms affected by UTI may need modern integrative '-omics' technologies, and metabolomics in particular. Here we present the first GC-APCI-MS-based explorative metabolomics study of UTI, using MS and FID detectors simultaneously. This provides high quality mass spectral data as well as semi-quantitative information demonstrating the feasibility of the GC-APCI-MS platform for non-targeted approaches. The work is part of a bigger project aiming at providing a comprehensive overview of UTI-induced changes in urine. Taking advantage of a fully clinically characterized cohort that offers the possibility of both case-control and longitudinal modelling, we can define UTI-induced change as a list of urinary metabolites which distinguish E. coli UTI patients from the subjects with no signs of an active infection. The list of molecular descriptors includes compounds related to bacterial activity such as lactic acid and lactose while other molecules show an association with the physiological status (inositol, citric acid).


Subject(s)
Atmospheric Pressure , Escherichia coli Infections/urine , Gas Chromatography-Mass Spectrometry/methods , Urinary Tract Infections/urine , Aged , Escherichia coli/physiology , Female , Humans , Lactic Acid/urine , Lactose/urine , Male , Middle Aged
11.
J Pharm Biomed Anal ; 109: 1-10, 2015 May 10.
Article in English | MEDLINE | ID: mdl-25746501

ABSTRACT

Methyl salicylate-2-O-ß-d-lactoside (MSL) is a natural salicylate derivative from the traditional Chinese medicine of Gaultheria yunnanensis (Franch.) Rehder (G. yunnanensis). As a non-steroidal anti-inflammatory drug (NSAID), MSL exerts a significant anti-arthritis effect but hardly has any gastrointestinal toxicity. In this paper, the pharmacokinetics, distribution, excretion and identification of MSL and its metabolites are described following rat oral and intravenous administration. The biological samples were quantified by UPLC-MS/MS and the metabolites in urine and feces were identified by using Q-TOF-MS. These results will support future investigations leading to clinical development of this drug.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/pharmacokinetics , Lactose/analogs & derivatives , Salicylates/pharmacokinetics , Animals , Anti-Inflammatory Agents, Non-Steroidal/urine , Biotransformation , Calibration , Chromatography, High Pressure Liquid , Feces/chemistry , Lactose/pharmacokinetics , Lactose/urine , Limit of Detection , Mass Spectrometry , Quality Control , Rats , Reproducibility of Results , Salicylates/urine , Tissue Distribution
12.
Int J Legal Med ; 128(5): 751-64, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24859230

ABSTRACT

Methadone plays an increasing role in drug-related deaths in Hamburg. To find out whether intravenous application of methadone plays a relevant role in methadone-related deaths, body fluids of all methadone-positive cases (n=130) and three buprenorphine-positive cases where a urine sample was available (n=58+3) were investigated for disaccharides (sucrose and lactose as markers for intravenous methadone abuse). Sixty-four percent of the urine samples of the methadone cases showed positive results for disaccharides (22 times sucrose alone, range 2 to >1,000 mg/L; 6 times lactose and sucrose; and 9 times lactose alone, range 22 to 382 mg/L). The three buprenorphine cases showed positive results for lactose in urine. In blood, it was not possible to detect any disaccharides. Of the 116 fatal methadone intoxications, 49 % were under opiate maintenance treatment (OMT) at the point of death (A-OMT), 30 % were never in OMT (N-OMT) and 21 % were formerly in an OMT, but not at the point of death (F-OMT). Of the deceased in the OMT group, 12 % (n=7) died within the first 2 weeks of treatment, six of them within the first week. Overall, intravenous abuse of methadone plays a relevant role in methadone-related fatal cases of substituted patients and of drug consumers not in therapy. Thus, it is necessary that therapists keep to the statutory regulations and give take-home doses only after at least 6 months of successful therapy and when there is no suspicion of intravenous abuse.


Subject(s)
Drug Overdose/mortality , Methadone/poisoning , Narcotics/poisoning , Substance Abuse, Intravenous/mortality , Adult , Buprenorphine/administration & dosage , Buprenorphine/analysis , Buprenorphine/poisoning , Female , Forensic Toxicology , Germany/epidemiology , Humans , Lactose/urine , Male , Methadone/administration & dosage , Methadone/analysis , Middle Aged , Narcotics/administration & dosage , Narcotics/analysis , Opiate Substitution Treatment/statistics & numerical data , Risk Factors , Sucrose/blood , Sucrose/urine
13.
Scand J Clin Lab Invest ; 74(3): 264-72, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24621206

ABSTRACT

BACKGROUND: Modern metabolomic profiling has not yet been applied to human breastfeeding research. A common reason for breastfeeding cessation is perceived insufficient milk production. We investigated broad biochemical profiles in maternal urine collected during and after pregnancy to identify biomarkers related to reduced reported breastfeeding. METHODS: Fasting urine was collected at three consultations (visit V1: gestational week 8-20; V2: week 28 ± 2; V3: 10-16 weeks postpartum) in the STORK Groruddalen program, a prospective, multiethnic cohort study of gestational diabetes involving healthy, pregnant women in Oslo, Norway, and analyzed using NMR spectroscopy. Breastfeeding at V3 was recorded in three categories: Exclusively breastfeeding (n = 326), partially breastfeeding (n = 156) and formula feeding (n = 67). RESULTS: Five metabolites were relevant to breastfeeding. Lactose was detected at V1 and increased to 0.1 mM/mM creatinine at V2. Postpartum excretion at V3 was significantly higher in exclusively breastfeeding women than partially or non-breastfeeding (median = 0.29, 0.23 and 0.04 mM/mM creatine, respectively; ANOVA p-value = 2e-70). Glycine excretion at V3 (0.12, 0.10 and 0.06, respectively; p = 2e-5) and at V2 were associated with breastfeeding (0.34, 0.33 and 0.26, respectively; p = 4e-5). Creatine and two unidentified substances also correlated with breastfeeding. NMR metabolomics found no other metabolites differing between categories during pregnancy (V1, V2), and did not predict individual breastfeeding postpartum (V3). CONCLUSION: Decreased glycine excretion at V2 may indicate difficulties meeting the metabolic demands of the growing fetus, but urine profiles contained otherwise little indication of early adaptations during pregnancy towards reduced biological potential to breastfeed.


Subject(s)
Breast Feeding , Glycine/urine , Metabolomics , Adaptation, Physiological , Adult , Biomarkers/urine , Creatine/urine , Creatinine/urine , Female , Gestational Age , Humans , Infant , Infant Formula , Infant, Newborn , Lactose/urine , Norway , Pregnancy , Prospective Studies , Time Factors
14.
J Anal Toxicol ; 37(9): 652-8, 2013.
Article in English | MEDLINE | ID: mdl-24099717

ABSTRACT

Methadone and buprenorphine are commonly used as oral substitutes in opiate maintenance programs to treat persons who are dependent on heroin. During these programs, patients are not allowed to continue using illicit drugs. Abstinence can easily be monitored by urine tests with immunochemical methods. It is well known that the intravenous abuse of heroin substitutes like methadone or buprenorphine has become common as well. The methadone-prescribing physician has no opportunity to check whether the opiate maintenance treatment patient takes his substitution medicines orally as intended or continues with his intravenous misuse now substituting the methadone instead of injecting heroin. In Germany, substitutes are available as liquids and tablets that contain carbohydrates as adjuvants. Sucrose is used to increase viscosity in liquids, while lactose is needed for pressing tablets (e.g., Methaddict® and Subutex®). In case of oral ingestion, disaccharides are broken down into monosaccharides by disaccharidases in the small intestine. These monosaccharides are absorbed into the blood stream by special monosaccharide transporters. Disaccharidases do not exist in blood, thus sucrose and lactose are not split if substitute medicines are injected intravenously. Our assumption, therefore, was that they are excreted unchanged in urine. We investigated a method for the detection of disaccharides in urine as markers of intravenous abuse of substitutes. Urine samples of 26 intravenous substitute abusers showed all positive results for lactose (76.9%) and/or sucrose (73.1%). The method is assumed to be useful to detect intravenous abuse of substitutes.


Subject(s)
Buprenorphine , Disaccharides/urine , Methadone , Narcotics , Opioid-Related Disorders/urine , Substance Abuse, Intravenous/urine , Adult , Calibration , Carbohydrate Sequence , Chemistry, Pharmaceutical , Chromatography, High Pressure Liquid , Female , Humans , Indicators and Reagents , Lactose/urine , Male , Middle Aged , Molecular Sequence Data , Reproducibility of Results , Substance Abuse Detection , Sucrose/urine , Young Adult
15.
Trop Gastroenterol ; 34(3): 136-43, 2013.
Article in English | MEDLINE | ID: mdl-24851522

ABSTRACT

AIM: Cirrhosis with portal hypertension (PHT) may be associated with increased small intestinal permeability (SIP), predisposing to malnutrition and bacterial translocation causing septicaemia, endotoxaemia and spontaneous bacterial peritonitis. However, data on SIP in extrahepatic portal venous obstruction (EHPVO), in which PHT occurs without hepatic dysfunction, are scanty. Such studies would help to know the effect of PHT on SIP independent of hepatic dysfunction; hence, we undertook this study. METHODS: A total of 96 patients with PHT (cirrhosis 71, EHPVO 25) underwent evaluation of SIP using urinary lactulose/mannitol excretion ratio over 6 hours after oral administration of 15 mL (10 g) lactulose and 5 g mannitol using 1H-NMR spectroscopy by a method described by us previously. RESULTS: Gender of patients with EHPVO and cirrhosis was comparable but patients with EHPVO were younger in age. The causes of cirrhosis were cryptogenic (n = 22), alcohol (n = 20), post-viral (n = 21) and others (n = 8). Twenty-seven (38%) patients with cirrhosis had ascites. Abnormal SIP was detected in 47 (49%) patients (40/71,56% with cirrhosis vs. 7/25, 28% with EHPVO, p = 0.01). Patients with cirrhosis had a higher urinary lactulose/mannitol excretion ratio than those with EHPVO (0.09, range 0-0.87 mmol vs. 0.05, 0-0.19 mmol; p = 0.008). Patients with abnormal SIP had a higher Child score, and more often had cirrhosis than EHPVO, ascites and deranged liver function. On multivariate analysis, presence of cirrhosis, ascites, high serum bilirubin level and prothrombin time were associated with abnormal SIP. CONCLUSIONS: Cirrhosis was associated with abnormal SIP, which was related to liver dysfunction. However, SIP was normal in patients with EHPVO.


Subject(s)
Hypertension, Portal/metabolism , Intestinal Absorption/physiology , Intestine, Small/metabolism , Liver Cirrhosis/metabolism , Vascular Diseases/metabolism , Adolescent , Adult , Aged , Female , Humans , Hypertension, Portal/urine , Lactose/urine , Liver Cirrhosis/urine , Male , Mannose/urine , Middle Aged , Vascular Diseases/urine , Young Adult
16.
PLoS One ; 7(12): e52399, 2012.
Article in English | MEDLINE | ID: mdl-23285025

ABSTRACT

This study aims to identify novel markers for gestational diabetes (GDM) in the biochemical profile of maternal urine using NMR metabolomics. It also catalogs the general effects of pregnancy and delivery on the urine profile. Urine samples were collected at three time points (visit V1: gestational week 8-20; V2: week 28±2; V3 10-16 weeks post partum) from participants in the STORK Groruddalen program, a prospective, multiethnic cohort study of 823 healthy, pregnant women in Oslo, Norway, and analyzed using (1)H-NMR spectroscopy. Metabolites were identified and quantified where possible. PCA, PLS-DA and univariate statistics were applied and found substantial differences between the time points, dominated by a steady increase of urinary lactose concentrations, and an increase during pregnancy and subsequent dramatic reduction of several unidentified NMR signals between 0.5 and 1.1 ppm. Multivariate methods could not reliably identify GDM cases based on the WHO or graded criteria based on IADPSG definitions, indicating that the pattern of urinary metabolites above micromolar concentrations is not influenced strongly and consistently enough by the disease. However, univariate analysis suggests elevated mean citrate concentrations with increasing hyperglycemia. Multivariate classification with respect to ethnic background produced weak but statistically significant models. These results suggest that although NMR-based metabolomics can monitor changes in the urinary excretion profile of pregnant women, it may not be a prudent choice for the study of GDM.


Subject(s)
Diabetes, Gestational/metabolism , Diabetes, Gestational/urine , Ethnicity , Adult , Citrates/urine , Cohort Studies , Discriminant Analysis , Female , Humans , Hyperglycemia/urine , Lactose/urine , Least-Squares Analysis , Magnetic Resonance Spectroscopy , Pregnancy , Reproducibility of Results , World Health Organization
17.
Eur J Clin Nutr ; 65(8): 959-64, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21559041

ABSTRACT

BACKGROUND/OBJECTIVES: Lactose-[(15)N, (15)N]-ureide is used to study the fate of the colonic urea-nitrogen metabolism. During the passage through the gastrointestinal tract, lactose ureide is hydrolysed to glucose ureide, which is absorbed to a limited extent from the small intestine and is excreted urinarily. In the present study, a procedure has been developed to quantify the urinary excretion of glucose-[(15)N, (15)N]-ureide. In addition, urine and faecal samples obtained during a dietary intervention study with the prebiotic lactulose were retrospectively analysed. SUBJECTS/METHODS: The glucose ureide and lactose ureide content was measured by GC-MS in 19 healthy volunteers. After consumption of a standard test meal containing 75 mg lactose-[(15)N, (15)N]-ureide, six healthy volunteers performed a fractionated 24 h urine collection to investigate the urinary excretion of glucose-[(15)N, (15)N]-ureide. In 13 volunteers, the effect of lactulose administration on the urinary excretion of glucose-[(15)N, (15)N]-ureide was analysed. RESULTS: The urinary excretion of glucose-[(15)N, (15)N]-ureide reached its maximum level in the 3-6 h urine collection and decreased in the 6-9 h urine. The label was still detectable in the 9-24 h urine collection. The cumulative excretion of (15)N-labelled glucose ureide after 24 h amounted 12.91%. No significant differences in glucose-[(15)N, (15)N]-ureide excretion were found in either of the urine fractions after administration of lactulose, compared with baseline. In none of the urine samples lactose-[(15)N, (15)N]-ureide was detected. CONCLUSIONS: In conclusion, the results obtained in the present study indicated that the percentage dose glucose-[(15)N, (15)N]-ureide recovered in urine is rather constant and not influenced by the presence of lactulose.


Subject(s)
Glucose/analogs & derivatives , Lactose/urine , Urea/analogs & derivatives , Urinalysis/methods , Adult , Diet , Feces , Female , Gas Chromatography-Mass Spectrometry , Humans , Lactulose/administration & dosage , Male , Prebiotics/analysis , Retrospective Studies , Urea/urine , Young Adult
18.
Am J Physiol Gastrointest Liver Physiol ; 300(3): G477-84, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21148400

ABSTRACT

Heavy exercise causes gut symptoms and, in extreme cases, "heat stroke" partially due to increased intestinal permeability of luminal toxins. We examined bovine colostrum, a natural source of growth factors, as a potential moderator of such effects. Twelve volunteers completed a double-blind, placebo-controlled, crossover protocol (14 days colostrum/placebo) prior to standardized exercise. Gut permeability utilized 5 h urinary lactulose-to-rhamnose ratios. In vitro studies (T84, HT29, NCM460 human colon cell lines) examined colostrum effects on temperature-induced apoptosis (active caspase-3 and 9, Baxα, Bcl-2), heat shock protein 70 (HSP70) expression and epithelial electrical resistance. In both study arms, exercise increased blood lactate, heart rate, core temperature (mean 1.4°C rise) by similar amounts. Gut hormone profiles were similar in both arms although GLP-1 levels rose following exercise in the placebo but not the colostrum arm (P = 0.026). Intestinal permeability in the placebo arm increased 2.5-fold following exercise (0.38 ± 0.012 baseline, to 0.92 ± 0.014, P < 0.01), whereas colostrum truncated rise by 80% (0.38 ± 0.012 baseline to 0.49 ± 0.017) following exercise. In vitro apoptosis increased by 47-65% in response to increasing temperature by 2°C. This effect was truncated by 60% if colostrum was present (all P < 0.01). Similar results were obtained examining epithelial resistance (colostrum truncated temperature-induced fall in resistance by 64%, P < 0.01). Colostrum increased HSP70 expression at both 37 and 39°C (P < 0.001) and was truncated by addition of an EGF receptor-neutralizing antibody. Temperature-induced increase in Baxα and reduction in Bcl-2 was partially reversed by presence of colostrum. Colostrum may have value in enhancing athletic performance and preventing heat stroke.


Subject(s)
Athletes , Colostrum/metabolism , Dietary Supplements , Heat Stroke/prevention & control , Intestinal Absorption , Intestinal Mucosa/metabolism , Physical Exertion , Adult , Animals , Apoptosis , Apoptosis Regulatory Proteins/metabolism , Biomarkers/blood , Biomarkers/urine , Cattle , Cross-Over Studies , Double-Blind Method , Electric Impedance , Female , Gastrointestinal Hormones/blood , HSP70 Heat-Shock Proteins/metabolism , HT29 Cells , Heat Stroke/etiology , Heat Stroke/metabolism , Hot Temperature , Humans , Intestines/pathology , Lactic Acid/blood , Lactose/urine , Male , Permeability , Placebo Effect , Pregnancy , Rhamnose/urine , Young Adult
19.
Eur J Clin Nutr ; 64(10): 1215-21, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20683456

ABSTRACT

BACKGROUND: The evaluation of ammonia detoxification by pre- and probiotics by means of colonic lactose-[(15)N(2)]ureide ((15)N-LU) degradation is of great interest both scientifically and in terms of nutrition physiology. OBJECTIVE: Pre- and probiotics were supplemented in healthy adults to evaluate the effect of the ammonia metabolism in the human colon by means of (15)N-LU. METHODS: A total of 14 participants aged 20-28 years daily received a regular diet either without (no treatment) or with supplementation of 30 g fibre of potatoes (FPs), 30 g wrinkle pea starch (WPS, resistant starch content: 12 and 70%, respectively) and 375 g Lactobacillus acidophilus (LC1) yoghurt, over a 10-day period in a randomised order. After 1 week, 5.7 mg/kg body weight (15)N-LU was administered together with breakfast. A venous blood sample was taken after 6 h. Urine and faeces were collected over a period of 48 and 72 h, respectively. The (15)N abundances were measured by isotope ratio mass spectrometry. RESULTS: The mean renal (15)N-excretion differed significantly between the supplementation of FP and no treatment (32.5 versus 46.3%, P=0.034), FP and LC1 (32.5 versus 51.6%, P=0.001), and WPS and LC1 (38.5 versus 51.6%, P=0.048). The mean faecal (15)N-excretion amounted to 42.7% (no treatment), 59.7% (FP), 41.8% (WPS) and 44.0% (LC1). In comparison with no treatment, the urinary (15)NH(3)-enrichment was significantly decreased at 16 h after FP supplementation. CONCLUSION: The prebiotic intake of FP and WPS lowered the colonic generation and the renal excretion of toxic (15)NH(3), respectively, when using (15)N-LU as a xenobiotic marker.


Subject(s)
Ammonia/metabolism , Colon/microbiology , Colon/physiology , Lactose/pharmacokinetics , Prebiotics , Probiotics/metabolism , Urea/analogs & derivatives , Adult , Feces/chemistry , Female , Food Microbiology , Humans , Lactobacillus acidophilus/metabolism , Lactose/blood , Lactose/urine , Male , Nitrogen Isotopes , Pisum sativum/chemistry , Plant Tubers/chemistry , Seeds/chemistry , Solanum tuberosum/chemistry , Starch/administration & dosage , Starch/metabolism , Urea/blood , Urea/pharmacokinetics , Urea/urine , Yogurt , Young Adult
20.
PLoS One ; 4(12): e8241, 2009 Dec 11.
Article in English | MEDLINE | ID: mdl-20011510

ABSTRACT

BACKGROUND: Milk is the sole source of nutrients for neonatal mammals and is generally considered to have co-evolved with the developmental needs of the suckling newborn. One evolutionary conserved constituent of milk and present on many glycoconjugates is sialic acid. The brain and colon are major sites of sialic acid display and together with the liver also of synthesis. METHODOLOGY/PRINCIPAL FINDINGS: In this study we examined in rats the relationship between the sialic acid content of milk and the uptake, utilization and synthesis of sialic acid in suckling pups. In rat milk sialic acid was found primarily as 3' sialyllactose and at highest levels between 3 and 10 days postpartum and that decreased towards weaning. In the liver of suckling pups sialic acid synthesis paralleled the increase in milk sialic acid reaching and keeping maximum activity from postnatal day 5 onwards. In the colon, gene expression profiles suggested that a switch from sialic acid uptake and catabolism towards sialic acid synthesis and utilization occurred that mirrored the change of sialic acid in milk from high to low expression. In brain sialic acid related gene expression profiles did not change to any great extent during the suckling period. CONCLUSIONS/SIGNIFICANCE: Our results support the views that (i) when milk sialic acid levels are high, in the colon this sialic acid is catabolized to GlcNAc that in turn may be used as such or used as substrate for sialic acid synthesis and (ii) when milk sialic acid levels are low the endogenous sialic acid synthetic machinery in colon is activated.


Subject(s)
N-Acetylneuraminic Acid/biosynthesis , Animals , Animals, Newborn , Brain/metabolism , Colon/metabolism , Databases, Genetic , Female , Gene Expression Profiling , Gene Expression Regulation, Developmental , Lactation/physiology , Lactose/blood , Lactose/urine , Liver/enzymology , Milk/chemistry , Multienzyme Complexes/genetics , Multienzyme Complexes/metabolism , Rats , Time Factors
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