Specificity of the Human Intestinal Disaccharidases and Implications for Hereditary Disaccharide Intolerance

Total Page:16

File Type:pdf, Size:1020Kb

Specificity of the Human Intestinal Disaccharidases and Implications for Hereditary Disaccharide Intolerance SPECIFICITY OF THE HUMAN INTESTINAL DISACCHARIDASES AND IMPLICATIONS FOR HEREDITARY DISACCHARIDE INTOLERANCE Arne Dahlqvist J Clin Invest. 1962;41(3):463-470. https://doi.org/10.1172/JCI104499. Research Article Find the latest version: https://jci.me/104499/pdf Journal of Clinical Investigation Vol. 41, No. 3, 1962 SPECIFICITY OF THE HUMAN INTESTINAL DISACCHARIDASES AND IMPLICATIONS FOR HEREDITARY DISACCHARIDE INTOLERANCE * By ARNE DAHLQVIST (From the Department of Physiological Chemistry, University of Lund, Sweden) (Submitted for publication June 27, 1961; accepted October 27, 1961) The existence of several different a-glucosidases 1) Jejunal sample, from a 40 year old woman; resection has recently been demonstrated in extracts of pig of the middle part of the small intestine was indicated by an intestinal tumor. From an 8-cm piece of normal intestinal mucosa (1-7). These enzymes have intestine, located in the distal decimeters of the jejunum, varying specificity for disaccharides with a-D-glu- 1.6 g of mucosa was scraped off with a glass slide. The copyranoside structure (e.g., maltose, sucrose, iso- mucosa was homogenized for 1 minute in an Ultra-Tur- maltose, trehalose), and thus the intestinal hy- rax homogenizer with 4.8 ml of 0.9 per cent NaCl, the drolysis of these sugars is caused by a more com- tube being chilled with crushed ice during homogenization. previously After removal of nuclei and greater cell debris by cen- plicated enzyme mixture than had been trifugation in an ordinary laboratory centrifuge (Wifug, believed (8, 9). rotor no. 103-30A, 4,000 rpm) for 10 minutes, the opales- The 8-glucosidase and /3-galactosidase activities cent supernate, which contains the disaccharidases (22), of extracts of pig intestinal mucosa, in contrast, was used for analysis. 2) Ileal sample, from a 26 year seem to be exerted by one enzyme, intestinal lac- old woman suffering from chronic ulcerative colitis; re- operation of ileocecal anastomosis indicated by abdominal tase (10, 11). abscess. A 15-cm piece of the distal part of the ileum It is not known whether the specificity of the was removed. The intestinal wall of this piece showed human intestinal disaccharidases parallels that of considerable induration, but the mucosa appeared macro- the pig enzymes. This question is of clinical im- scopically normal; 3.0 g of mucosa was obtained by portance, however, since several cases of hereditary scraping with a glass slide. The mucosa was homoge- nized as described above with 9.0 ml of 0.9 per cent inability to digest certain disaccharides have been NaCl. recently described, and are apparently caused by Assay of disaccharidase activities was performed by inherited deficiency of single intestinal disacchari- the methods previously described (23, 24) using the dases (12-19). Tris-glucose oxidase reagent (24). One unit of disac- Since the human intestinal content, obtained by charidase activity causes 5 per cent hydrolysis in 2.0 ml a catheter during the digestion of a meal, contains of 0.028 M substrate, which is equal to the formation of 1 mg monosaccharide (23), in 60 minutes at 370 C and at essentially no disaccharidases (20, 21), this ma- optimum pH. terial cannot be used for the study of the specificity Assay of polysaecharidase activities was done as previ- of these enzymes. Therefore homogenates have ously described (25). One unit of amylase or dextranase been prepared of human intestinal mucosa, ob- activity catalyzes an increase in reducing power corre- tained from pieces of small intestine cut out during sponding to 1 mg of disaccharide (monohydrate) in 60 minutes at 370 C, and may thus be compared with the surgical operations. These homogenates had unit for disaccharidase activity. powerful disaccharidase activities, and the speci- Assay of protein was performed by the method of ficity of the enzymes responsible for these activi- Lowry, Rosebrough, Farr and Randall (26) with the ties has been studied by heat inactivation. modified reagent B introduced by Eggstein and Kreutz (27). A standard curve was prepared with human serum by AB Kabi (Stockholm). AND METHODS albumin, kindly supplied MATERIALS Heat inactivation. When a solution of an enzyme is Homogenates of human intestinal mucosa. Two sam- heated at a sufficiently high temperature the enzyme is ples were obtained, one from the distal part of the inactivated, following the kinetics of a first-order reac- jejunum, and the other from the distal part of the ileum. tion. The temperature interval within which the velocity constant for the inactivation increases from zero (no * This investigation was supported by grants from the measurable inactivation) to very high values (complete Swedish Medical Research Council and the Royal Physi- inactivation within a few minutes) is usually less than 100. ographic Society at Lund, Sweden. Since the different glycosidases present in extracts of pig 463 464 ARNE DAHLQVIST intestinal mucosa have widely different sensitivities to paper indicate that the human intestine contains disac- heat, fractionated heat inactivation provided a useful charidases which are essentially similar to the correspond- method for the separation of these enzymes (3, 28, 29). ing enzymes of the pig, although some differences are The rate of the heat inactivation at a certain tempera- found. The chromatographic separation of the pig en- ture is strongly dependent on the pH of the solution; zymes succeeded only with the use of a special tech- thus an appropriate buffer must be added. It is also nique-mutual displacement chromatography (29)- desirable to heat the enzyme solution to the desired in- which demanded rather large amounts of enzyme ma- activation temperature as quickly as possible and then to terial. The limited amount of enzyme available with hu- maintain this temperature within 0.10 during the ex- man preparations prohibited separation experiments with periment. The enzyme solution which is to be inacti- this method. Chromatographic separation of the human vated (usually a volume of 5 to 10 ml) was therefore disaccharidases will have to await the development of a first immersed in a preheating bath that had a tempera- suitable micromethod. ture 7° to 80 higher than the inactivation bath. Dur- RESULTS ing the preheating the tube was continously shaken, and the temperature of the enzyme solution was measured The homogenates had powerful disaccharidase with a thermometer having 0.10 gradations. At the activities. The relative rate of hydrolysis of dif- moment the desired inactivation temperature was reached (under these conditions this occurred in less than 1 min- ferent disaccharides was essentially the same as ute) the tube was transferred to the inactivation bath; at that reported earlier for preparations from the mu- the the same time a zero-time sample was taken for en- cosa of the adult pig (23, 25), except that the rela- zyme analysis and a stopwatch was started. Care was tive isomaltase activity of the human preparations taken that the inactivation temperature was never ex- was stronger and the trehalase activity somewhat ceeded during preheating. New samples for enzyme analy- sis (0.5 to 1 ml) were withdrawn at intervals, immedi- weaker than in the pig (Table I). ately blown down into tubes chilled with crushed ice, and The lactase activity of the jejunal sample was so stored until analyzed. strong, but this activity was practically absent in The enzyme solutions for heat inactivation in the pres- the ileal sample, indicating that lactase in the hu- ent case were prepared by mixing 1 vol of homogenate man is localized in the proximal part of the in- (the j ejunal sample, which was strongest in disaccharidase activity, had first been diluted 1:2 with distilled water) testine as it is in the pig (25). This is also in ac- with 4 vol of 0.0125 M sodium phosphate buffer, pH 7.0. cordance with the finding that lactose is absorbed Validity of separation by heat inactivation. The sepa- in the proximal part of he human small intestine ration of two enzymatic activities, present in the same (21). preparation, only on the basis of their different sensitivi- The cellobiase and gentiobiase activities in the ties to heat, does not conclusively prove that the two ac- (Table tivities are manifestations of different enzyme proteins; two samples paralleled the lactase activity heating the solution may affect activators or inhibitors, I), indicating that also in the human intestine breaking single bonds within the enzyme molecule may ,8-glucosides and /3-galactosides may be hydrolyzed alter the specificity of the enzyme, and so forth. In- by a single enzyme (10, 11). versely, the parallel heat inactivation of two different en- zymatic activities does not necessarily mean that these are caused by the same enzyme; two different enzymes TABLE I may very well have similar heat inactivation properties. Carbohydrase activities of the homogenates of human small The results of heat inactivation experiments therefore intestinal mucosa * must be compared with those of other separation meth- ods, such as fractionation with different precipitants, Carbohydrase a) Jejunal b) Ileal electrophoresis, ion-exchange chromatography, and so on. activity sample sample the existence of several different disac- By such methods unitsIg mucosa charidases in pig intestinal mucosa has been conclusively Maltase (total) 948 292 demonstrated and the specificity of the different enzymes I nvertase 360 40 elucidated (3-7, 10, 28-30). In this study the results of Isomaltase 272 69 Trehalase 31 17 the heat inactivation experiments agreed very well with Turanase 74 23 those of the other methods. Furtthermore, the heat in- Palatinase 59 12 activation analysis was found to be the most simple and Lactase 412 3.2 accurate method for the analysis of the mixture of disac- Cellobiase 78 0.6 Gentiobiase 2.4 0.0 charidases present in extracts of pig intestinal mucosa Amylase 1,328 960 (3, 29).
Recommended publications
  • Sucrase-Isomaltase Deficiency Causing Persistent Bloating and Diarrhea in an Adult Female
    Open Access Case Report DOI: 10.7759/cureus.14349 Sucrase-Isomaltase Deficiency Causing Persistent Bloating and Diarrhea in an Adult Female Varsha Chiruvella 1 , Ayesha Cheema 1 , Hafiz Muhammad Sharjeel Arshad 2 , Jacqueline T. Chan 3 , John Erikson L. Yap 2 1. Internal Medicine, Medical College of Georgia at Augusta University, Augusta, USA 2. Gastroenterology and Hepatology, Medical College of Georgia at Augusta University, Augusta, USA 3. Pediatric Endocrinology, Medical College of Georgia at Augusta University, Augusta, USA Corresponding author: Varsha Chiruvella, [email protected] Abstract Congenital sucrase isomaltase deficiency (CSID) is an autosomal recessive disorder which leads to chronic intestinal malabsorption of nutrients from ingested starch and sucrose. Symptoms usually present after consumption of fruits, juices, grains, and starches, leading to failure to thrive and malnutrition. Diagnosis is suspected on detailed patient history and confirmed by a disaccharidase assay using small intestinal biopsies or sucrose hydrogen breath test. Treatment of CSID consists of limiting sucrose in diet and replacement therapy with sacrosidase. Due to its nonspecific symptoms, CSID may be undiagnosed in many patients for several years. We present a case of a 50-year-old woman with persistent symptoms of bloating in spite of extensive evaluation and treatment. Categories: Endocrinology/Diabetes/Metabolism, Gastroenterology Keywords: sucrase-isomaltase, starch intolerance, disaccharidase assay, ibs, hydrogen breath test Introduction Congenital sucrase isomaltase deficiency (CSID), also known as genetic sucrase deficiency, is a multifaceted intestinal malabsorption disorder with an autosomal recessive mutation in the sucrase-isomaltase (SI) gene on chromosome 3 (3q25-q26). Sucrase-isomaltase is a type II membrane enzyme complex and member of the disaccharidase family required for the breakdown of α-glycosidic linkages in sucrose and maltose.
    [Show full text]
  • Disaccharidase Deficiencies
    J Clin Pathol: first published as 10.1136/jcp.s3-5.1.22 on 1 January 1971. Downloaded from J. clin. Path., 24, Suppl. (Roy. Coll. Path.), 5, 22-28 Disaccharidase deficiencies G. NEALE From the Department ofMedicine, Royal Postgraduate Medical School, Du Cane Road, London Up to 12 years ago the absorption of disaccharides capable of hydrolysing maltose, which may explain was a problem in physiology which attracted little why maltase deficiency is not found as an isolated attention and which appeared to be unrelated to the defect of the enterocyte. Isomaltase and sucrase problems of clinical medicine. Indeed, most text- appear to be distinct but linked entities, and hence books stated incorrectly that the disaccharides were they are absent together in the hereditary condition hydrolysed to monosaccharides in the lumen of the of sucrase-isomaltase deficiency (Dahlquist and small intestine despite the evidence of half a century Telenius, 1969). Lactase activity consists of at least before, which had suggested that they were digested two separate enzymes, one of which is not in the by the mucosal surface (Reid, 1901). The renewal of brush border but within the cell (Zoppi, Hadom, interest in the subject of disaccharide absorption Gitzelmann, Kistler, and Prader, 1966). The signifi- occurred after the description of congenital lactase cance of intracellular lactase activity is uncertain. It deficiency by Holzel, Schwarz, and Sutcliffe (1959) cannot play any part in the normal digestion of and of sucrase-isomaltase deficiency by Weijers, lactose which is a function of the brush border of the van de Kamer, Mossel, and Dicke (1960).
    [Show full text]
  • Intestinal Sucrase Deficiency Presenting As Sucrose Intolerance in Adult Life
    BRnUTE 20 November 1965 MEDICAL JOURNAL 1223 Br Med J: first published as 10.1136/bmj.2.5472.1223 on 20 November 1965. Downloaded from Intestinal Sucrase Deficiency Presenting as Sucrose Intolerance in Adult Life G. NEALE,* M.B., M.R.C.P.; M. CLARKt M.B., M.R.C.P.; B. LEVIN,4 M.D., PH.D., F.C.PATH. Brit. med. J., 1965, 2, 1223-1225 Diarrhoea due to failure of the small intestine to hydrolyse studies of the jejunal mucosa. He was discharged from hospital a certain dietary disaccharides is now a well-recognized congenital week after starting a sucrose-free and restricted starch diet and has disorder of infants and children. It was first suggested for since remained well. lactose (Durand, 1958) and later for sucrose (Weijers et al., 1960) and for isomaltose in association with sucrose (Auricchio Methods et al., 1962). It has been confirmed for lactose and for sucrose intolerance by quantitative estimation of enzyme activities in Initially the patient was on a normal ward diet estimated to the intestinal mucosa (Auricchio et al., 1963b; Dahlqvist et al., contain 50-80 g. of sucrose a day. After 10 days sucrose was 1963 ; Burgess et al., 1964; Levin, 1964). In all cases present- eliminated from the diet, and after a further three days starch ing in childhood there is a history of diarrhoea when food intake was restricted to 150 g. a day. Carbohydrate tolerance yielding the relevant disaccharide is introduced into the diet. was determined after an overnight fast by estimating blood Symptoms decrease with age, so that older children may be glucose levels, using a specific glucose oxidase method, after asymptomatic (Burgess et al., 1964) and are able to tolerate ingestion of 50 g.
    [Show full text]
  • Yeast Genome Gazetteer P35-65
    gazetteer Metabolism 35 tRNA modification mitochondrial transport amino-acid metabolism other tRNA-transcription activities vesicular transport (Golgi network, etc.) nitrogen and sulphur metabolism mRNA synthesis peroxisomal transport nucleotide metabolism mRNA processing (splicing) vacuolar transport phosphate metabolism mRNA processing (5’-end, 3’-end processing extracellular transport carbohydrate metabolism and mRNA degradation) cellular import lipid, fatty-acid and sterol metabolism other mRNA-transcription activities other intracellular-transport activities biosynthesis of vitamins, cofactors and RNA transport prosthetic groups other transcription activities Cellular organization and biogenesis 54 ionic homeostasis organization and biogenesis of cell wall and Protein synthesis 48 plasma membrane Energy 40 ribosomal proteins organization and biogenesis of glycolysis translation (initiation,elongation and cytoskeleton gluconeogenesis termination) organization and biogenesis of endoplasmic pentose-phosphate pathway translational control reticulum and Golgi tricarboxylic-acid pathway tRNA synthetases organization and biogenesis of chromosome respiration other protein-synthesis activities structure fermentation mitochondrial organization and biogenesis metabolism of energy reserves (glycogen Protein destination 49 peroxisomal organization and biogenesis and trehalose) protein folding and stabilization endosomal organization and biogenesis other energy-generation activities protein targeting, sorting and translocation vacuolar and lysosomal
    [Show full text]
  • Activation and Detoxification of Cassava Cyanogenic Glucosides by the Whitefly Bemisia Tabaci
    www.nature.com/scientificreports OPEN Activation and detoxifcation of cassava cyanogenic glucosides by the whitefy Bemisia tabaci Michael L. A. E. Easson 1, Osnat Malka 2*, Christian Paetz1, Anna Hojná1, Michael Reichelt1, Beate Stein3, Sharon van Brunschot4,5, Ester Feldmesser6, Lahcen Campbell7, John Colvin4, Stephan Winter3, Shai Morin2, Jonathan Gershenzon1 & Daniel G. Vassão 1* Two-component plant defenses such as cyanogenic glucosides are produced by many plant species, but phloem-feeding herbivores have long been thought not to activate these defenses due to their mode of feeding, which causes only minimal tissue damage. Here, however, we report that cyanogenic glycoside defenses from cassava (Manihot esculenta), a major staple crop in Africa, are activated during feeding by a pest insect, the whitefy Bemisia tabaci, and the resulting hydrogen cyanide is detoxifed by conversion to beta-cyanoalanine. Additionally, B. tabaci was found to utilize two metabolic mechanisms to detoxify cyanogenic glucosides by conversion to non-activatable derivatives. First, the cyanogenic glycoside linamarin was glucosylated 1–4 times in succession in a reaction catalyzed by two B. tabaci glycoside hydrolase family 13 enzymes in vitro utilizing sucrose as a co-substrate. Second, both linamarin and the glucosylated linamarin derivatives were phosphorylated. Both phosphorylation and glucosidation of linamarin render this plant pro-toxin inert to the activating plant enzyme linamarase, and thus these metabolic transformations can be considered pre-emptive detoxifcation strategies to avoid cyanogenesis. Many plants produce two-component chemical defenses as protection against attacks from herbivores and patho- gens. In these plants, protoxins that are ofen chemically protected by a glucose residue are activated by an enzyme such as a glycoside hydrolase yielding an unstable aglycone that is toxic or rearranges to form toxic products1.
    [Show full text]
  • Congenital Sucrase-Isomaltase Deficiency
    Congenital sucrase-isomaltase deficiency Description Congenital sucrase-isomaltase deficiency is a disorder that affects a person's ability to digest certain sugars. People with this condition cannot break down the sugars sucrose and maltose. Sucrose (a sugar found in fruits, and also known as table sugar) and maltose (the sugar found in grains) are called disaccharides because they are made of two simple sugars. Disaccharides are broken down into simple sugars during digestion. Sucrose is broken down into glucose and another simple sugar called fructose, and maltose is broken down into two glucose molecules. People with congenital sucrase- isomaltase deficiency cannot break down the sugars sucrose and maltose, and other compounds made from these sugar molecules (carbohydrates). Congenital sucrase-isomaltase deficiency usually becomes apparent after an infant is weaned and starts to consume fruits, juices, and grains. After ingestion of sucrose or maltose, an affected child will typically experience stomach cramps, bloating, excess gas production, and diarrhea. These digestive problems can lead to failure to gain weight and grow at the expected rate (failure to thrive) and malnutrition. Most affected children are better able to tolerate sucrose and maltose as they get older. Frequency The prevalence of congenital sucrase-isomaltase deficiency is estimated to be 1 in 5, 000 people of European descent. This condition is much more prevalent in the native populations of Greenland, Alaska, and Canada, where as many as 1 in 20 people may be affected. Causes Mutations in the SI gene cause congenital sucrase-isomaltase deficiency. The SI gene provides instructions for producing the enzyme sucrase-isomaltase.
    [Show full text]
  • The Distribution of Trehalase, Sucrase, Α-Amylase, Glucoamylase and Lactase
    Downloaded from Br. J. Nutr. (197z),28, 129 https://www.cambridge.org/core The distribution of trehalase, sucrase, a-amylase, glucoamylase and lactase (8-galactosidase) along the small intestine of five pigs BY J. A. S'I'EVENS" AND D. E. KIDDER . IP address: Departments of Animal Husbandry and Veterinary Medicine, University of Bristol Langfwd House, Lungford, Bristol BSI 8 70U 170.106.40.40 (Received 24 September 1971 - Accepted 30 December 1971) I. Sucrase, trehalase (EC 3.2. I .28), a-amylase (RC 3.2.I. I) and glucoamylase ("-1.4 , on glucan glucohydrolase, BC 3.2.I .3) activities have been measured in the small intestine 25 Sep 2021 at 22:09:31 mucosa of five pigs varying in age from 19-30 weeks. The determinations were made at frequent intervals along the entire length starting 5 x 10-l m from the pylorus. Lactasc (/I-galactosidase, EC 3.2,I .23) has similarly been measured in one pig. 2. All these enzymes were present in the sample obtained from nearest to the pylorus and rose rapidly in the first few metres. 3. Trehalase and lactase were similarly distributed with a peak activity in the proximal quarter of the small intestine, falling to very low levels in the distal half. 4. Sucrase and glucoamylase resembled one another in distribution pattern with a peak , subject to the Cambridge Core terms of use, available at approximately midway along the small intestine, followed by a slight decrease in sucrase activity distally and a rather greater decrease with glucoamylase. 5. a-Amylasc activity, assumed to be duc to adsorhcd pancrcatic enzyme, had no regular pattern of distribution.
    [Show full text]
  • Generated by SRI International Pathway Tools Version 25.0, Authors S
    Authors: Pallavi Subhraveti Ron Caspi Peter Midford Peter D Karp An online version of this diagram is available at BioCyc.org. Biosynthetic pathways are positioned in the left of the cytoplasm, degradative pathways on the right, and reactions not assigned to any pathway are in the far right of the cytoplasm. Transporters and membrane proteins are shown on the membrane. Ingrid Keseler Periplasmic (where appropriate) and extracellular reactions and proteins may also be shown. Pathways are colored according to their cellular function. Gcf_001431645Cyc: Stenotrophomonas panacihumi JCM 16536 Cellular Overview Connections between pathways are omitted for legibility. Anamika Kothari molybdate spermidine ammonium phosphate putrescine RS01245 RS09040 RS02020 RS09210 RS06445 ModC RS13295 RS07950 RS10935 RS05290 CcmE RS10150 RS15175 CcmA TatC RS15730 PotA FliR FliN FliF RS16780 RS13205 RS11350 RS08505 RS08615 RS04655 HtpX MreD RodA RS11935 SecA Amt RS14010 RS09060 RS11475 FliJ FtsE Cls FtsY SecF RS04370 RS14605 RS03760 RS08055 RS10260 RS10235 RS11315 RarD RS07635 RS12840 RS06270 RS15230 MurJ RS07085 RS02925 FlhA RS06365 AmpE MgtE RS05150 RS17505 PstB spermidine molybdate ammonium putrescine phosphate RS11800 FliD Cofactor, Carrier, and Vitamin Biosynthesis Amino Acid Degradation Aromatic Compound Macromolecule Modification tRNA-uridine 2-thiolation NADH repair (prokaryotes) Degradation di-trans,octa-cis UDP-N-acetyl- ditrans,octacis- a peptidoglycan with UDP-N-acetyl-α-D- L-alanyl-γ-D- an N-terminal- an N-terminal- a peptidoglycan (R)-4-hydroxy-
    [Show full text]
  • Disaccharidase Deficiency and Malabsorption of Carbohydrates
    SINGAPORE MEDICAL JOURNAL DISACCHARIDASE DEFICIENCY AND MALABSORPTION OF CARBOHYDRATES C K Lee SYNOPSIS A large proportion of man's caloric intake is carbohydrate and starch and sucrose account for over three-quarters of the total consumed. But the rapid change of the food industry from an art to a high specialised industry in recent years have made available a variety of rare food sugars, amongst which are various disacharides. Since the digestion or enzymic breakdown of carbohydrates is a normal initial requirement that precedes their absorption, and metabolism of carbohydrates varies according to their molecular structure, these rare sugars can cause diseases of carbohydrate intolerance and malabsorption. Intolerance and malabsorption can be due to polysaccharide intolerance because of amylase dy- sfunction (caused by the absence of pancreatic amylases) or malfunctioning of absorptive process (caused by damaged or atrophied absorptive mucosa as a result of another primary disease or a variety of other casautive agents or factors, thus resulting in the Department of Chemistry inability of carbohydrate absorption by the alimentary system). A National University of Singapore third type of intolerance is due to primary deficiency or impaired Kent Ridge activity of digestive disaccharidases of the small intestine. The Singapore 0511 physiological significance and the metabolic consequences of such a lactase, sucrase-isomaltase, mal- C K Lee, Ph.D., F.I.F.S.T., C.Chem. F.R.S.C. deficiency or impaired activity of Senior Lecturer tase and trehalase are discussed. 6 VOLUME 25 NO.1 FEBRUARY 19M INTRODUCTION abundance in the free state. It is a constituent of the important plant and animal reserve sugars, starch and Recent years have seen a considerable advance in all glycogen.
    [Show full text]
  • Congenital Sucrase-Isomaltase Deficiency: What, When, and How?
    October 2020 Volume 16, Issue 10, Supplement 5 Congenital Sucrase-Isomaltase Deficiency: What, When, and How? William D. Chey, MD, AGAF, FACG, FACP Professor of Medicine University of Michigan Health System Ann Arbor, Michigan Brooks Cash, MD Dan and Lille Sterling Professor of Gastroenterology Chief, Division of Gastroenterology, Hepatology, and Nutrition University of Texas Health Science Center at Houston Houston, Texas Anthony Lembo, MD Professor of Medicine Harvard Medical School Boston, Massachusetts Daksesh B. Patel, DO Illinois Gastroenterology Group/GI Alliance Chief, Division of Gastroenterology and Hepatology AMITA St Francis Hospital Evanston, Illinois Accredited by Rehoboth McKinley Christian Health Care Services Kate Scarlata, RDN, LDN Owner, For a Digestive Peace of Mind, LLC Digestive Health Nutrition Consulting Medway, Massachusetts A CME Activity Approved for 1.0 AMA PRA Category 1 CreditTM Provided by the Gi Health Foundation Release Date: October 2020 ON THE WEB: Expiration Date: gastroenterologyandhepatology.net October 31, 2021 Supported by an Estimated time to educational grant from Indexed through the National Library of Medicine complete activity: QOL Medical, LLC (PubMed/Medline), PubMed Central (PMC), and EMBASE 1.0 hour Congenital Sucrase-Isomaltase Deficiency: What, When, and How? To claim 1.0 AMA PRA Category 1 CreditTM for this activity, please visit: gihealthfoundation.org/CSIDMONOGRAPH Target Audience Disclosures This CME monograph will target gastroenterologists, primary care physi- Faculty members are required to inform the audience when they are dis- cians, nurse practitioners, physician assistants, and nurses. cussing off-label, unapproved uses of devices and drugs. Physicians should consult full prescribing information before using any product mentioned Goal Statement during this educational activity.
    [Show full text]
  • Chrebp-Knockout Mice Show Sucrose Intolerance and Fructose Malabsorption
    Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 1 February 2018 doi:10.20944/preprints201802.0005.v1 1 Article 2 ChREBP-Knockout Mice Show Sucrose Intolerance 3 and Fructose Malabsorption 4 Takehiro Kato1, Katsumi Iizuka1,2,*, Ken Takao1, Yukio Horikawa1, Tadahiro Kitamura3, Jun Takeda1 5 1Department of Diabetes and Endocrinology, Graduate School of Medicine, Gifu University, Gifu 501-1194, 6 Japan; [email protected] (T.K.); [email protected] (K.I.); [email protected] (K.T.); 7 [email protected] (Y.H.); [email protected] (JT). 8 2Gifu University Hospital Center for Nutritional Support and Infection Control, Gifu 501-1194, Japan 9 3Metabolic Signal Research Center, Institute for Molecular and Cellular Regulation, Gunma University, 10 Gunma 371-8512, Japan; [email protected] (T.K.) 11 *Correspondence: [email protected]; Tel: +81-58-230-6564; Fax: +81-58-230-6376 12 13 Abstract: We have previously reported that 60% sucrose diet-fed ChREBP knockout mice (KO) 14 showed body weight loss resulting in lethality. We aimed to elucidate whether sucrose and 15 fructose metabolism are impaired in KO. Wild type mice (WT) and KO were fed a diet containing 16 30% sucrose with/without 0.08% miglitol, an α-glucosidase inhibitor, and these effects on 17 phenotypes were tested. Furthermore, we compared metabolic changes of oral and peritoneal 18 fructose injection. Thirty percent sucrose diet feeding did not affect phenotypes in KO. However, 19 miglitol induced lethality in 30% sucrose-fed KO. Thirty percent sucrose plus miglitol diet-fed KO 20 showed increased cecal contents, increased fecal lactate contents, increased growth of 21 lactobacillales and Bifidobacterium and decreased growth of clostridium cluster XIVa.
    [Show full text]
  • Supplementary Information
    Supplementary information (a) (b) Figure S1. Resistant (a) and sensitive (b) gene scores plotted against subsystems involved in cell regulation. The small circles represent the individual hits and the large circles represent the mean of each subsystem. Each individual score signifies the mean of 12 trials – three biological and four technical. The p-value was calculated as a two-tailed t-test and significance was determined using the Benjamini-Hochberg procedure; false discovery rate was selected to be 0.1. Plots constructed using Pathway Tools, Omics Dashboard. Figure S2. Connectivity map displaying the predicted functional associations between the silver-resistant gene hits; disconnected gene hits not shown. The thicknesses of the lines indicate the degree of confidence prediction for the given interaction, based on fusion, co-occurrence, experimental and co-expression data. Figure produced using STRING (version 10.5) and a medium confidence score (approximate probability) of 0.4. Figure S3. Connectivity map displaying the predicted functional associations between the silver-sensitive gene hits; disconnected gene hits not shown. The thicknesses of the lines indicate the degree of confidence prediction for the given interaction, based on fusion, co-occurrence, experimental and co-expression data. Figure produced using STRING (version 10.5) and a medium confidence score (approximate probability) of 0.4. Figure S4. Metabolic overview of the pathways in Escherichia coli. The pathways involved in silver-resistance are coloured according to respective normalized score. Each individual score represents the mean of 12 trials – three biological and four technical. Amino acid – upward pointing triangle, carbohydrate – square, proteins – diamond, purines – vertical ellipse, cofactor – downward pointing triangle, tRNA – tee, and other – circle.
    [Show full text]