Pancreatic function in amyotrophic lateral sclerosis

Utterback, Robert A.; Cummins, Alvin J.; Cape, Charles A.; Goldenberg, Julio

doi:10.1136/jnnp.33.4.544

Cited by 11 publications

(6 citation statements)

References 11 publications

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“…This histocompatability antigen is also increased in Japanese patients with Hashimoto's thyroiditis." 5 The presence and significance of circulating immune complexes in the serum of patients with motor neurone disease has recently been noted and discussed by Oldstone et al 6 Their studies have so far failed to reveal any specific viral or myelin antigens in tissues subject to deposition of these immune complexes. The production of antibodies and the formation of immune complexes may be a secondary response to damaged neural tissue rather than a primary response to a causative agent such as a virus or a central nervous system specific protein.…”

Section: Discussionmentioning

confidence: 99%

Motor neurone disease and hyperthyroid Graves' disease: a chance association?

McMenamin¹,

Croxson²

1980

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Discussionmentioning

confidence: 99%

Motor neurone disease and hyperthyroid Graves' disease: a chance association?

McMenamin¹,

Croxson²

1980

Journal of Neurology, Neurosurgery & Psychiatry

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“… Utterback et al. (1970) analyzed the pancreatic function of 10 ALS patients and 1 patient with chronic pancreatitis.…”

Section: Gastrointestinal (Gi) Disorders In Human Alsmentioning

confidence: 99%

“…This study raised the question if there is a direct relationship between ALS and the pancreas or if alterations of the pancreas are due to secondary complications. Utterback et al (1970) analyzed the pancreatic function of 10 ALS patients and 1 patient with chronic pancreatitis. They found that the patients experienced a variety of intestinal symptoms.…”

Section: Gastrointestinal (Gi) Disorders In Human Alsmentioning

confidence: 99%

A Gut Feeling in Amyotrophic Lateral Sclerosis: Microbiome of Mice and Men

Martin

Battistini

Sun

2022

Front. Cell. Infect. Microbiol.

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Amyotrophic lateral sclerosis (ALS) is a severely debilitating disease characterized by progressive degeneration of motor neurons. ALS etiology and pathophysiology are not well understood. It could be the consequences of complex interactions among host factors, microbiome, and the environmental factors. Recent data suggest the novel roles of intestinal dysfunction and microbiota in ALS etiology and progression. Although microbiome may indeed play a critical role in ALS pathogenesis, studies implicating innate immunity and intestinal changes in early disease pathology are limited. The gastrointestinal symptoms in the ALS patients before their diagnosis are largely ignored in the current medical practice. This review aims to explore existing evidence of gastrointestinal symptoms and progress of microbiome in ALS pathogenesis from human and animal studies. We discuss dietary, metabolites, and possible therapeutic approaches by targeting intestinal function and microbiome. Finally, we evaluate existing evidence and identify gaps in the knowledge for future directions in ALS. It is essential to understanding the microbiome and intestinal pathogenesis that determine when, where, and whether microbiome and metabolites critical to ALS progression. These studies will help us to develop more accurate diagnosis and better treatment not only for this challenging disease, but also for other neurodegenerative diseases.

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“…Of these, nineteen reported impaired insulin secretion [48][49][50][51][52][53] or signaling. [54][55][56][57][58][59][60][61][62][63][64][65][66] Only two early papers reported normal glucose tolerance, one using neurological patients rather than healthy controls, 67 and one not using controls at all. 68 Another paper found increased plasma and CSF alpha-hydroxybutyrate (a pre-diabetes marker), 69 and another reported insulin resistance (IR) in bvFTD.…”

Section: Insulin Is Impaired In Alsmentioning

confidence: 99%

Insulin-Based Treatment for Amyotrophic Lateral Sclerosis

Rappoport¹

2022

Preprint

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Background Amyotrophic Lateral Sclerosis (ALS) is a devastating disease involving motor neuron degeneration. The few drugs approved for treatment have at most a marginal benefit, and death usually occurs 2-5 years after diagnosis. Methods A thorough manual examination of the relevant literature, covering over 35,000 papers. Results Two major phenomena that are generally not known to clinicians were found. First, insulin signaling is impaired in ALS even in patients not diagnosed with diabetes (DB). Almost all studies that have explicitly tested insulin function in non-DB ALS patients using glucose tolerance tests (18 out of 20, 1964-2022, different groups) have found it to be impaired. Second, there is strong evidence for excessive insulin-independent glucose uptake (IIGU) in ALS. In addition, (i) early/late diabetes are associated with increased/decreased risk, respectively; (ii) insulin-based diabetes drugs are protective in ALS in large retrospective human studies; and (iii) strong animal and human evidence shows that insulin opposes all of the major pathological processes in ALS. Conclusion Most ALS patients have insulin impairment, yet this is commonly not diagnosed, likely because excessive IIGU normalizes glucose levels. The impairment promotes disease progression. Late diabetes is associated with decreased risk because high glucose levels indicate non-excessive IIGU, and because diabetes drugs are protective. Insulin-based treatment (e.g., GLP1 agonists, insulin) is beneficial and can be disease-modifying in ALS and in frontotemporal dementia variants comorbid with ALS. ALS patients should be routinely tested for insulin function and treated if test results are positive.

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Pancreatic function in amyotrophic lateral sclerosis

Abstract: SUMMARY No abnormality of exocrine function of the pancreas was found in 10 patients with amyotrophic lateral sclerosis. Eight patients showed abnormal glucose metabolism, attributed to the effects of age, malnutrition, diminished physical activity, and decreased muscle mass.

Cited by 11 publications

References 11 publications

Motor neurone disease and hyperthyroid Graves' disease: a chance association?

Motor neurone disease and hyperthyroid Graves' disease: a chance association?

A Gut Feeling in Amyotrophic Lateral Sclerosis: Microbiome of Mice and Men

Insulin-Based Treatment for Amyotrophic Lateral Sclerosis

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