PubMed Health⌕ Search

Biomedical subjects

H Rosling

Publications and source records attributed to H Rosling.

At least 37 records · Page 2Linked to original sources

Cyanide detoxification in rats exposed to acetonitrile and fed a low protein diet.

Different neurological syndromes have been associated with exposure to cyanide. Dietary cyanide exposure from cassava roots combined with a low intake of the sulfur amino acids necessary for cyanide detoxification has been implicated in the causation of konzo, an upper motoneuron disease identified in Africa. We have investigated the effect of a low protein diet on the capacity for cyanide detoxification. Rats were fed normal chow containing 18% protein or a low protein diet with 5% protein. To expose rats to cyanide the drinking water was supplemented with 40 or 80 mM acetonitrile (CH3CN) for up to 4 weeks. Weight gain was monitored and 24-hr urines were collected for analyses of total sulfur, inorganic sulfate, thiocyanate, and 2-aminothiolazine-4-carboxylic acid (ATC). Blood was collected for analyses of cyanide and cyanate. Rats on a normal diet grew throughout the experiment, while those on a low protein diet initially lost weight and then stabilized at a constant weight. Rats exposed to acetonitrile all progressively lost weight, those on a low protein diet at the highest rate. Signs of neurological damage were not observed. Rats not exposed to acetonitrile excreted < 0.2% of sulfur as thiocyanate and those on a low protein diet reduced their total sulfur excretion to one-third that of rats of the normal diet. Rats on the normal diet did not change total sulfur excretion during exposure to acetonitrile, although thiocyanate now contributed more than two-thirds of excreted sulfur. Rats on a low protein diet exposed to acetonitrile increased both total sulfur and thiocyanate excretion to the levels of rats on a normal diet. Rats exposed to acetonitrile had manyfold increases of circulating concentrations of cyanide and cyanate and of urinary excretion of ATC. There was a positive correlation between blood cyanide concentrations and the plasma concentration of cyanate. It is concluded that the rat has a high capacity for detoxification of cyanide. During adaptation to a low protein intake, sulfur is conserved but cyanide detoxification is still possible at the cost of extensive protein catabolism. It is thus possible that subclinical cyanide exposure could interfere with normal growth and development. The observation of a relationship between circulating cyanide on the one hand and circulating cyanate and urinary excretion of ATC on the other highlights the possibility that cyanide metabolites may mediate neurotoxic effects of cyanide.

Acetonitriles↗

Milling reduces the goitrogenic potential of cassava.

Cyanide exposure from consumption of insufficiently processed cassava has been implicated in aggravating iodine deficiency disorders (IDD). The cyanide metabolite, thiocyanate (SCN) may interfere with iodine (I) uptake of the thyroid gland. A study on 217 women in an IDD endemic area in western Tanzania showed that 98% consumed cassava daily. Total and visible goitre rates were 72.8% and 13.3%, respectively. Median urinary iodine was 3.6 micrograms/dl indicating moderate iodine deficiency. Processing methods which remove cyanogens from cassava roots have changed with time. Urinary thiocyanate (mean; 128 mumol/l) was moderately increased, but women who frequently milled cassava had significantly lower urinary thiocyanate levels. This indicates that mechanical milling could reduce the goitrogenic potential of cassava and we conclude that IDD in the studied area is mainly due to iodine deficiency and sustainable iodine supplementation should be given highest priority.

Adolescent↗

Analysis of the cyanide metabolite 2-aminothiazoline-4-carboxylic acid in urine by high-performance liquid chromatography.

The cyanide metabolite 2-aminothiazoline-4-carboxylic acid (ATC) was converted to N-carbamylcysteine and analyzed by high-performance liquid chromatography (HPLC) and fluorometric detection. ATC was first separated from interfering substances by passing through the cation exchanger AG 50W-X8. Interfering disulfides were converted to thiols by reduction of the eluate with thiopropyl-Sepharose 6B. The thiols were then absorbed to the organomercurial absorbent p-acetoxymercurianiline-Sepharose 4B while ATC was obtained in the effluent. ATC was then converted to N-carbamylcysteine by ring opening at high temperature in an alkaline environment. Derivatization of N-carbamylcysteine was with N-(7-dimethylamino-4-methyl-3-coumarinyl)maleimide. The imprecision (CV) of the method was 3.6% and the analytical recovery was quantitative. The detection limit was 0.3 microM. ATC in urine was stable for at least 3 months when stored at -196 to +20 degrees C. The ATC concentration in urine was below the limit of detection in health nonsmokers. The utility of the method was demonstrated by the finding of up to 10.5 microM ATC concentrations in urine samples from human subjects in Mozambique living on a high dietary intake of cyanide from the cassava root. In a metabolic study rats were exposed to acetonitrile in the drinking water. After 4 weeks very high ATC levels were found in the urine, representative values from two rats being 195 and 525 microM, respectively.

Animals↗

Fate in humans of dietary intake of cyanogenic glycosides from roots of sweet cassava consumed in Cuba.

We studied if consumption of boiled fresh roots from sweet cassava varieties grown in Cuba resulted in exposure to cyanogenic glycosides and their final breakdown product, cyanide. When adult, nonsmoking subjects consumed 1-4 kg cassava over 2 days, their urinary levels of the main cyanide metabolite, thiocyanate, only increased from a mean +/- SEM of 12 +/- 2 to 22 +/- 2 mumol/l, indicating a negligible cyanide exposure. Their mean urinary linamarin, the main cyanogenic glucoside in cassava, increased from 2 +/- 1 to 68 +/- 16 mumol/l. In a second experiment 5 subjects consumed one meal of 0.5 kg boiled cassava that contained 105 mumol linamarin and 8 mumol hydrogen cyanide (HCN). Quantitative urine collections prior to and after intake showed that 28% of linamarin was excreted during the following 24 hours, whereas a modest increase of urinary thiocyanate (SCN) only corresponded to the small amount of free HCN ingested. These results indicate that the dominant cyanogen in boiled cassava is glycosides that pass through the human body without causing cyanide exposure. It remains to be studied whether humans occasionally possess intestinal or tissue beta-glucosidases that can hydrolyse cyanogenic glycosides from cassava.

Adult↗

A specific and sensitive method for the determination of linamarin in Urine.

A method is described for the quantitative determination of the cyanogenic glycoside linamarin. A preseparation procedure for urine samples was necessary to remove interfering substances. This was done by solid-phase extraction on a silica column containing cyclohexyl functional groups, which retained linamarin but allowed thiocyanate to pass unrestricted through the column. After elution of linamarin from the column by 35% (v/v) aqueous methanol, the glycoside was quantified following enzymatic hydrolysis, using the specified enzyme linamarase, and the free cyanide thus liberated was estimated spectrophotometrically. This method allowed quantification of linamarin in urine down to 10 mumol/l, with an estimated recovery of 91%. In 75 Tanzanian subjects consuming insufficiently processed cassava, the mean (+/- SD) urinary linamarin concentration was 104 (+/- 104) mumol/l (range 0 - 644 mumol/L), while that for thiocyanate was 486 (+/- 451) mumol/l (range 10-2,940 mumol/l), giving an approximate 1:5 molar concentration ratio between urinary linamarin and thiocyanate.

Chromatography, Affinity↗

Glycaemic control of insulin-dependent diabetes mellitus in Sudan: influence of insulin shortage.

Insulin availability and routine diabetes care were cross-sectionally investigated in 122 (M/F; 59/63) insulin-dependent diabetic patients aged 6-60 years with > or = 1 year duration using a structured questionnaire interview followed by a free conversation. Haemoglobin A1c, blood glucose, and serum lipids were measured in the fasting state to assess the metabolic control. Only 12% of the patients had acceptable glycaemic control (HbA1c < 7.5%). Increased age, shorter diabetes duration, and higher body mass index were associated with better metabolic control. Omission or reduction of the insulin dose was experienced by 51% of the patients due to insulin shortage. The interview data consistently indicated that insulin non-availability had induced poor compliance to therapy regimens and lack of motivation for optimum glycaemic control. Due to limited resources, most of the patients received insufficient diabetes care and education, leading to lower rates of clinic attendance (55%), and dietary non-compliance (78.5%). Elevated haemoglobin A1c was associated with higher fasting blood glucose levels (P < 0.001), serum triglycerides (P < 0.05), and urinary glucose (P < 0.001). Measurable fasting C-peptide was observed in 52.5% of the patients and was related to the age at diagnosis, and body mass index (P < 0.001 for both). There is a considerable potential to improve diabetes care and education practice, and if accessibility to insulin is simultaneously facilitated, the glycaemic control in Sudanese diabetic patients will improve.

Adolescent↗

Dietary determinants of a non-progressive spastic paraparesis (Konzo): a case-referent study in a high incidence area of Zaire.

BACKGROUND: Konzo is an upper motor neuron disease in Africa, characterized by an abrupt onset of a permanent but non-progressive spastic paraparesis. It is named after the local designation in the first report from Zaire. Konzo has been attributed to a metabolic insult from the combined effect of high cyanide and low sulphur intake from several weeks of exclusive consumption of insufficiently processed bitter cassava roots. METHODS: The association between insufficient soaking of cassava roots and konzo is assessed in a matched case-referent study with multivariate conditional logistic regression including 57 case-referent pairs from a rural high incidence community of Zaire. RESULTS: In the multivariate analysis short processing of cassava in the form of only 2 nights soaking yielded an odds ratio of 11.0 (95% confidence interval 1.7-73) when controlling for poverty-related factors and diet. We also show a dose-response relationship for insufficient cassava soaking, both unadjusted and adjusted for potential confounders. CONCLUSIONS: This study supports a causal relationship between insufficient processing of bitter cassava and konzo.

Adolescent↗

Reducing cassava toxicity by heap-fermentation in Uganda.

Processing of cassava roots by the Alur tribe in Uganda includes a stage of solid substrate fermentation in heaps. Changes in cyanogen levels during the process, microflora involved, and protein levels, amino acid patterns and mycotoxin contamination of the final products were studied. Processing was monitored at six rural households and repeated at laboratory site, comparing it to sun-drying. Flour samples from rural households were analysed for residual cyanogens, mutagenicity, cytotoxicity and aflatoxins. Mean (+/- SD) total cyanogen levels in flours collected at rural households were 20.3 (+/- 16.8) mg CN equivalents kg-1 dry weight in 1990 (n = 23) and 65.7 (+/- 56.7) in 1992 (n = 21). Mean (+/- SD) levels of cyanohydrins plus HCN were 9.1 (+/- 8.7) in the 1992 flours. Total cyanogen levels in the village monitored batches were reduced considerably by heap-fermentation from 436.3 (+/- 140.7) to 20.4 (+/- 14.0) mg CN equivalents kg-1 dry weight cassava. Residual cyanogen levels were positively correlated with particle size of the resulting crumbs. Heap-fermentation was significantly more effective in reducing cyanogen levels than sun-drying alone, but did not always result in innocuous levels of of cyanogens. Dominant mycelial growth was from the fungi Neurospora sitophila, Geotrichum candidum and Rhizopus oryzae. No mutagenicity, cytotoxicity nor aflatoxins could be detected in the flours. Protein quantity and quality were not significantly reduced. Cassava gel viscosity pattern was modified to the consumers' preference by this method. As the removal of cyanogens was more efficient and we found no new obvious health risk, heap-fermentation can be regarded as an improvement compared to sun-drying alone in areas where cassava varieties with higher cyanogen levels prevail, but we recommend optimisation of the process for ensuring still safer products.

Dietary Proteins↗

Fluorometric determination of cyanate in plasma by conversion to 2,4(1H,3H)-quinazolinedione and separation by high-performance liquid chromatography.

A fluorometric high-performance liquid-chromatographic method is described for the determination of cyanate in human plasma. The method is based on the derivatization of cyanate with 2-aminobenzoic acid (anthranilic acid), leading to a stable cyclic fluorescent product, 2,4(1H,3H)-quinazolinedione. The fluorescent product was extracted with ethyl acetate, passed through a cation-exchange resin to eliminate the excess of derivatization reagent, and then concentrated on a Sep-Pak C-18 cartridge before reversed-phase chromatography and fluorometric detection. The precision of the method was satisfactory (coefficient of variation 2.3%) and the analytical recovery was quantitative (103%). Detection limit was found to be 8 nmol/liter from a 1-ml plasma sample. Cyanate in plasma was stable for 3 months when stored in liquid nitrogen. The mean and SD cyanate level in human plasma from 17 healthy nonsmoking subjects was 45 +/- 21 nmol/liter.

Adult↗

Microdiffusion method with solid state detection of cyanogenic glycosides from cassava in human urine.

A method for quantitative determination of cyanogenic glycosides in human urine is described. It is based on enzymatic cleavage of the glycosides, microdiffusion of the hydrogen cyanide formed, solid state detection by colour formation on a picrate-impregnated sheet, and subsequent rating of the coloured spot by the absorption of transmitted light at 540 nm with a thin-layer (TLC) densitometer. The method has been tested using normal as well as pathological urines containing glucose, protein, leucocytes, blood and bacteria. The method allows quantification of urinary linamarin above 70 mumol/litre, in 40 microliters urine. In Mozambican subjects consuming insufficiently processed cassava the mean urinary linamarin levels were 211 mumol/litre, indicating for the first time that substantial amounts of the main cyanogenic glycoside in cassava may be absorbed from the human gut and excreted intact in the urine.

Administration, Oral↗

Konzo: a distinct disease entity with selective upper motor neuron damage.

Two Tanzanian patients with konzo were severely disabled by a non-progressive spastic paraparesis, since the sudden onset during an epidemic six years earlier. At the time of onset they had a high dietary intake of cyanide from exclusive consumption of insufficiently processed bitter cassava roots. MRI of brain and spinal cord were normal but motor evoked potentials on magnetic brain stimulation were absent, even in the only slightly affected upper limbs. Other neurophysiological investigations were largely normal but the more affected patient had central visual field defects. Konzo is a distinct disease entity with selective type upper motor neuron damage.

Adult↗