Malabsorption Of Nutrients Research Articles

Severe pneumonia in adults caused by Tropheryma whipplei and Candida sp. infection: a 2019 case series

BackgroundWhipple’s disease is a chronic infectious disease caused by the Gram-positive bacterium Tropheryma whipplei (TW), which not only affects the gastrointestinal tract and causes malabsorption of nutrients, but several other systems, such as the cardiovascular system, central nervous system, the joints, and the vascular system, can also be simultaneously involved. The aim of this report was to be able to alert the clinician to severe pneumonia caused by TW combined with Candida sp.Case presentationThe case study was conducted on patients in September and November 2019. After routine examination and treatment, the results were not satisfactory. A bronchoalveolar lavage (BAL) using metagenomics next-generation sequencing was conducted on two adults who presented with fever, cough, and progressive dyspnea and who had no history of gastrointestinal symptoms, immunodeficiency diseases, or use of immunosuppressive agents. TW and Candida sp. were detected in in BAL.ConclusionsThis is a report of life-threatening pneumonia caused by TW combined with Candida sp. in a Chinese population.

The Role of Brain-Derived Neurotrophic Factor in Irritable Bowel Syndrome.

Several studies have implied a role of brain-derived neurotrophic factor (BDNF) in abdominal pain modulation in irritable bowel syndrome (IBS). The aim of this study was to establish BDNF protein expression in human colonic biopsies and to show variation in IBS compared to controls. BDNF protein and mRNA levels were correlated with IBS symptom severity based on the IBS-symptom severity score (IBS-SSS). Biopsies from the descending colon and IBS-SSS were obtained from 10 controls and 20 IBS patients. Total protein of biopsies was extracted and assessed by ELISA and Western Blot. Total mRNA was extracted and gene expression measured by nCounter analysis. In IBS patients, symptom severity scores ranged from 124 to 486 (mean ± sem: 314.2 ± 21.2, >300 represents severe IBS) while controls ranged from 0 to 72 (mean ± sem: 27.7 ± 9.0, <75 represents healthy subjects, p < 0.001). IBS patients reported significantly more food malabsorption, former abdominal surgery and psychiatric comorbidities. BDNF protein was present in all samples and did not differ between IBS and controls or sex. Subgroup analysis showed that female IBS patients expressed significantly more BDNF mRNA compared to male patients (p < 0.05) and male IBS-D patients had higher IBS symptom severity scores and lower BDNF mRNA and protein levels compared to male controls (p < 0.05). Scatter plot showed a significant negative correlation between IBS-SSS and BDNF mRNA levels in the cohort of male IBS-D patients and their male controls (p < 0.05). We detected a high proportion of gastrointestinal surgery in IBS patients and confirmed food intolerances and psychiatric diseases as common comorbidities. Although in a small sample, we demonstrated that BDNF is detectable in human descending colon, with higher BDNF mRNA levels in female IBS patients compared to males and lower mRNA and protein levels in male IBS-D patients compared to male controls. Further research should be directed toward subgroups of IBS since their etiologies might be different.

Serological Tests Assessment in Patients Suspected to have Celiac Disease Attending the Gastroenterology and Hepatology Teaching Hospital in Baghdad

Background: Celiac disease is characterized by small intestinal malabsorption of nutrients after the ingestionof wheat gluten or related proteins from rye and barley, villus atrophy of the small intestinal mucosa, promptclinical and histologic improvement following strict adherence to a gluten-free diet, and relapse when glutenis retaken.Aim of the Study: Evaluation of patients seeking gastroenterology and hepatology teaching hospital/medicalcity/Baghdad with suspected celiac disease regarding serological investigation, histological findings andgenetic testing, to determine sensitivity, specificity, positive predictive value and negative predictive valuefor every test.Patients and Method: The study is a cross sectional descriptive analytic study conducted at the teachinghospital of gastroenterology and hepatology/Baghdad/Iraq during a period from the 1st of February 2018 tothe 1st of April 2019. After thorough history and Clinical examination patients with suspected celiac diseasewere sent for serological investigation (TTG IgA and IgG), (antigliadin IgA and IgG), all patients were sentfor endoscopic examination for duodenal biopsies with subsequent histological assessment. Patients whofailed to be confirmed (positive serology and negative histology or vice versa) were sent either for HLAgenotyping or for IgG Deaminated gliadin peptide. Sensitivity &amp; specificity were measured for each test.Results: A total of 140 suspected celiac disease patients involved in this study. Mean age was 18.9 yearsand ranged from 2 years to 60 years. Male represented 36.4% of the cases while female represented 63.6%.Only 19 patients show positive family history of celiac disease (13.6 %). Regarding associated autoimmunediseases, the majority (111 patients) have no associated diseases (79.3%) while the other patients who haveassociations most of them show positive association with type 1 DM (16.4%).Fifty patients (35.7%) presented with short stature, (25.7%) came with diarrhea. The other symptoms varybetween bloating and distention, unexplained anemia and weight loss. Constipation was seen in one patient.tTG IgA and tTG IgG showed high sensitivity, specificity, positive predictive value and negative predictivevalue while antigliadin antibody failed to show these significant results.Conclusion: The use of serologic markers inceliac is easy, direct, noninvasive and reliableand could be benefit in the diagnosis andmonitoring of the disease. More specifically,both the tTG-IgA/IgG are very good markersin the diagnostis of CD. This study confirmedthe high specificity and sensitivity of tTG, and the low results of AGA, but celiac serology does not replace the biopsy in the diagnosis but is useful as anassistant for diagnosis.

Zdravstvena nega pacijenta sa celijakijom tokom bolničkog lečenja

Celiac disease is a chronic autoimmune disease of the small intestine that occurs after ingesting foods that contain gluten. In hypersensitive people, gluten from food triggers immune reactions and leads to irritation, inflammation and atrophy of the small intestinal mucosa with consequent malabsorption of nutrients. The only proven treatment for celiac disease is a strict, lifelong gluten-free diet. By following a diet, it is possible to effectively control the disease and preserve the quality of life. However, if the condition worsens, health professionals must ensure adequate nutrition during their stay in the hospital, and treatment in accordance with the identified needs. This paper presents the specifics of determining the need for care in patients with celiac disease (nursing history, determination of nutritional status and elimination data). Then, we considered the most common problems in the field of nursing care such as: knowledge deficit, diarrhea and vomiting, high risk of dehydration, malnutrition, risk of inadequate thermoregulation and inefficient health maintenance. Nursing interventions are also presented in order to solve these problems, during the hospital treatment of patients with celiac disease.

Aberrant Epithelial Differentiation Contributes to Pathogenesis in a Murine Model of Congenital Tufting Enteropathy.

Background & AimsCongenital tufting enteropathy (CTE) is an intractable diarrheal disease of infancy caused by mutations of epithelial cell adhesion molecule (EpCAM). The cellular and molecular basis of CTE pathology has been elusive. We hypothesized that the loss of EpCAM in CTE results in altered lineage differentiation and defects in absorptive enterocytes thereby contributing to CTE pathogenesis.MethodsIntestine and colon from mice expressing a CTE-associated mutant form of EpCAM (mutant mice) were evaluated for specific markers by quantitative real-time polymerase chain reaction, Western blotting, and immunostaining. Body weight, blood glucose, and intestinal enzyme activity were also investigated. Enteroids derived from mutant mice were used to assess whether the decreased census of major secretory cells could be rescued.ResultsMutant mice exhibited alterations in brush-border ultrastructure, function, disaccharidase activity, and glucose absorption, potentially contributing to nutrient malabsorption and impaired weight gain. Altered cell differentiation in mutant mice led to decreased enteroendocrine cells and increased numbers of nonsecretory cells, though the hypertrophied absorptive enterocytes lacked key features, causing brush border malfunction. Further, treatment with the Notch signaling inhibitor, DAPT, increased the numbers of major secretory cell types in mutant enteroids (graphical abstract 1).ConclusionsAlterations in intestinal epithelial cell differentiation in mutant mice favor an increase in absorptive cells at the expense of major secretory cells. Although the proportion of absorptive enterocytes is increased, they lack key functional properties. We conclude that these effects underlie pathogenic features of CTE such as malabsorption and diarrhea, and ultimately the failure to thrive seen in patients.

Changes in fecal microbiota with CFTR modulator therapy: A pilot study

Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes. While we identified no statistically significant fecal changes with either treatment, we detected trends in the PI cohort when initiating lumacaftor/ivacaftor towards decreased fecal fat content and towards fecal microbiomes that more closely resembled the fecal microbiota of people without PI. While these findings support a model in which nutrient malabsorption resulting from CF-induced PI drives fecal dysbiosis, they must be validated in future, larger studies of fecal microbiome and malabsorption outcomes with highly effective CFTR modulator therapies.

Pharmacological and Parenteral Nutrition-Based Interventions in Microvillus Inclusion Disease.

Microvillus inclusion disease (MVID) is a rare inherited and invariably fatal enteropathy, characterized by severe intractable secretory diarrhea and nutrient malabsorption. No cure exists, and patients typically die during infancy because of treatment-related complications. The need for alternative treatment strategies is evident. Several pharmacological interventions with variable successes have been tried and reported for individual patients as part of their clinical care. Unfortunately, these interventions and their outcomes have remained hidden in case reports and have not been reviewed. Further, recent advances regarding MVID pathogenesis have shed new light on the outcomes of these pharmacological interventions and offer suggestions for future clinical research and trials. Hence, an inventory of reported pharmacological interventions in MVID, their rationales and outcomes, and a discussion of these in the light of current knowledge is opportune. Together with a discussion on MVID-specific pharmacokinetic, -dynamic, and -genetic concerns that pose unique challenges regarding pharmacological strategies, we envision that this paper will aid researchers and clinicians in their efforts to develop pharmacological interventions to combat this devastating disease.

Fermented sorghum porridge fortified with moringa leaf powder and baobab fruit pulp cured children from moderate acute malnutrition in Benin

Inappropriate feeding, too early introduction of complementary foods and restriction in food selection are a major cause of malnutrition among young children in developing countries. Food-to-food fortification is a good strategy to enhance the nutritional quality of children’s diet. This strategy is more and more promoted because it allows delivery of micronutrients to a large population in a cost-effective manner.The present study aimed at testing the effect of the consumption of sorghum porridge fortified with moringa leaf powder and baobab fruit pulp on the nutritional status of children aged 6 to 59 months in Northern Benin. A two-week intervention was implemented in Tanguiéta (Benin) among children affected by moderate acute malnutrition, using 400g of fermented sorghum porridge fortified with15g of a designed mix of moringa leaf powder and baobab fruit pulp. Sixty-three children aged 6–59 months who had malnutrition assessed by anthropometry were randomly selected and assigned to a treatment or a control group. Children in the treatment group consumed the fortified formula daily for two weeks in a nutritional rehabilitation hearth whereas those in the control group had their habitual diet. Their nutritional status was evaluated using anthropometry. Recovery rate and average weight gain of children were computed.Results show that daily consumption of the fortified food for two weeks did not significantly (P&gt; 0.05) increase children’s weight in treatment vs. control. However, average weight gain was 9.85g/kg/day in the treatment group and total recovery rate at risk of malnutrition and moderate acute malnutrition was 62.50% among children who fully complied with the intervention. Fermented sorghum porridge fortified with moringa leaf powder and baobab fruit pulp may be promoted to scale in more regions of Benin as a local affordable and effective therapeutic food against child acute malnutrition. Further investigation of its potential effect while accounting for parasitic infection is needed, to eliminate all risks of intestinal micro nutrient malabsorption or malaria and enhance the effectiveness of the fortified food on children’s weight as well as their iron status.

Circulating Zinc and Copper Levels are Associated with Sperm Quality in Obese Men after Metabolic Surgery: A Pilot Study.

(1) Background: Inadequate levels of several trace elements and vitamins may impair spermatogenesis in men. Although weight loss after metabolic surgery normalizes male reproductive hormones, sperm quality seems to not improve. We hypothesized that circulating concentrations of zinc, copper and other trace elements and vitamins might be involved. (2) Methods: We studied 20 men submitted to metabolic surgery at baseline and after two years. Hormone profiles, serum trace elements and vitamins were studied together with sperm analysis. (3) Results: At follow-up, serum testosterone, follicle-stimulating hormone and inhibin B concentrations increased showing a beneficial hormonal response for spermatogenesis. Conversely, serum copper, zinc and ferritin showed a decline after surgery. In total, 33% of men showed zinc deficiency, 27% copper deficiency and 20% iron deficiency, among others. Sperm analysis showed that all revaluated patients had at least one abnormal parameter. Serum zinc concentrations showed a positive correlation with progressive motility (r = 0.577, p = 0.031), and serum ferritin a positive correlation with sperm volume (ρ = 0.535, p = 0.049). Serum copper showed a weak and near significant correlation with motility (r = 0.115, p = 0.051). (4) Conclusions: The lack of improvement in sperm quality in obese men after metabolic surgery may be related to nutrient malabsorption, especially zinc, copper and iron.

Inducible Nitric Oxide Regulates Na-Glucose Co-transport in a Spontaneous SAMP1/YitFc Mouse Model of Chronic Ileitis.

In mammalian small intestine, glucose is primarily absorbed via Na-dependent glucose co-transporter (SGLT1) on the brush border membrane (BBM) of absorptive villus cells. Malabsorption of nutrients (e.g., glucose) leads to malnutrition, a common symptom of inflammatory bowel disease (IBD), where the mucosa is characterized by chronic inflammation. Inducible nitric oxide (iNO) is known to be elevated in IBD mucosa. SAMP1/YitFc (SAMP1) mouse is a spontaneous model of chronic ileitis that develops lesions in its terminal ileum, very similar to human IBD. How SGLT1 may be affected in SAMP1 model of chronic ileitis is unknown. Ten-week-old SAMP1 mice with AKR mice as control were treated with N6-(1-iminoethyl)-L-lysine dihydrochloride (L-NIL) to inhibit iNO production. Intracellular NO levels were found to be increased in villus cells from SAMP1 mice. Moreover, SGLT1 and Na+/K+-ATPase activities and BBM SGLT1 expression were significantly decreased. However, L-NIL treatment reduced the intracellular iNO production, and reversed both downregulated SGLT1 and Na+/K+-ATPase activities in SAMP1 mice. Inhibition of iNO by L-NIL treatment also significantly reversed the BBM SGLT1 protein expression in SAMP1 mice. L-NIL reversed the inflammation mediated downregulation of SGLT1 activity by restoring the BBM SGLT1 expression. Thus, regulation of SGLT1 in chronic ileitis is likely mediated by iNO.

IDENTIFIKASI PARASIT USUS DAN SEL DARAH PADA FESES BALITA GIZI BURUK DI MULYOREJO KECAMATAN TIRTO KABUPATEN PEKALONGAN

&lt;p&gt;Nutrients come from food consumed through the digestion process such as absorption, transportation, storage and metabolism. Malnutrition during the golden age (under five years old) is irreversible, malnutrition affects brain development.&lt;/p&gt;&lt;p&gt;Malnutrition caused by less consumption of food and infectious diseases. Intestinal infection by parasites is one of the types of infectious diseases in toddlers that can cause malabsorption of nutrients and reduce appetite. In addition, intestinal infections can also cause injury, so that blood cells are obtained in the feces. These all increase the risk of malnutrition.&lt;/p&gt;&lt;p&gt;This research aim to find intestinal parasitic infection and blood cells in malnourished toddlers in Mulyorejo, Tirto District, Pekalongan Regency.&lt;/p&gt;&lt;p&gt;The research method is descriptive, to describe the results of feces examination, data collection by feces examination in the laboratory, using the direct method and centrifugation to get intestinal parasites. The population in this research were all malnourished toddlers in Mulyorejo in August 2019 with 8 of total respondents. For sample using total sampling of all respondents.&lt;/p&gt;&lt;p&gt;The results is intestinal parasitic infections were not found in 8 samples tested, intestinal protozoa 0 (0%) and intestinal worms from group soil transmitted helminth 0 (0%). Examination of blood cells, found 2 feces samples (25%) contain with normal leukocytes and 6 samples (75%) exceeded from normal limits. Other than that, 0 feces samples (0%) with normal erythrocytes and 8 samples (100%) exceeded from normal limits.&lt;/p&gt;The conclusions of this research is intestinal parasitic infections such as intestinal protozoa 0 (0%) and intestinal worms 0 (0%) were not found in 8 samples tested, but blood cells were present with exceeded from normal limits.

Senescence-accelerated mouse prone 8 mice exhibit specific morphological changes in the small intestine during senescence and after pectin supplemented diet.

Impairment of gastrointestinal function and reduction of nutrient absorption associated with aging contribute to increased risk of malnutrition in the elderly population, resulting in physical weakness and vulnerability to disease. The present study was performed to examine the relationships between aging-associated morphological changes of the small intestine and nutrient malabsorption using senescence-accelerated mouse prone 8 (SAMP8) mice. Comparison of the morphology of the small intestine of young (22-week-old) and senescent (43-week-old) SAMP8 mice showed no significant changes in villus length, while the mRNA expression levels of secretory cell marker genes were significantly reduced in senescent mice. In addition, crypts recovered from the small intestine of senescent mice showed a good capacity to form intestinal organoids ex vivo, suggesting that the regenerative capacity of intestinal stem cells (ISCs) was unaffected by accelerated senescence. These results indicated that changes induced by accelerated senescence in the small intestine of SAMP8 mice are different from changes reported previously in normal aging mouse models. Biochemical analyses of serum before and during senescence also indicated that senescent SAMP8 mice are not in a malabsorption state. Furthermore, a diet supplemented with persimmon pectin had a mild effect on the small intestine of senescent SAMP8 mice. Intestinal villus length was slightly increased in the medial part of the small intestine of pectin-fed mice. In contrast, intestinal crypt formation capacity was enhanced by the pectin diet. Organoid culture derived from the small intestine of mice fed pectin exhibited a greater number of lobes per organoid compared with those from mice fed a control diet, and Lyz1 and Olfm4 mRNA levels were significantly increased. In conclusion, accelerated senescence induced exclusive changes in the small intestine, which were not related to nutrient malabsorption. Therefore, the SAMP8 strain may not be a suitable model to evaluate the effects of aging on intestinal homeostasis and nutrient absorption impairment.

Enteroendocrine cells couple nutrient sensing to nutrient absorption by regulating ion transport

The ability to absorb ingested nutrients is an essential function of all metazoans and utilizes a wide array of nutrient transporters found on the absorptive enterocytes of the small intestine. A unique population of patients has previously been identified with severe congenital malabsorptive diarrhea upon ingestion of any enteral nutrition. The intestines of these patients are macroscopically normal, but lack enteroendocrine cells (EECs), suggesting an essential role for this rare population of nutrient-sensing cells in regulating macronutrient absorption. Here, we use human and mouse models of EEC deficiency to identify an unappreciated role for the EEC hormone peptide YY in regulating ion-coupled absorption of glucose and dipeptides. We find that peptide YY is required in the small intestine to maintain normal electrophysiology in the presence of vasoactive intestinal polypeptide, a potent stimulator of ion secretion classically produced by enteric neurons. Administration of peptide YY to EEC-deficient mice restores normal electrophysiology, improves glucose and peptide absorption, diminishes diarrhea and rescues postnatal survival. These data suggest that peptide YY is a key regulator of macronutrient absorption in the small intestine and may be a viable therapeutic option to treat patients with electrolyte imbalance and nutrient malabsorption.

The Effect of Bariatric Surgery on Exocrine Pancreatic Function.

After bariatric surgery (BS), patients might suffer from nutrient maldigestion, malabsorption, and vitamin deficiencies. In this study, our aim was to assess pancreatic functions after BS using fecal elastase-1 assay (FE-1). Sixty patients (21M) undergoing BS and 20 (6M) healthy controls were included into the study. Stool samples were collected 1year after surgery. Ten patients from one anastomosis gastric bypass (OAGB) and single anastomosis duodenal switch (SADS) groups with the lowest value of FE-1 and GIQLI scores were given pancreatic enzyme replacement therapy (PERT). After PERT, FE-1, excess weight loss (EWL), BMI, GIQLI scores, and vitamin D levels were measured. Vitamin D levels were detected as 19.04 (9-46.5) pg/ml, 15.1 (8.4-23.6) pg/ml, 17.8 (5-30) pg/ml, and 21.79 (11-40.3) pg/ml after sleeve gastrectomy (SG), OAGB, SADS, and control groups, respectively (p= 0.04). GIQLI scores in the first year were found to have increased in all patients (p= 0.02). FE-1 levels were found as 642.35 (566.3-711.4) μg/g, 378.52 (183.5-561.1) μg/g, 458.88 (252.5-593, 5) μg/g, and 518.2 (351.6-691) μg/g for the SG, OAGB, SADS, and control groups, respectively. There was a strong inverse correlation between EWL and FE-1 levels at the end of the first year (Spearman's rho = - 0.688, p= 0.003). After having performed PERT for patients with the lowest FE-1 levels, the levels increased to 683.39 (615.5-720) μg/g in the OAGB and 691.5 (643.1-720) μg/g in the SADS groups (p= 0.011). FE-1 measurements demonstrated that many patients suffer from malabsorption after OAGB or SADS, whereas functions remain normal after SG. PERT corrects pancreatic functions without affecting weight loss and also contributes to the normal serum level of vitamin D.

Recent advances in the mechanisms underlying the beneficial effects of bariatric and metabolic surgery.

Bariatric and metabolic surgery (BMS) is the most effective treatment for obesity, type 2 diabetes and co-morbidities, including nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. The beneficial effects of BMS are beyond the primary goal of gastric restriction and nutrients malabsorption. Roux-en-Y gastric bypass and vertical sleeve gastrectomy are the 2 most commonly performed procedures of BMS. Both surgeries lead to physiologic changes in gastrointestinal tract; subsequently alter bile acids pool and composition, gut microbial activities, gut hormones, and circulating exosomes; and ultimately contribute to the improved glycemic control, insulin sensitivity, lipid metabolism, energy expenditure, and weight loss. The mechanisms underlying the benefits of BMS likely involve the bile acid-signaling pathway mediated mainly by nuclear farnesoid X receptor and the membrane Takeda G protein-coupled receptor, bile acids-gut microbiota interaction, and exosomes. In this review, we focus on recent advances in potential mechanisms and aim to learn novel insights into the molecular mechanisms underlying metabolic disorders.

Physicochemical Compatibility Investigation of Mesalazine and Folic Acid Using Chromatographic and Thermoanalytical Techniques.

Inflammatory bowel disease is a common name for Crohn’s disease and ulcerative colitis. These inflammatory states cause damage in the sidewalls of the gastrointestinal tract, resulting in malabsorption of food and vitamins. Folic acid (Vitamin B9) is often associated with inflammatory bowel diseases since reduced overall folate concentration in the human body may lead to the development of colorectal cancer and megaloblastic anaemia. However, its deficiency is easily compensated by taking an additional folic acid pill during regular therapy. At the moment, there are no studies that have examined the compatibility of folic acid with 5-aminosalicylate drugs used in the treatment of inflammatory bowel diseases. In this work, differential scanning calorimetry, forced degradation studies, isothermal stress testing and dissolution stability testing were used to determine the stability of folic acid and one of the most commonly used 5-aminosalicylates, mesalazine, when present in the same solution or blend. To monitor the assay of folic acid, mesalazine and nine of its related impurities, a single HPLC method was developed. Results of compatibility studies showed that no physicochemical interaction between mesalazine and folic acid occurs when combined, opening the path to the development of new formulations, such as a mesalazine/folic acid fixed-dose combination.

Potential contribution of the gut microbiota to hypoglycemia after gastric bypass surgery.

Obesity has become a global health problem. Lifestyle modification and medical treatment only appear to yield short-term weight loss. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it sustains weight reduction and results in the remission of obesity-associated comorbidities for obese individuals. However, patients who undergo this surgery may develop hypoglycemia. To date, the diagnosis is challenging and the prevalence of post-RYGB hypoglycemia (PRH) is unclear. RYGB alters the anatomy of the upper gastrointestinal tract and has a combined effect of caloric intake restriction and nutrient malabsorption. Nevertheless, the physiologic changes after RYGB are complex. Although hyperinsulinemia, incretin effects, dysfunction of β-cells and α-cells, and some other factors have been widely investigated and are reported to be possible mediators of PRH, the pathogenesis is still not completely understood. In light of the important role of the gut microbiome in metabolism, we hypothesized that the gut microbiome might also be a critical link between RYGB and hypoglycemia. In this review, we mainly highlight the current possible factors predisposing individuals to PRH, particularly related to the gut microbiota, which may yield significant insights into the intestinal regulation of glucose metabolic homeostasis and provide novel clues to improve the treatment of type 2 diabetes mellitus.

The Remember/Regeneration Therapy Method as a New Holistic Approach for Celiac Disease: Two Case Reports

Background: celiac disease (cd) is a widespread disorder caused by an intolerance to gluten which is a protein found in many foods in genetically susceptible individuals. The disease is characterized by small-intestinal mucosal injury and nutrient malabsorption. Currently, in spite of a life-long gluten-free diet is the effective and available treatment option for patients with CD, the widespread use of wheat-derived gluten in the food industry limits the effectiveness of treatment. Therefore, it is needed to perform further studies on nondietary therapies which solve the causes of the disease. The Remember/Regeneration Therapy Method (RTM) is a novel holistic medicine approach that targets physiopathological changes in quadruplet body structures and includes various complementary methods such as acupuncture, ozone therapy, and phytotherapy, etc. in different combinations which are determined depending on the disease.

Suplementação alimentar da vitamina D na prevenção contra o vírus covid-19

A deficiência de alimentos e o sedentarismo são fatores que influenciam na qualidade e expectativa de vida do ser humano, prejudicando sua imunidade a possíveis problemas de saúde, dando espaço a contaminação do vírus SARS-CoV-2 que afeta principalmente pessoas com má-absorção de nutrientes. O vírus da doença Covid-19 em contato com a boca, olhos e nariz onde se liga as células da mucosa criando novas células que se multiplicam contaminando células saudáveis que causam sintomas iniciais leves como dor de garganta, tosse e febre, alcançando sintomas mais graves que podem ser fatais pela dificuldade para respirar, abalando a saúde de idosos e pessoas vulneráveis com problemas respiratórios. Por meios de cuidados devemos nos precaver ao vírus, começando pela nossa alimentação como forma de cuidado e prevenção através da suplementação da vitamina D.

Determining the Biosynthetic Pathway of Rhodoquinone in C. elegans

Parasitic helminths infect more than 1.5 billion people, with third world countries being the most affected. Parasites are transmitted through soil and contaminated water and they feed on host tissue in order to grow and reproduce. Infections cause anemia, malabsorption of nutrients, and loss of appetite. While inside a host, parasites anaerobically respire by using an alternative electron transport chain that uses rhodoquinone (RQ) as an electron carrier instead of ubiquinone (Q), which is used in aerobic respiration. Mammalian hosts produce and use Q for aerobic respiration, but they do not make or require RQ. An ideal anti‐parasitic drug target would be an enzyme that is used only for the biosynthesis of RQ ‐ not the biosynthesis of Q. Caenorhabditis elegans have been used as a model system for parasitic helminths in order to investigate RQ biosynthesis. RNAi feeding experiments were performed to identify genes required for several steps in the RQ biosynthetic pathway in C. elegans. Several genes were identified that are common to both Q and RQ biosynthetic pathways (coq‐3, coq‐5, and coq‐6). However, knockdown of the kynu‐1 gene from the kynurenine pathway affected only RQ production. Additional experiments involving knock‐outs of other C. elegans genes in the kynurenine pathway confirmed the requirement of kynu‐1 and the corresponding arylamine products for the biosynthesis of RQ. The roles ofcoq‐2 and coq‐3 MV genes in the biosynthesis of RQ in C. elegans were further investigated in this study using RNAi knockdowns and characterization was performed with RT‐qPCR and LC‐MS.Support or Funding InformationGonzaga Science Research Program and Agencia Nacional para la Innovación y la Investigación ANII FCE_1_2014_104366