PKU‐related dysgammaglobulinaemia: The effect of diet therapy on IgE and allergic sensitization

Riva, Enrica; Fiocchi, Alessandro; Agostoni, Carlo; Biasucci, Giacomo; Sala, Marco; Banderali, Giuseppe; Luotti, D.; Giovannini, Marcello

doi:10.1007/bf00712013

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…Arginine, the precursor for nitric oxide, which has been shown to be elevated in asthma [14], and glutamine, which has powerful anti-bacterial properties in vivo [15], are also of interest. In addition, phenylalanine is potentially important since uncontrolled phenylketonuria is associated with increased plasma immunoglobulin E and atopic dermatitis [16]. Previous studies have also drawn attention to tryptophan, where the metabolic pathways may differ in asthmatic subjects as compared to control subjects, as demonstrated by elevated urinary kynurenic acid and xanthurenic acid excretion in children with asthma [17][18][19].…”

mentioning

confidence: 99%

Amino acids and asthma: a case-control study

Fogarty¹,

Broadfield²,

Lewis³

et al. 2004

Eur Respir J

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Amino acids contribute to various anti-oxidant and immunological activities relevant to asthma pathogenesis, raising the possibility that differences in amino acids may be involved in asthma aetiology. The authors hypothesised that cystine reduces the risk of asthma via glutathione metabolism. Methionine, glutamine, glutamic acid and glycine may have potential protective effects, whilst arginine, phenylalanine and tryptophan may have adverse effects in asthma.Fasting plasma levels of amino acids were compared in a case-control study. A total of 89 adults, aged 18-65 yrs, with asthma controlled by inhaled corticosteroids, were recruited from a volunteer database and local primary care registers, and compared with 89 controls individually matched for age, sex and primary care centre.Contrary to the primary hypothesis, cases had higher fasting plasma cystine levels than controls, and there was no difference between cases and controls in any of the other amino acids tested, with the exception of plasma glycine, which was associated with a strongly reduced risk of asthma (odds ratio for the highest tertile compared to lowest 0.30 (95% confidence interval (0.11-0.82)).This study negates the hypothesis that higher fasting plasma cystine levels have a protective effect on the risk of asthma, although the inverse correlation with plasma glycine deserves further investigation.

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confidence: 99%

Amino acids and asthma: a case-control study

Fogarty¹,

Broadfield²,

Lewis³

et al. 2004

Eur Respir J

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“…There was a higher frequency of allergic sensitization and lower prevalence of asthma in the PKU vs control group. No differences were observed in the prevalence of eczema or allergic rhinitis . In contrast, Burton et al reported a significantly higher prevalence of asthma, rhinitis, and certain autoimmune diseases in AwPKU compared to matched controls .…”

Section: Immune Health and Inflammationmentioning

confidence: 82%

“…No differences were observed in the prevalence of eczema or allergic rhinitis. 55 In contrast, Burton et al reported a significantly higher prevalence of asthma, rhinitis, and certain autoimmune diseases in AwPKU compared to matched controls. 5 The Burton study was based on analyses of Medicare Insurance based study, and as the method of diagnosis of asthma was not defined, it is possible some cases of asthma may have in fact been reflux symptoms.…”

Section: Immune Health and Inflammationmentioning

confidence: 90%

Phenylketonuria, co‐morbidity, and ageing: A review

Vardy

MacDonald

Ford³

et al. 2020

J of Inher Metab Disea

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Phenylketonuria (PKU) is a metabolic condition which, left untreated, results in severe and irreversible brain damage. Newborn screening and the development of the low phenylalanine (Phe) diet have transformed the outcomes for people with PKU. Those who have benefited from early treatment are now approaching their fifth and sixth decade. It is therefore timely to consider multi‐morbidity in PKU and the effects of ageing, in parallel with the wider benefits of emerging treatment options in addition to dietary relaxation. We have conducted the first literature review of co‐morbidity and ageing in the context of PKU. Avenues explored have emerged from limited study of multi‐morbidity to date and the knowledge and critical enquiry of the authors. Findings suggest PKU to have a wider impact than brain development, and result in several intriguing questions that require investigation to attain the best outcomes for people with PKU in adulthood moving through to older age. We recognise the difficulty in studying longitudinal outcomes in rare diseases and emphasise the necessity to develop PKU registries and cohorts that facilitate well‐designed studies to answer some of the questions raised in this review. Whilst awaiting new information in these areas we propose that clinicians engage with patients to make personalised and well‐informed decisions around Phe control and assessment for co‐morbidity.

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“…Notably, glutathione depletion resulted in a shift toward the Th2 lymphocyte phenotype, which is associated with asthmatic inflammation. Phe, for example, has been associated with increased plasma immunoglobulin E and atopic dermatitis (Riva et al, 1994). Therefore, it is possible that alterations in the amino acid profile in the lung environment, arising from the protein-type amino acids in the haze PM 2.5 , contributed to the increase in asthmatic inflammation (Peterson et al, 1998).…”

Section: Discussionmentioning

confidence: 98%