Potential of Diet and Dietary Supplementation to Ameliorate the Chronic Clinical Perturbations of Metabolic Syndrome
Stephen T. Sinatra, Mark C. Houston in Nutritional and Integrative Strategies in Cardiovascular Medicine, 2015
To be absorbed, CHO must be broken down into monosaccharides. At a minimum, two major enzymes are involved in this process. Alpha-amylase from saliva and pancreatic juice decomposes starches into monosaccharide, disaccharide, trisaccharide, and oligosaccharide units. Alpha-glucosidases bound in the brush border of the small intestines further divide the remaining larger units into monosaccharides.87 To give an example, sucrose, commonly referred to as “table sugar‚” is a disaccharide of linked glucose and fructose. Sucrase, an alpha-glucosidase, breaks down sucrose into glucose and fructose. Different monosaccharides are absorbed by different transport mechanisms.87 As a general principal, the smaller the CHO molecule, the more rapid is the absorption (high glycemic index). This rapid absorption has been connected to the harm that excess sugar intake (high glycemic load) induces.84,85
Fetal and Postnatal Development of the Small and Large Intestine
Jean Morisset, Travis E. Solomon in Growth of the Gastrointestinal Tract: Gastrointestinal Hormones and Growth Factors, 2017
The neonatal rodent small intestine is mainly characterized by the presence of high lactase activity and the absence of sucrase.8 Indeed, lactase, which hydrolyzes milk lactose and is already detectable in late fetal life, attains maximal activity during the first 2 weeks after birth and then declines, reaching adult values by the end of the fourth week. On the other hand, sucrase activity is undetectable during the first 2 weeks, but appears on approximately day 15 and rises rapidly, reaching adult levels by the end of the fourth week. Maltase, glucoamylase, and trehalase have low activities during the first 2 weeks, then undergo a substantial increase during the next 2 weeks. These enzymatic modifications are correlated with quantitative changes in the protein bands of brush border microvillus membranes as studied by gel electrophoresis.
Inhibiting the Absorption of Dietary Carbohydrates and Fats with Natural Products
Christophe Wiart in Medicinal Plants in Asia for Metabolic Syndrome, 2017
Degradation products of starch are hydrolyzed in the jejunum into free absorbable glucose by 4 brush border α-glucosidases arranged into 2 enzymatic complexes termed as sucrase–isomaltase and maltase–glucoamylase.22 Members of the family Menispermaceae often accumulate isoquinoline alkaloids that hamper glucose absorption by inhibiting enterocyte membrane bound α-glucosidases. As an example, Tinospora crispa (L.) Hook. f. & Thomson synthetize palmatine, jatrorrhizine, and magnoflorine that inhibited the enzymatic activity of sucrase with IC50 of 36.2, 23.4, and 9.8 μg/mL, respectively.23 In the same experiment, palmatine, jatrorrhizine, and magnoflorine inhibited the enzymatic activity of maltase with IC50 values equal to 22, 38.4, and 7.6 μg/mL.23 Magnoflorine at a dose of 20 mg/kg mitigated the raise in glycaemia induced by oral administration of 2 g/kg of glucose to rodents.23 Magnoflorine is known to induce hypotension when parenterally administered and to be nontoxic in animals when given orally.24
The challenges of oral drug delivery via nanocarriers
Published in Drug Delivery, 2018
Jonas Reinholz, Katharina Landfester, Volker Mailänder
However, the oral dosage form also has several drawbacks. Before the orally applied drug is able to reach its target, in most instances it needs to overcome multiple compartments of the human body, which is challenging for a broad spectrum of pharmaceuticals, especially for protein- or peptide-based ones. In general, the first major challenge for the drug after ingestion is surviving the harsh acidic pH value in the stomach. In addition, the proteases pepsin and cathepsin start to digest proteins into peptides. Once the drug surpasses the stomach and enters the small intestine via the duodenum, it faces the major enzymatic digestion machinery of the human body. Oligosaccharides and maltose are degraded into glucose, fructose, galactose, and mannose via sucrase, maltase, and lactase. Lipids are cleaved into glycerol and fatty acids via the pancreatic triacylglycerol lipase and carboxyl ester lipase. Peptides are digested into amino acids via trypsin, chymotrypsin, carboxypeptidase, dipeptidase, and aminopeptidase.
Sucrose intolerance in adults with common functional gastrointestinal symptoms
Published in Baylor University Medical Center Proceedings, 2022
Christine L. Frissora, Satish S. C. Rao
About 70% of the adult population is affected by some form of carbohydrate malabsorption. Sucrose malabsorption may be more prevalent than previously recognized.1 Sucrose intolerance, caused by a deficiency in sucrase enzyme activity in the small intestine, presents with postprandial cramping, bloating, gas, and diarrhea. These are common symptoms that are often attributed to functional gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS). There are increasing reports of patients diagnosed with IBS whose symptoms are actually due, at least in part, to carbohydrate malabsorption, including sucrose.2–5 Sucrose intolerance due to congenital sucrase-isomaltase deficiency (CSID) is rare. Secondary or acquired sucrose intolerance is more common and caused by intestinal brush border injury. The gold standard test for sucrase deficiency is the sucrase enzyme activity assay from duodenal biopsies. Alternatively, the sucrose breath test is a noninvasive way to diagnose sucrose malabsorption.6 When sucrase deficiency is detected, a trial therapy of dietary modification and enzyme replacement therapy can be initiated. Our objective was to describe our clinical experience with a large group of adult patients presenting with chronic GI symptoms who were screened for sucrose malabsorption using breath testing and to discuss clinical outcomes in a subgroup who were followed up in our clinic.
Antihistamines-refractory chronic pruritus in psoriatic patients undergoing biologics: aprepitant vs antihistamine double dosage, a real-world data
Published in Journal of Dermatological Treatment, 2022
Giovanni Damiani, Khalaf Kridin, Alessia Pacifico, Piergiorgio Malagoli, Paolo D. M. Pigatto, Renata Finelli, Fabio S. Taccone, Lorenzo Peluso, Rosalynn R. Z. Conic, Nicola L. Bragazzi, Marco Fiore
Exclusion criteria comprehended: (i) pediatric patients (<18 years) or pregnant woman, (ii) different type of psoriasis (i.e. erythrodermic psoriasis, guttate psoriasis, impetigo herpetiformis, pustular psoriasis, drug-induced psoriasis), (iii) the presence of acute or chronic infections (HIV, hepatitis B and C, tuberculosis), (iv) renal, hepatic or metabolic conditions able to induce pruritus, (v) other concomitant autoimmune/auto-inflammatory conditions except psoriatic arthritis or psoriatic spondylitis, (vi) concomitant dermatoses, atopic background, or even history of positive patch test, (vii) drugs recently introduced (<3 months) or capable to trigger pruritus, (viii) use of medical contraceptives, (ix) hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency, (x) ongoing therapies with pimozide, terfenadine, astemizolo, cisapride, or ergot derivates, (xi) active disease or even history of psychiatric diagnoses, (xii) VAS <6mm.
Related Knowledge Centers
- Catalysis
- Enzyme
- Fructose
- Glucose
- Hydrolysis
- Invertase
- Sucrose
- Small Intestine
- Sucrase-Isomaltase
- Brush Border