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1.
Cell Death Dis ; 12(10): 853, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34535624

RESUMO

Inflammatory bowel disease (IBD) has a close association with transketolase (TKT) that links glycolysis and the pentose phosphate pathway (PPP). However, how TKT functions in the intestinal epithelium remains to be elucidated. To address this question, we specifically delete TKT in intestinal epithelial cells (IECs). IEC TKT-deficient mice are growth retarded and suffer from spontaneous colitis. TKT ablation brings about striking alterations of the intestine, including extensive mucosal erosion, aberrant tight junctions, impaired barrier function, and increased inflammatory cell infiltration. Mechanistically, TKT deficiency significantly accumulates PPP metabolites and decreases glycolytic metabolites, thereby reducing ATP production, which results in excessive apoptosis and defective intestinal barrier. Therefore, our data demonstrate that TKT serves as an essential guardian of intestinal integrity and barrier function as well as a potential therapeutic target for intestinal disorders.


Assuntos
Trifosfato de Adenosina/biossíntese , Apoptose , Colite/patologia , Intestinos/metabolismo , Intestinos/patologia , Transcetolase/metabolismo , Animais , Apoptose/genética , Proliferação de Células/genética , Colite/genética , Colo/patologia , Metabolismo Energético , Células Epiteliais/metabolismo , Células Epiteliais/patologia , Feminino , Deleção de Genes , Ontologia Genética , Mucosa Intestinal/patologia , Antígeno Ki-67/metabolismo , Camundongos Endogâmicos C57BL , Camundongos Knockout , NADP/metabolismo , Retocele/patologia , Transcetolase/deficiência , Regulação para Cima/genética
2.
Mol Genet Metab ; 131(1-2): 147-154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32828637

RESUMO

Inborn errors of metabolism (IEM) involving the non-oxidative pentose phosphate pathway (PPP) include the two relatively rare conditions, transketolase deficiency and transaldolase deficiency, both of which can be difficult to diagnosis given their non-specific clinical presentations. Current biochemical testing approaches require an index of suspicion to consider targeted urine polyol testing. To determine whether a broad-spectrum biochemical test could accurately identify a specific metabolic pattern defining IEMs of the non-oxidative PPP, we employed the use of clinical metabolomic profiling as an unbiased novel approach to diagnosis. Subjects with molecularly confirmed IEMs of the PPP were included in this study. Targeted quantitative analysis of polyols in urine and plasma samples was accomplished with chromatography and mass spectrometry. Semi-quantitative unbiased metabolomic analysis of urine and plasma samples was achieved by assessing small molecules via liquid chromatography and high-resolution mass spectrometry. Results from untargeted and targeted analyses were then compared and analyzed for diagnostic acuity. Two siblings with transketolase (TKT) deficiency and three unrelated individuals with transaldolase (TALDO) deficiency were identified for inclusion in the study. For both IEMs, targeted polyol testing and untargeted metabolomic testing on urine and/or plasma samples identified typical perturbations of the respective disorder. Additionally, untargeted metabolomic testing revealed elevations in other PPP metabolites not typically measured with targeted polyol testing, including ribonate, ribose, and erythronate for TKT deficiency and ribonate, erythronate, and sedoheptulose 7-phosphate in TALDO deficiency. Non-PPP alternations were also noted involving tryptophan, purine, and pyrimidine metabolism for both TKT and TALDO deficient patients. Targeted polyol testing and untargeted metabolomic testing methods were both able to identify specific biochemical patterns indicative of TKT and TALDO deficiency in both plasma and urine samples. In addition, untargeted metabolomics was able to identify novel biomarkers, thereby expanding the current knowledge of both conditions and providing further insight into potential underlying pathophysiological mechanisms. Furthermore, untargeted metabolomic testing offers the advantage of having a single effective biochemical screening test for identification of rare IEMs, like TKT and TALDO deficiencies, that may otherwise go undiagnosed due to their generally non-specific clinical presentations.


Assuntos
Erros Inatos do Metabolismo dos Carboidratos/genética , Erros Inatos do Metabolismo/genética , Transaldolase/deficiência , Transaldolase/genética , Transcetolase/genética , Adulto , Biomarcadores/sangue , Erros Inatos do Metabolismo dos Carboidratos/sangue , Erros Inatos do Metabolismo dos Carboidratos/metabolismo , Erros Inatos do Metabolismo dos Carboidratos/patologia , Criança , Pré-Escolar , Cromatografia Líquida , Feminino , Humanos , Lactente , Masculino , Espectrometria de Massas , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/metabolismo , Erros Inatos do Metabolismo/patologia , Metabolômica , Via de Pentose Fosfato/genética , Transaldolase/sangue , Transaldolase/metabolismo , Transcetolase/sangue , Transcetolase/deficiência , Adulto Jovem
3.
Diabetes ; 69(7): 1355-1367, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32295803

RESUMO

Obesity has recently become a prevalent health threat worldwide. Although emerging evidence has suggested a strong link between the pentose phosphate pathway (PPP) and obesity, the role of transketolase (TKT), an enzyme in the nonoxidative branch of the PPP that connects PPP and glycolysis, remains obscure in adipose tissues. In this study, we specifically deleted TKT in mouse adipocytes and found no obvious phenotype upon normal diet feeding. However, adipocyte TKT abrogation attenuated high-fat diet-induced obesity, reduced hepatic steatosis, improved glucose tolerance, alleviated insulin resistance, and increased energy expenditure. Mechanistically, TKT deficiency accumulated nonoxidative PPP metabolites and decreased glycolysis and pyruvate input into the mitochondria, leading to increased lipolytic enzyme gene expression and enhanced lipolysis, fatty acid oxidation, and mitochondrial respiration. Therefore, our data not only identify a novel role of TKT in regulating lipolysis and obesity but also suggest that limiting glucose-derived carbon into the mitochondria induces lipid catabolism and energy expenditure.


Assuntos
Tecido Adiposo/metabolismo , Lipólise , Obesidade/prevenção & controle , Transcetolase/fisiologia , Animais , Dieta Hiperlipídica , Metabolismo Energético , Fígado Gorduroso/prevenção & controle , Resistência à Insulina , Camundongos , Transcetolase/deficiência
4.
Cell Death Dis ; 11(1): 31, 2020 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-31949131

RESUMO

Transketolase (TKT), which is a metabolic enzyme in the nonoxidative phase of the pentose phosphate pathway (PPP), plays an important role in providing cancer cells with raw materials for macromolecular biosynthesis. The ectopic expression of TKT in hepatocellular carcinoma (HCC) was reported previously. However, the role of TKT in the initiation of liver cancer is still obscure. In our previous study, we found that TKT deficiency protects the liver from DNA damage by increasing levels of ribose 5-phosphate and nucleotides. What's more interesting is that we found TKT deficiency reduced bile acids and loss of TKT promoted the farnesoid receptor (FXR) expression. We further showed that TKT translocated into the nucleus of HCC cell lines through interacting with the signal transducer and activator of transcription 1 (STAT1), and then the complex inhibited FXR expression by promoting the binding of histone deacetylase 3 (HDAC3) to FXR promoter.


Assuntos
Carcinoma Hepatocelular/genética , Núcleo Celular/metabolismo , Regulação Neoplásica da Expressão Gênica , Histona Desacetilases/metabolismo , Neoplasias Hepáticas/genética , Regiões Promotoras Genéticas , Receptores Citoplasmáticos e Nucleares/genética , Transcetolase/metabolismo , Animais , Ácidos e Sais Biliares/metabolismo , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Humanos , Fígado/metabolismo , Fígado/patologia , Neoplasias Hepáticas/patologia , Camundongos Endogâmicos C57BL , Camundongos Knockout , Ligação Proteica , Transporte Proteico , Receptores Citoplasmáticos e Nucleares/metabolismo , Fator de Transcrição STAT1/metabolismo , Transcetolase/deficiência
5.
Eur Rev Med Pharmacol Sci ; 23(19): 8501-8505, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31646581

RESUMO

OBJECTIVE: Aim of the study was to assess the possible vitamin B1 deficiency in relation to the exacerbation of Crohn's disease (CD) in adult patients. PATIENTS AND METHODS: Forty-nine Crohn's disease (CD) patients with different disease activity (The Crohn's Disease Activity Index-CDAI) were included in the study. Anthropometrical and biochemical parameters, i.e., high sensitive C-reactive protein, were assessed. The spectrophotometric method was used to measure the transketolase activity (TK) in erythrocytes. The normalized transketolase activity ratio (NTKZ) and the percentage of activation with thiamine pyrophosphate (%TPP) were also evaluated. RESULTS: The mean values of BMI were close to cut-off: 18.5 kg/m2, indicating a poor nutritional status in CD patients. The patients with moderate-to-severe active CD had a statistically significant higher value of CDAI and hsCRP concentrations compared to those being in the asymptomatic remission or at the mildly active stage of the disease. The level of NTKZ and %TPP were statistically different between the analyzed groups, showing the deficit of vitamin B1 in the group of moderate-to-severe active CD patients (Mean ± SD; NTKZ: 1.99 ± 0.87 vs. 1.54 ± 0.62 U/g Hb; % of TPP: 0.15 ± 0.78 vs. 54.90 ± 38.80). CONCLUSIONS: Vitamin B1 deficiency is part of the Crohn's disease manifestation in moderate-to-severe active patients.


Assuntos
Doença de Crohn/metabolismo , Eritrócitos/enzimologia , Transcetolase/metabolismo , Adulto , Doença de Crohn/diagnóstico , Feminino , Humanos , Masculino , Espectrofotometria , Transcetolase/análise , Transcetolase/deficiência
6.
Cancer Res ; 79(14): 3689-3701, 2019 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-31101762

RESUMO

De novo nucleotide biosynthesis is essential for maintaining cellular nucleotide pools, the suppression of which leads to genome instability. The metabolic enzyme transketolase (TKT) in the nonoxidative branch of the pentose phosphate pathway (PPP) regulates ribose 5-phosphate (R5P) levels and de novo nucleotide biosynthesis. TKT is required for maintaining cell proliferation in human liver cancer cell lines, yet the role of TKT in liver injury and cancer initiation remains to be elucidated. In this study, we generated a liver-specific TKT knockout mouse strain by crossing TKTflox/flox mice with albumin-Cre mice. Loss of TKT in hepatocytes protected the liver from diethylnitrosamine (DEN)-induced DNA damage without altering DEN metabolism. DEN treatment of TKT-null liver increased levels of R5P and promoted de novo nucleotide synthesis. More importantly, supplementation of dNTPs in primary hepatocytes alleviated DEN-induced DNA damage, cell death, inflammatory response, and cell proliferation. Furthermore, DEN and high-fat diet (HFD)-induced liver carcinogenesis was reduced in TKTflox/floxAlb-Cre mice compared with control littermates. Mechanistically, loss of TKT in the liver increased apoptosis, reduced cell proliferation, decreased TNFα, IL6, and STAT3 levels, and alleviated DEN/HFD-induced hepatic steatosis and fibrosis. Together, our data identify a key role for TKT in promoting genome instability during liver injury and tumor initiation. SIGNIFICANCE: These findings identify transketolase as a novel metabolic target to maintain genome stability and reduce liver carcinogenesis.


Assuntos
Dano ao DNA , Neoplasias Hepáticas Experimentais/enzimologia , Fígado/efeitos dos fármacos , Fígado/enzimologia , Nucleotídeos/metabolismo , Ribosemonofosfatos/metabolismo , Transcetolase/deficiência , Animais , Dietilnitrosamina , Glicólise , Fígado/metabolismo , Neoplasias Hepáticas Experimentais/induzido quimicamente , Neoplasias Hepáticas Experimentais/genética , Neoplasias Hepáticas Experimentais/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Via de Pentose Fosfato
7.
Lett Appl Microbiol ; 64(1): 73-78, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27739585

RESUMO

Normally, low d-ribose production was identified as responsible for plenty of acid formation by Bacillus subtilis due to its carbon overflow. An approach of co-feeding glucose and sodium citrate is developed here and had been proved to be useful in d-ribose production. This strategy is critical because it affects the cell concentration, the productivity of d-ribose and, especially, the formation of by-products such as acetoin, lactate and acetate. d-ribose production was increased by 59·6% from 71·06 to 113·41 g l-1 without acid formation by co-feeding 2·22 g l-1  h-1 glucose and 0·036 g l-1  h-1 sodium citrate to a 60 g l-1 glucose reaction system. Actually, the cell density was also enhanced from 11·51 to 13·84 g l-1 . These parameters revealed the importance of optimization and modelling of the d-ribose production process. Not only could zero acid formation was achieved over a wide range of co-feeding rate by reducing glycolytic flux drastically but also the cell density and d-ribose yield were elevated by increasing the hexose monophosphate pathway flux. SIGNIFICANCE AND IMPACT OF THE STUDY: Bacillus subtilis usually produce d-ribose accompanied by plenty of organic acids when glucose is used as a carbon source, which is considered to be a consequence of mismatched glycolytic and tricarboxylic acid cycle capacities. This is the first study to provide high-efficiency biosynthesis of d-ribose without organic acid formation in B. subtilis, which would be lower than the cost of separation and purification. The strain transketolase-deficient B. subtilis CGMCC 3720 can be potentially applied to the production of d-ribose in industry.


Assuntos
Bacillus subtilis/metabolismo , Citratos/metabolismo , Glucose/metabolismo , Ribose/biossíntese , Acetoína/metabolismo , Bacillus subtilis/enzimologia , Bacillus subtilis/genética , Via de Pentose Fosfato , Citrato de Sódio , Transcetolase/deficiência , Transcetolase/genética
8.
Eur J Med Genet ; 57(10): 543-51, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25078763

RESUMO

We identified six patients presenting with a strikingly similar clinical phenotype of profound syndromic intellectual disability of unknown etiology. All patients lived in the same village. Extensive genealogical work revealed that the healthy parents of the patients were all distantly related to a common ancestor from the 17th century, suggesting autosomal recessive inheritance. In addition to intellectual disability, the clinical features included hypotonia, strabismus, difficulty to fix the eyes to an object, planovalgus in the feet, mild contractures in elbow joints, interphalangeal joint hypermobility and coarse facial features that develop gradually during childhood. The clinical phenotype did not fit any known syndrome. Genome-wide SNP genotyping of the patients and genetic mapping revealed the longest shared homozygosity at 3p22.1-3p21.1 encompassing 11.5 Mb, with no other credible candidate loci emerging. Single point parametric linkage analysis showed logarithm of the odds score of 11 for the homozygous region, thus identifying a novel intellectual disability predisposition locus. Whole-genome sequencing of one affected individual pinpointed three genes with potentially protein damaging homozygous sequence changes within the predisposition locus: transketolase (TKT), prolyl 4-hydroxylase transmembrane (P4HTM), and ubiquitin specific peptidase 4 (USP4). The changes were found in heterozygous form with 0.3-0.7% allele frequencies in 402 whole-genome sequenced controls from the north-east of Finland. No homozygotes were found in this nor additional control data sets. Our study facilitates clinical and molecular diagnosis of patients with this novel autosomal recessive intellectual disability syndrome. However, further studies are needed to unambiguously identify the underlying genetic defect.


Assuntos
Cromossomos Humanos Par 3 , Deficiência Intelectual/genética , Adolescente , Adulto , Análise Mutacional de DNA , Anormalidades do Olho/genética , Feminino , Finlândia , Genes Recessivos , Heterogeneidade Genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Hipotonia Muscular/genética , Linhagem , Fenótipo , Prolil Hidroxilases/genética , Análise de Sequência de DNA , Síndrome , Transcetolase/deficiência , Transcetolase/genética , Ubiquitina Tiolesterase/genética , Proteases Específicas de Ubiquitina , Adulto Jovem
9.
J Microbiol Biotechnol ; 23(4): 560-4, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23568212

RESUMO

D-Ribose is a value-added five-carbon sugar used for riboflavin production. To investigate the effects of oxygen supply and mixed sugar concentration on microbial production of D-ribose, a transketolase-deficient Bacillus subtilis SPK1 was cultured batch-wise using xylose and glucose. A change of agitation speed from 300 rpm to 600 rpm at 1 vvm of air supply increased both the xylose consumption rate and D-ribose production rate. Because the sum of the specific consumption rates for xylose and glucose was similar at all agitation speeds, metabolic preferences between xylose and glucose might depend on oxygen supply. Although B. subtilis SPK1 can take up xylose and glucose by the active transport mechanism, a high initial concentration of xylose and glucose was not beneficial for high D-ribose production.


Assuntos
Bacillus subtilis/metabolismo , Oxigênio/metabolismo , Ribose/biossíntese , Transcetolase/deficiência , Bacillus subtilis/enzimologia , Glucose/metabolismo , Xilose/metabolismo
10.
J Ind Microbiol Biotechnol ; 36(10): 1289-96, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19603213

RESUMO

In this study, the effects of citrate addition on D-ribose production were investigated in batch culture of a transketolase-deficient strain, Bacillus subtilis EC2, in shake flasks and bioreactors. Batch cultures in shake flasks and a 5-l reactor indicated that supplementation with 0.2-0.5 g l(-1) of citrate enhanced D: -ribose production. When B. subtilis EC2 was cultivated in a 15-l reactor in a complex medium, the D: -ribose concentration was 70.9 g l(-1) with a ribose yield of 0.497 mol mol(-1). When this strain was grown in the same medium supplemented with 0.3 g l(-1) of citrate, 83.4 g l(-1) of D-ribose were obtained, and the ribose yield was increased to 0.587 mol mol(-1). Addition of citrate reduced the activities of pyruvate kinase and phosphofructokinase, while it increased those of glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase. Metabolic flux distribution in the stationary phase indicated that citrate addition resulted in increased fluxes in the pentose phosphate pathway and TCA cycle, and decreased fluxes in the glycolysis and acetate pathways.


Assuntos
Bacillus subtilis/metabolismo , Ácido Cítrico/metabolismo , Ribose/biossíntese , Transcetolase/deficiência , Bacillus subtilis/enzimologia , Bacillus subtilis/genética , Reatores Biológicos , Ácido Cítrico/farmacologia , Meios de Cultura/química , Ativadores de Enzimas/metabolismo , Ativadores de Enzimas/farmacologia , Inibidores Enzimáticos/metabolismo , Inibidores Enzimáticos/farmacologia , Glucosefosfato Desidrogenase/metabolismo , Fosfofrutoquinases/antagonistas & inibidores , Fosfogluconato Desidrogenase/metabolismo , Piruvato Quinase/antagonistas & inibidores
11.
Appl Environ Microbiol ; 73(17): 5471-6, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17630301

RESUMO

Recombinant Saccharomyces cerevisiae strains that produce the sugar alcohols xylitol and ribitol and the pentose sugar D-ribose from D-glucose in a single fermentation step are described. A transketolase-deficient S. cerevisiae strain accumulated D-xylulose 5-phosphate intracellularly and released ribitol and pentose sugars (D-ribose, D-ribulose, and D-xylulose) into the growth medium. Expression of the xylitol dehydrogenase-encoding gene XYL2 of Pichia stipitis in the transketolase-deficient strain resulted in an 8.5-fold enhancement of the total amount of the excreted sugar alcohols ribitol and xylitol. The additional introduction of the 2-deoxy-glucose 6-phosphate phosphatase-encoding gene DOG1 into the transketolase-deficient strain expressing the XYL2 gene resulted in a further 1.6-fold increase in ribitol production. Finally, deletion of the endogenous xylulokinase-encoding gene XKS1 was necessary to increase the amount of xylitol to 50% of the 5-carbon sugar alcohols excreted.


Assuntos
Engenharia Genética/métodos , Glucose/metabolismo , Pentoses/metabolismo , Ribitol/metabolismo , Saccharomyces cerevisiae/genética , Xilitol/metabolismo , Biotecnologia/métodos , Meios de Cultura , D-Xilulose Redutase/genética , Monoéster Fosfórico Hidrolases/genética , Monoéster Fosfórico Hidrolases/metabolismo , Recombinação Genética , Ribose/metabolismo , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo , Transcetolase/deficiência , Transcetolase/genética
12.
Mol Cell Biol ; 22(17): 6142-7, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12167708

RESUMO

Transketolase (TKT) is a ubiquitous enzyme used in multiple metabolic pathways. We show here by gene targeting that TKT-null mouse embryos are not viable and that disruption of one TKT allele can cause growth retardation ( approximately 35%) and preferential reduction of adipose tissue ( approximately 77%). Other TKT(+/-) tissues had moderate ( approximately 33%; liver, gonads) or relatively little ( approximately 7 to 18%; eye, kidney, heart, brain) reductions in mass. These mice expressed a normal level of growth hormone and reduced leptin levels. No phenotype was observed in the TKT(+/-) cornea, where TKT is especially abundant in wild-type mice. The small female TKT(+/-) mice mated infrequently and had few progeny (with a male/female ratio of 1.4:1) when pregnant. Thus, TKT in normal mice appears to be carefully balanced at a threshold level for well-being. Our data suggest that TKT deficiency may have clinical significance in humans and raise the possibility that obesity may be treated by partial inhibition of TKT in adipose tissue.


Assuntos
Tecido Adiposo/patologia , Transtornos do Crescimento/genética , Infertilidade Feminina/genética , Transcetolase/fisiologia , Tecido Adiposo/enzimologia , Alelos , Animais , Peso Corporal , Córnea/enzimologia , Modelos Animais de Doenças , Desenvolvimento Embrionário e Fetal/genética , Metabolismo Energético/genética , Proteínas do Olho/genética , Proteínas do Olho/fisiologia , Feminino , Marcação de Genes , Transtornos do Crescimento/enzimologia , Transtornos do Crescimento/patologia , Hormônio do Crescimento/sangue , Heterozigoto , Infertilidade Feminina/enzimologia , Íntrons/genética , Leptina/deficiência , Tamanho da Ninhada de Vivíparos/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mórula/patologia , Mutagênese Insercional , Tamanho do Órgão , Fenótipo , Gravidez , Comportamento Sexual Animal , Transcetolase/deficiência , Transcetolase/genética
13.
Appl Microbiol Biotechnol ; 48(2): 141-8, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9299771

RESUMO

The production of D-ribose by fermentation has received much attention lately, possibly because of the use of this pentose to synthesize antiviral and anticancer drugs. This review briefly outlines the methods that have been used to synthesize D-ribose since it was identified in yeast RNA, and focuses in particular on the latest developments in D-ribose fermentation, which have led to D-ribose yields that exceed 90 g/1. Furthermore, the various transketolase-deficient D-ribose-producing mutants that are used, and the biochemical and genetic rationales applied to select them or to enhance their D-ribose productivities, are dealt with. Attention is also drawn to the unusual pleiotropic characteristics of the mutant strains, as well as to the industrial and academic applications of D-ribose.


Assuntos
Bacillus/metabolismo , Fermentação , Ribose/biossíntese , Proteínas Recombinantes/biossíntese , Transcetolase/deficiência
14.
J Am Coll Nutr ; 7(1): 61-7, 1988 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3343477

RESUMO

Erythrocyte transketolase (TKA) and thiamin pyrophosphate percentage uptake, or effect (TPPE) were performed on 1011 patients between 1983 and 1986. The subjects were drawn from a private practice specializing in nutritional correction as a major therapeutic thrust. Either TKA or TPPE or both were abnormal in 283 (28%). Out of the total number of patients with these abnormal studies 36 have been selected as representative. Their clinical presentation is correlated with subsequent laboratory testing in order to draw attention to the practical value of the test in a clinical setting. These data are presented because of the surprisingly high incidence of abnormal tests, that strongly suggests that there is widespread marginal nutritional deficiency in the United States and that it represents a clinical problem that deserves far more attention than it is presently receiving.


Assuntos
Eritrócitos/enzimologia , Distúrbios Nutricionais/sangue , Transcetolase/sangue , Adolescente , Adulto , Criança , Pré-Escolar , Terapia Combinada , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distúrbios Nutricionais/complicações , Distúrbios Nutricionais/dietoterapia , Cooperação do Paciente , Educação de Pacientes como Assunto , Tiamina/uso terapêutico , Tiamina Pirofosfato/sangue , Tiamina Pirofosfato/deficiência , Transcetolase/deficiência
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