Biomedical subjects
Publications and source records attributed to M Ledochowski.
Three patients with premenstrual dysphoric disorder (PMDD) and recurrent vulvovaginal candidiasis (VVC) underwent sertraline therapy (Tresleen, a selective serotonin-reuptake inhibitor; Pfizer) for PMDD. During sertraline intervention, patients had no recurrent episodes of acute VVC. Antifungal activity was observed for sertraline against various isolates of Candida species.
BACKGROUND: Fructose malabsorption is frequently seen in the general population and is characterised by the inability to absorb fructose efficiently. Due to fructose malabsorption, fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO(2) and H(2). Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequence. We recently found that fructose malabsorption is associated with low plasma folic acid concentrations and low serum tryptophan and zinc. Because fructose malabsorption apparently is associated not only with malabsorption of other nutrients, but also with abdominal discomfort, it was of interest to examine whether mild pancreatitis may be involved. METHODS: We retrospectively examined our data in 159 otherwise healthy adults (110 females, 49 males) aged 14-84 years (mean 45.6+/-14.4 S.D.) with gastrointestinal complaints for serum amylase and serum lipase concentrations. The patients have been tested earlier for fructose malabsorption and lactose maldigestion by measuring breath H(2) concentrations after an oral dose of 25 g fructose and 50 g lactose, respectively, 1 week apart. RESULTS: Fructose malabsorption (H(2) concentrations > or =20 ppm over baseline values) was detected in 107 of 159 individuals (67.3%). These subjects with fructose malabsorption presented with significantly higher serum amylase concentrations (73.1 U/l+/-25.7 S.D.) compared to individuals with normal fructose absorption (59.6 U/l+17.9 S.D; p=0.0009). Fructose malabsorbers also presented with higher serum lipase concentrations (122.0 U/l+/-100.3 S.D.) compared to normals (89.5 U/l+/-46.5 S.D.; p<0.05). To determine whether this finding is a consequence of any sort of malabsorption syndrome or whether it is specific for fructose malabsorption, all subjects were screened for lactose maldigestion. Lactose maldigestion (H(2) concentrations>20 ppm over baseline after lactose loading) was found in 50 of 159 individuals (31.4%). There were no significant differences in either amylase or lipase concentrations in lactose maldigestors. CONCLUSION: Serum amylase and lipase concentrations are higher in subjects with fructose malabsorption compared to normals. Therefore, fructose malabsorption should be considered as a differential diagnosis in moderately elevated serum amylase.
Polarized human T helper (Th) cells play a key role in the network of the specific immune system compartments. Cell-mediated immune response depends on activation of Th1-type cells, typically producing and releasing interferon-gamma and interleukin-2, whereas activation of Th2-type cells and production of cytokines such as interleukin-4, -5, and -10 are involved in humoral immune response and the production of immunoglobulins. Increased amounts of neopterin are produced during the Th1-type immune response by human monocytes/macrophages upon stimulation with the Th1-derived cytokine interferon-gamma, and thus the determination of neopterin concentrations allows us to monitor Th1-type immune response. We compared serum concentrations of neopterin with immunoglobulin E (IgE), a typical product of the Th2-type immune response, in order to examine the relationship between Th1-type and Th2-type immune system stimulation in 709 healthy outpatients, who visited the physician's office for a medical health checkup. Eleven percent presented with serum neopterin concentrations >8.7 nmol/L; 26% had increased serum concentrations of IgE (>100 kIU/L). There existed an inverse correlation between serum neopterin and IgE concentrations (Spearman's rank correlation coefficient: r(s) = -0.100; P < 0.01) which was stronger when excluding data < or = 8.7 nmol/L neopterin and < or = 100 kIU/L IgE (n = 246; r(s) = -0.519; P < 0.0001). Data indicate that increased serum neopterin concentrations are associated with low serum IgE and increased serum IgE with low serum neopterin concentrations. This finding fully agrees with the current understanding that in humans the activation of Th1 and Th2 cell-mediated immune responses are down-regulating each other.
The age-related decline in dehydroepiandrosterone (DHEA) production is currently attracting attention because of its possible relevance to the etiology and management of a number of age-related clinical disorders. Various abnormalities of immune system function have been described in the elderly. Among them, increased concentrations of neopterin have been reported, which is produced by human monocytes/macrophages upon stimulation by interferon-gamma. In order to examine the relation of serum DHEA to serum neopterin, we studied 281 otherwise healthy outpatients, who visited the physician's office for a medical health check-up. 10% presented with increased neopterin concentrations, 0.4% had increased DHEA sulfate (DHEAs) concentrations. DHEAs concentrations were significantly higher in patients with lower neopterin concentrations (Mann-Whitney test: U=4793, P<0.0001). There existed a rather strong inverse correlation between DHEAs concentrations and serum neopterin concentrations (Spearman's rank correlation: r(s)=-0.221, P<0.0001). The data support the concept that the decrease of DHEA with increasing age is related to immune system activation. Oxidative stress which accompanies immune response may diminish DHEA synthesis.
BACKGROUND: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO2, H2, CH4 and lactic acid. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequence and can be seen in about 50% of fructose malabsorbers. Recently it was found that fructose malabsorption was associated with early signs of depressive disorders. Therefore, it was investigated whether fructose malabsorption is associated with abnormal tryptophan metabolism. METHODS: Fifty adults (16 men, 34 women) with gastrointestinal discomfort were analyzed by measuring breath hydrogen concentrations after an oral dose of 50 g fructose after an overnight fast. They were classified as normals or fructose malabsorbers according to their breath H2 concentrations. All patients filled out a Beck depression inventory questionnaire. Blood samples were taken for plasma tryptophan and kynurenine measurements. RESULTS: Fructose malabsorption (breath deltaH2 production >20 ppm) was detected in 35 of 50 individuals (70%). Subjects with fructose malabsorption showed significantly lower plasma tryptophan concentrations and significantly higher scores in the Beck depression inventory compared to those with normal fructose absorption. CONCLUSIONS: Fructose malabsorption is associated with lower tryptophan levels that may play a role in the development of depressive disorders. High intestinal fructose concentration seems to interfere with L-tryptophan metabolism, and it may reduce availability of tryptophan for the biosynthesis of serotonin (5-hydroxytryptamine). Fructose malabsorption should be considered in patients with symptoms of depression and disturbances of tryptophan metabolism.
This study investigated the fungicidal activity of selective serotonin reuptake inhibitors (SSRIs) against clinical isolates of Aspergillus fumigatus (n = 11), Aspergillus flavus (n = 9), Aspergillus terreus (n = 10) and Candida parapsilosis (ATCC 22019). The common drugs fluoxetine, seroxate, sertraline, paroxetine and reboxetine were applied in a broth microdilution test. In addition, we examined whether a post-antibiotic effect occurs following short exposure to the drugs. The various SSRIs showed time- and dose-dependent effects and were fungicidal towards the organisms tested. Sertraline and fluoxetine were the most active drugs, yet there were differences in the susceptibility of the various isolates tested. A lag of regrowth was dependent on the various SSRIs tested and their concentration. Treatment for 4 h at concentrations of sertraline below and equipotent to the minimal fungicidal concentration resulted in a lag of regrowth of 8-24 h for isolates of A. fumigatus and A. flavus. In conclusion, our in vitro studies clearly demonstrate antifungal effects of SSRIs. Animal studies are needed to evaluate the potential role of these psychotropic drugs in the management of fungal infections.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fructose and lactose malabsorption are characterized by impaired duodenal fructose transport or by the deficiency of mucosal lactase, respectively. As a consequence, the nonabsorbed saccharides reach the colon, where they are broken down by bacteria to short fatty acids, CO2, and H2. Bloating, cramps, osmotic diarrhea, and other symptoms of irritable bowel syndrome are the consequence and can be seen in about 50% of carbohydrate malabsorbers. We have previously shown that fructose as well as lactose malabsorption were associated with signs of mental depression. It was therefore of interest to investigate possible interactions between fructose and lactose malabsorption and their influence on the development of signs of depression. In all, 111 otherwise healthy volunteers (81 females and 30 males) with gastrointestinal complaints were analyzed by measuring breath H2 concentrations after an oral dose of 50 g lactose and of 50 g fructose one week apart. They were classified as normals, isolated fructose malabsorbers, isolated lactose malabsorbers, and combined fructose/lactose malabsorbers. All patients filled out a Beck's depression inventory-questionnaire. Twenty-five individuals (22.5%) were neither fructose nor lactose malabsorbers (group 1), 69 (62.2%) were only fructose malabsorbers (group 2), 4 (3.6%) were only lactose malabsorbers (group 3), and 13 (11.7%) presented with fructose and lactose malabsorption together (group 4). Isolated fructose malabsorption and combined fructose/lactose malabsorption was significantly associated with a higher Beck's depression score. Further analysis of the data show that this association was strong in females (P < 0.01), but there was no such association between carbohydrate malabsorption and early signs of depression in males. In conclusion, the data confirm that fructose malabsorption may play a role in the development of mental depression in females and additional lactose malabsorption seems to further increase the risk for development of mental depression.
Mood disturbances and depression are supposed to have a negative impact on patients' outcome in malignant tumour disease. On the other hand, poor prognosis in cancer patients is associated with chronic immune challenge which is paralleled by enhanced degradation of the essential amino acid tryptophan and thus decreased plasma tryptophan concentrations. Because tryptophan is precursor for the biosynthesis of the neurotransmitter serotonin (= 5-hydroxytryptamine, 5HT), low tryptophan concentrations will lead to decreased availability of serotonin which finally increases the susceptibility for the development of mood disturbances and depression in the patients. Thus, the development of depression in cancer patients may result from chronic cellular immune stimulation. In conclusion, a more aggressive tumour rather than depression will be responsible for worse outcome of cancer patients and will be associated with a more drastic challenge of the immune system, as a side effect leading to neurotransmitter disturbances.
BACKGROUND: Fructose malabsorption is characterized by the inability to absorb fructose efficiently. As a consequence fructose reaches the colon where it is broken down by bacteria to short fatty acids, CO2 and H2. Bloating, cramps, osmotic diarrhea and other symptoms of irritable bowel syndrome are the consequences and can be seen in about 50% of fructose malabsorbers. We have previously shown that fructose malabsorption is associated with early signs of mental depression and low serum tryptophan concentrations. It was therefore of interest whether a fructose-reduced diet could not only improve gastrointestinal complaints but also depressive signs seen in fructose malabsorbers. METHODS: Fifty-three adults (12 males, 41 females), who were identified as fructose malabsorbers according to their breath-H2 concentrations, filled out a Beck's depression inventory-questionnaire, and a questionnaire with arbitrary scales for measurement of meteorism, stool frequency and quality of life for a 4-week period before dietary intervention and 4 weeks after dietary change as for fructose- and sorbitol-reduced diet. RESULTS: Depression scores were reduced by 65.2% after 4 weeks of diet (P < 0.0001), and there was a significant reduction of meteorism (P < 0.0001) and stool frequency (P < 0.01). Improvement of signs of depression and of meteorism was more pronounced in females than in males. CONCLUSION: Fructose- and sorbitol-reduced diet in subjects with fructose malabsorption does not only reduce gastrointestinal symptoms but also improves mood and early signs of depression.
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Tryptophan is a constituent of proteins and in parallel it represents a source for mainly two pivotal biochemical pathways: the generation of 5-hydroxytryptamine (serotonin), and the formation of kynurenine by the enzymes tryptophan pyrrolase (TP) and indoleamine 2,3-dioxygenase (IDO). IDO is induced by interferon-gamma (IFN-gamma) in a broad variety of cells. Therefore, enhanced tryptophan degradation is observed in diseases and disorders concomitant with cellular immune activation, e.g. infectious diseases, autoimmune diseases, malignant diseases as well as in pregnancy. IFN-gamma-derived tryptophan degradation may represent an effector mechanism within in the comprehensive network of immune stimulation. In addition, the cytostatic and, respectively, antiproliferative properties on e.g., T-lymphocytes may contribute to the immunomodulatory function of IFN-gamma. However, especially in states of persistent immune activation increased tryptophan catabolism leads to the depletion of free serum tryptophan and to the accumulation of neuroactive kynurenine metabolites. As a consequence, serotonergic functions may be affected, and the neurotoxic properties of kynurenine derivatives may lead to neuronal disorders evoking neurological/psychiatric symptoms. This notion provides a basis for the better understanding of mood disorders and related syptoms in chronic diseases. Moreover, IDO could represent a link between the immunological network and neuroendocrine functions with far reaching consequences regarding to the psychological status of patients.
Fructose malabsorption is characterized by the inability to absorb fructose efficiently. Consequently fructose reaches the colon and is broken down by bacteria to short-fatty-acids, CO2 and H2. Recently we found that fructose malabsorption was associated with signs of depression. It was therefore of interest to find out whether fructose malabsorption is associated with abnormal tryptophan metabolism. Breath hydrogen concentrations were measured in 50 after an oral dose of 50 g fructose allowing to classify them as normals (n = 15) or fructose malabsorbers (n = 35). Blood samples were taken for tryptophan and kynurenine measurements. Fructose malabsorbers showed significantly lower plasma tryptophan concentrations and significantly higher depression scores compared to normals. Fructose malabsorption is associated with lower tryptophan levels which may play a role in the development of depressive disorders.
Obesity is frequently associated with insulin resistance. Recently an important role of the cytokine tumor necrosis factor-alpha in mediating insulin resistance of obesity through its overexpression in fat tissue has been reported. In order to examine the relation of insulin resistance to obesity and to serum neopterin, as a parameter of immune activation, we studied 1234 otherwise healthy outpatients, who visited the physician's office for a medical health check-up. 7% showed elevated glucose concentrations, 34% elevated body mass indices. There were significant correlations between glucose concentrations and body mass indices and of the latter with serum neopterin concentrations. Neopterin concentrations were significantly higher in patients with elevated body mass indices (Mann-Whitney test, U = 131 358, p = 0.0003) and elevated glucose concentrations (Mann-Whitney test, U = 35 350 p =0.02). The data may indicate that moderate immune stimulation plays a role in the development of insulin resistance, and an influence of tumor necrosis factor-alpha seems to be probable.