Serum diamine oxidase activity as a predictor of gastrointestinal toxicity and malnutrition due to anticancer drugs

Miyoshi, Jinsei; Miyamoto, Hiroshi; Goji, Takahiro; Taniguchi, Tatsuya; Tomonari, Tetsu; Sogabe, Masamichi; Kimura, Tooru; Kitamura, Shinji; Okamoto, Koichi; Fujino, Yuichi; Muguruma, Naoki; Okahisa, Toshiya; Takayama, Tetsuji

doi:10.1111/jgh.13004

Cited by 47 publications

(28 citation statements)

References 30 publications

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“…Yee et al has found that an established first-line treatment for patients in T2DM, metformin, inhibits DAO activity [52]. Previous study also found that serum DAO activity decreased step-by-step significantly during anticancer drug therapy in human, which may be to serve as a useful predictor of gastrointestinal toxicity due to anticancer drug [53]. Our present data found that the levels of DAO also increased significantly in CRC patients, which was correlated with Lactobacillus, Bifidobacterium, and Clostridium cluster I negatively and with F. nucleatum and Enterobacteriaceae positively.…”

Section: Discussionmentioning

confidence: 95%

Alterations of the Predominant Fecal Microbiota and Disruption of the Gut Mucosal Barrier in Patients with Early-Stage Colorectal Cancer

Liu

Cheng

et al. 2020

BioMed Research International

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Growing evidence indicated that the gut microbiota was the intrinsic and essential component of the cancer microenvironment, which played vital roles in the development and progression of colorectal cancer (CRC). In our present study, we investigated the alterations of fecal abundant microbiota with real-time quantitative PCR and the changes of indicators of gut mucosal barrier from 53 early-stage CRC patients and 45 matched healthy controls. We found that the traditional beneficial bacteria such as Lactobacillus and Bifidobacterium decreased significantly and the carcinogenic bacteria such as Enterobacteriaceae and Fusobacterium nucleatum were significantly increased in CRC patients. We also found gut mucosal barrier dysfunction in CRC patients with increased levels of endotoxin (LPS), D-lactate, and diamine oxidase (DAO). With Pearson’s correlation analysis, D-lactate, LPS, and DAO were correlated negatively with Lactobacillus and Bifidobacterium and positively with Enterobacteriaceae and F. nucleatum. Our present study found dysbiosis of the fecal microbiota and dysfunction of the gut mucosal barrier in patients with early-stage CRC, which implicated that fecal abundant bacteria and gut mucosal barrier indicators could be used as targets to monitor the development and progression of CRC in a noninvasive and dynamic manner.

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Section: Discussionmentioning

confidence: 95%

Alterations of the Predominant Fecal Microbiota and Disruption of the Gut Mucosal Barrier in Patients with Early-Stage Colorectal Cancer

Liu

Cheng

et al. 2020

BioMed Research International

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“…Another possible explanation is that Elental could help to maintain mucosal integrity in the gastrointestinal tract, thereby resulting in maintained nutrient absorption. Anticancer drugs, such as 5-fluorouracil, can induce small intestinal mucosal injury and plasma diamine oxidase (DAO) has been reported to be a useful indicator of mucosal injury of the gastrointestinal tract (43). Tanaka et al (7) recently reported that plasma DAO activity was decreased after chemotherapy in patients with esophageal cancer, and patients treated with the Elental diet exhibited a significant increase in DAO activity after chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

The amino acid-rich elemental diet Elental® preserves lean body mass during chemo- or chemoradiotherapy for esophageal cancer

et al. 2016

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Chemo (chemoradio) therapy can induce oral mucositis and change body composition in patients with esophageal cancer. The impact of the amino acid-rich elemental diet Elental® on oral mucositis and changes in body composition during chemo (chemoradio) therapy is unclear. Thus, the purpose of the present study was to examine the preventive effects of Elental on oral mucositis and sarcopenia progression during chemo (chemoradio) therapy for esophageal cancer. Patients were randomized to receive either azulene oral rinse (Arm 1) or Elental (Arm 2) during the treatment cycle (4 weeks). The incidence of oral mucositis and other adverse events was evaluated weekly. Body composition pre- and post-treatment cycle was measured by bioelectric impedance analysis. Thirty‑three patients (17 azulene and 16 Elental) completed the study, and the groups were well matched. Elental tended to reduce the incidence of oral mucositis (Arm 1, 23.5% and Arm 2, 12.5%), but there was no statistically significant difference between the groups. The average body mass index (BMI) and body fat mass decreased significantly in both groups after the treatments. Lean body mass (LBM) was reduced in Arm 1, but was increased in Arm 2 after the treatment; the relative change of LBM after the treatment was significant between Arm 1 and Arm 2 (P=0.007). This study revealed that Elental nutrition could counteract sarcopenia development during chemoradiotherapy for esophageal cancer. These properties may lead to improvement of the quality of life and clinical outcome of esophageal cancer patients treated with chemo (chemoradio) therapy (Clinical Trial Registry ID: UMIN 000007960).

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“…Furthermore, DAO and citrulline, useful early markers in the diagnosis of intestinal mucositis, were both affected by radiation. DAO, which is found primarily in the villus epithelial cells of the small intestine, has been reported to increase in the serum in parallel with the severity of small intestinal mucosal injury induced by anticancer drugs (Miyoshi et al, ) or after radiation exposure (Khayyal et al, ). On the other hand, the serum level of citrulline, a nonprotein amino acid produced exclusively by the enterocytes of the small bowel (Barzał, Szczylik, Rzepecki, Jaworska, & Anuszewska, ), has been shown to decrease secondary to reduction of intestinal functional capacity and impairment of the mucosal barrier as a result of chemotherapy (Herbers, Feuth, Donnelly, & Blijlevens, ) or radiation exposure (Khayyal et al, ).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effect of a chamomile extract in protecting against radiation‐induced intestinal mucositis

Khayyal

Kreuter

Kemmler

et al. 2019

Phytotherapy Research

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Compounds that prevent radiation‐induced mucositis may offer new therapeutic strategies for maintaining intestinal integrity in patients undergoing radiotherapy. A specially formulated chamomile extract was studied with the hope of proving efficacy in this regard. Intestinal mucositis was induced in rats by exposing them to whole body gamma‐irradiation. Rats were treated orally with the extract for 5 days before and 2 days after radiation exposure. One day later, rats were sacrificed. Histological examination of segments of small intestine showed shortening and fusion of villi, activation of mucus secreting glands, inflammatory cell infiltration of lamina propria, and mucosal atrophy. Intestinal homogenates showed an increase in tumor necrosis factor, a pro‐inflammatory cytokine, and myeloperoxidase, an indicator of cellular infiltration, as well as in thiobarbituric acid reactive substances and a reduction in glutathione content. Intestinal injury was further evidenced by an increase in diamine oxidase and a reduction in citrulline levels in the serum. A rise in apoptosis was evidenced by an increase in cytosolic cytochrome c, caspase‐3, and depletion of mitochondrial B‐cell lymphoma‐2/ Bax ratio. Most histological changes and associated derangement in related parameters were largely prevented by the chamomile extract, thus paving the way to a new therapeutic approach towards the management of radiation‐induced intestinal mucositis.

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Serum diamine oxidase activity as a predictor of gastrointestinal toxicity and malnutrition due to anticancer drugs

Abstract: Serum DAO activity sensitively indicates gastrointestinal damage prior to symptom onset and can be a useful predictor of intestinal mucosal damage and nutritional status in patients receiving chemotherapy.

Cited by 47 publications

References 30 publications

Alterations of the Predominant Fecal Microbiota and Disruption of the Gut Mucosal Barrier in Patients with Early-Stage Colorectal Cancer

Alterations of the Predominant Fecal Microbiota and Disruption of the Gut Mucosal Barrier in Patients with Early-Stage Colorectal Cancer

The amino acid-rich elemental diet Elental® preserves lean body mass during chemo- or chemoradiotherapy for esophageal cancer

Effect of a chamomile extract in protecting against radiation‐induced intestinal mucositis

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