119 results on '"Dietmar Enko"'
Search Results
2. Tryptophan recovery index as a new biomarker for fitness
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Alexander Pichler, Andreas Meinitzer, Dietmar Enko, Peter Schober, Georg Singer, Christoph Castellani, Markus Herrmann, Sandra J. Holasek, Holger Till, and Jana Maria Windhaber
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tryptophan ,kynurenine ,kynurenic acid ,kynurenine pathway ,exercise ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Biology (General) ,QH301-705.5 - Abstract
The maximal oxygen uptake (VO2max) and maximal power output (Pmax) are commonly used parameters to evaluate the endurance fitness status. A connection between exercise and the kynurenine pathway (KP), which describes the metabolism of unused tryptophan, has already been reported. However, a potential association of the KP with endurance fitness levels remains unknown. In this study, adolescent competitive athletes performed an exhaustive incremental exercise test. Blood samples were taken before, directly after, and 30 minutes after the end of exercise. Tryptophan (Trp), kynurenine (Kyn) and kynurenic acid (KA) serum levels were determined by high-performance liquid chromatography (HPLC). Forty-four male and 27 female athletes (median age: 16 years) were recruited. During exhaustive exercise tests, Trp initially declined and then increased 30 minutes after discontinuing exercise. Similar findings were observed for Kyn, whereas KA levels behaved inversely. After incremental exhaustive exercise the relative increase of Trp concentrations, termed the tryptophan-recovery-index (TRI), showed a highly significant positive correlation with VO2max and Pmax (r=0.468 and 0.491, p-values
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- 2022
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3. Helicobacter pylori infection and lactose intolerance increase expiratory hydrogen
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Wolfgang J. Schnedl, Nathalie Meier-Allard, Michael Schenk, Sonja Lackner, Dietmar Enko, Harald Mangge, and Sandra J. Holasek
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irritable bowel syndrome ,lactose intolerance ,histamine intolerance ,diamine oxidase ,fructose malabsorption ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Biology (General) ,QH301-705.5 - Abstract
Infection with Helicobacter pylori (H.pylori) may cause dyspepsia and/or unexplained functional nonspecific, gastrointestinal complaints of the irritable bowel syndrome (IBS) spectrum. Hitherto, in H. pylori infected patients with symptoms of the IBS spectrum the occurrence of additional food intolerance/malabsorption is not evaluated. We used a retrospective analysis of charts from 548 patients who presented with gastrointestinal complaints of the irritable bowel syndrome spectrum. An enzyme-linked IgA immunosorbent assay or histologic evaluation of gastric mucosa were used to detect H. pylori infection. A hydrogen breath (H2) test was performed to evaluate fructose malabsorption (FM) and lactose intolerance (LIT). Serum diamine oxidase value of
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- 2022
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4. Sex-specific differences in trimethylamine N-oxide (TMAO) concentrations before and after cardiac rehabilitation in acute myocardial infarction patients
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Andreas Baranyi, Andreas Meinitzer, Dirk von Lewinski, Hans-Bernd Rothenhäusler, Omid Amouzadeh-Ghadikolai, Hanns Harpf, Leonhard Harpf, Heimo Traninger, Ronald Hödl, Birgit M. Harb, Barbara Obermayer-Pietsch, Melanie Schweinzer, Celine K. Braun, and Dietmar Enko
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trimethylamine n-oxide (tmao) ,acute myocardial infarction ,sex differences ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Biology (General) ,QH301-705.5 - Abstract
Trimethylamine N-oxide (TMAO) is a biomarker of cardiovascular risk and may enhance the progression of atherosclerosis. The aim of the study was to determine whether there are sex-specific differences in TMAO concentrations before and after cardiac rehabilitation in acute myocardial infarction (AMI) patients. A total of 56 participants [45/56 (80.4 %) males, 11/56 (19.6 %) females] were drawn from AMI inpatients hospitalized at the Division of Cardiology, Medical University of Graz, Austria. For the assessment of TMAO, serum samples were collected within the first day after hospital admission due to AMI and at the start and end of cardiac rehabilitation. Shortly after hospital admission due to AMI, females had significantly higher TMAO blood concentrations than males. These initially high TMAO levels remained almost unchanged in the female AMI patients until the start of cardiac rehabilitation and only reached the lower TMAO concentrations observed in the male patients after rehabilitation [female patients: TMAO (acute myocardial infarction) = 5.93 μmol/L (SE = 1.835); TMAO (start of rehabilitation) = 5.68 μmol/L (SE = 1.217); TMAO (end of rehabilitation) = 3.89 μmol/L (SE = 0.554); male patients: TMAO (acute myocardial infarction) = 3.02 μmol/L (SE = 0.255), TMAO (start of rehabilitation) = 3.91 μmol/L (SE = 0.346), TMAO (end of rehabilitation) = 4.04 μmol/L (SE = 0.363)]. After AMI, women might be at higher cardiovascular risk due to persistently higher levels of TMAO. High TMAO levels in women might decrease after cardiac rehabilitation due to cardiac rehabilitation-associated lifestyle modifications. These lifestyle modifications after AMI might also prevent increases in TMAO concentrations in men.
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- 2022
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5. Functional Abdominal Pain Disorders in Children May Be Associated with Food Intolerance/Malabsorption
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Wolfgang J. Schnedl, Michael Schenk, Simon Michaelis, Dietmar Enko, and Harald Mangge
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functional abdominal pain disorders ,irritable bowel syndrome ,fructose malabsorption ,histamine intolerance ,lactose intolerance ,Pediatrics ,RJ1-570 - Abstract
Functional abdominal pain disorders (FAPDs) are among the most common types of chronic pain disorders in children. FAPD symptoms are characterized by chronic abdominal pain and changed bowel movements. The pathophysiology of FAPDs in children is unknown, but these conditions may have an imprecise clinical overlap to food intolerance/malabsorption. We report on 51 consecutive children (23/28 males/females; median age 15.3 years) with investigated FAPDs from 2017 to 2022 in this retrospective pilot study. Small intestinal biopsies in children demonstrated the association of lactase and diamine oxidase (DAO), which prompted us to perform hydrogen (H2) breath tests for lactose intolerance (LIT) and determine serum DAO for the evaluation of histamine intolerance (HIT) in pediatric patients with FAPDs. To complete the food intolerance/malabsorption evaluation tests, we included a search for antibodies against tissue transglutaminase to find celiac disease (CD), performed H2 breath tests to detect fructose malabsorption (FM), and conducted a search for IgA antibodies against H. pylori infection. The results demonstrate that all 51 children evaluated were diagnosed with food intolerance/malabsorption and/or various combinations thereof. Seven children showed FM, eight of the children had HIT, and eight children had LIT. The other children had combinations: thirteen children (25.5%) had HIT and LIT, seven children (9.8%) had FM with HIT, five children (13.7%) had FM and LIT, and three children (5.9%) had a triple combination of FM, HIT, and LIT. By describing this method of personalized investigation for food intolerance/malabsorption in children with FAPDs, we demonstrate that functional abdominal pain disorders may be associated with food intolerance/malabsorption. After such diagnosis in this pediatric population, a registered dietitian helped to establish a reduction and/or exclusion diet individually tailored to their symptomatology.
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- 2023
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6. Implementation of a Dual-Column Liquid Chromatography-Tandem Mass-Spectrometry Method for the Quantification of Isavuconazole in Clinical Practice
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Dietmar Enko, Sieglinde Zelzer, Markus Herrmann, Robert Krause, and Andreas Meinitzer
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antifungal agents ,isavuconazole ,liquid chromatography-tandem mass-spectrometry ,therapeutic drug monitoring ,triazole ,Medicine - Abstract
Objectives Therapeutic drug monitoring (TDM) of isavuconazole, which is a novel broad-spectrum antimycoticum against invasive fungal infections, ensures an effective exposure of the drug and minimizes the risk of toxicity. This study is aimed at evaluating the analytical performance of a dual-column liquid chromatography-tandem mass-spectrometry (LC-MS/MS) method for isavuconazole quantification. Materials and Methods The method was performed on a Voyager TSQ Quantum triple quadrupole instrument equipped with an Ultimate 3000 chromatography system (Thermo Fisher Scientific, San Jose, California, United States). Analytical and preanalytical requirements of the isavuconazole LC-MS/MS method were evaluated. Sample stability measurements were performed at room temperature (RT) and in serum tubes with separator gel. Results The isavuconazole LC-MS/MS method was linear over the concentration range of 0.2 to 12.8 mg/L. The coefficient of determination (r 2) always exceeded 0.999. Within- and between-run precision ranged between 1.4 to 2.9% and 1.5 to 3.0%, the recovery between 93.9 and 102.7%. At RT, serum samples were stable for 3 days. Isavuconazole serum concentrations were significantly lower after incubation (18 hours) in serum tubes with separator gel at RT. Conclusion The dual-column isavuconazole LC-MS/MS is a reliable tool for the TDM of isavuconazole. Serum samples are stable for at least 3 days and should be collected in tubes without separator gel.
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- 2021
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7. Myeloperoxidase as a Potential Biomarker of Acute-Myocardial-Infarction-Induced Depression and Suppression of the Innate Immune System
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Andreas Baranyi, Dietmar Enko, Andreas Meinitzer, Dirk Von Lewinski, Hans-Bernd Rothenhäusler, Leonhard Harpf, Heimo Traninger, Barbara Obermayer-Pietsch, Birgit M. Harb, Melanie Schweinzer, Moritz Platzer, and Sieglinde Zelzer
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myeloperoxidase ,depression ,innate immune system ,acute myocardial infarction ,Therapeutics. Pharmacology ,RM1-950 - Abstract
While myeloperoxidase (MPO) serves as an indicator of both neutrophil and innate-immune-system function, the potential suppression of the innate immune system in patients with acute myocardial infarction (AMI)-induced depression might be evidenced by a decrease in MPO serum levels. The aim of this prospective study was to (1) determine whether serum concentrations of MPO vary immediately and 6 months after AMI and (2) to investigate whether MPO concentrations at the time of the AMI are significant predictors of AMI-induced depression and the depression-associated suppression of the innate immune system. A total of 109 AMI patients were assessed with the Hamilton Depression Scale (HAMD-17) immediately after admission to the hospital and 6 months later. The MPO status was assessed with serum samples, which were also collected immediately and 6 months after AMI. The depressive patients showed significantly lower MPO blood levels immediately and 6 months after the AMI compared to the patients without depression (ANCOVA: MPO (depression) F = 4.764, df = 1, p = 0.031). The baseline MPO was observed as a significant predictor (p = 0.027) of AMI-induced depression 6 months after AMI. MPO is a potential biomarker for AMI-induced depression, indicating a depression-associated suppression of the innate immune system.
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- 2022
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8. Evaluation of symptoms and symptom combinations in histamine intolerance
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Wolfgang J. Schnedl, Sonja Lackner, Dietmar Enko, Michael Schenk, Sandra J. Holasek, and Harald Mangge
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Diamine oxidase ,Histamine ,Irritable bowel syndrome ,Gluten ,Gastrointestinal diseases ,Medicine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background/Aims Food intolerance/malabsorption, particularly histamine intolerance (HIT), may cause nonspecific functional gastrointestinal and extraintestinal symptoms. We evaluated gastrointestinal and extraintestinal symptoms in patients with HIT. Methods In an analysis of outpatients’ charts we identified 133 patients, who presented with recurring nonspecific functional gastrointestinal, extraintestinal symptoms, and a diamine oxidase value
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- 2019
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9. Assessment of trimethylamine N-oxide (TMAO) as a potential biomarker of severe stress in patients vulnerable to posttraumatic stress disorder (PTSD) after acute myocardial infarction
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Andreas Baranyi, Dietmar Enko, Dirk von Lewinski, Hans-Bernd Rothenhäusler, Omid Amouzadeh-Ghadikolai, Hanns Harpf, Leonhard Harpf, Heimo Traninger, Barbara Obermayer-Pietsch, Melanie Schweinzer, Celine K. Braun, and Andreas Meinitzer
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trimethylamine n-oxide (tmao) ,acute myocardial infarction ,gut permeability ,posttraumatic stress disorder (ptsd) ,depression ,biomarker ,Psychiatry ,RC435-571 - Abstract
Background: Posttraumatic stress disorder (PTSD) is a frequently observed stress-related disorder after acute myocardial infarction (AMI) and it is characterized by numerous symptoms, such as flashbacks, intrusions and anxiety, as well as uncontrollable thoughts and feelings related to the trauma. Biological correlates of severe stress might contribute to identifying PTSD-vulnerable patients at an early stage. Objective: Aims of the study were (1) to determine whether blood levels of trimethylamine N-oxide (TMAO) vary immediately after AMI in patients with/without AMI-induced PTSD symptomatology, (2) to investigate whether TMAO is a potential biomarker that might be useful in the prediction of PTSD and the PTSD symptom subclusters re-experiencing, avoidance and hyperarousal, and (3) to investigate whether TMAO varies immediately after AMI in patients with/without depression 6 months after AMI. Method: A total of 114 AMI patients were assessed with the Hamilton-Depression Scale after admission to the hospital and 6 months later. The Clinician Administered PTSD Scale for DSM-5 was used to explore PTSD-symptoms at the time of AMI and 6 months after AMI. To assess patients’ TMAO status, serum samples were collected at hospitalization and 6 months after AMI. Results: Participants with PTSD-symptomatology had significantly higher TMAO levels immediately after AMI than patients without PTSD-symptoms (ANCOVA: TMAO(PTSD x time), F = 4.544, df = 1, p = 0.035). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO became a significant predictor of PTSD-symptomatology. No significant differences in TMAO levels immediately after AMI were detected between individuals with/without depression 6 months after AMI. Conclusions: An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increase in gut permeability to trimethylamine, the precursor of TMAO. Thus, an elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD.
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- 2021
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10. Oxidative Status in Adult Anorexia Nervosa Patients and Healthy Controls—Results from a Cross-Sectional Pilot Study
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Jolana Wagner-Skacel, Fiona Haidacher, Markus Wiener, Karoline Pahsini, Sabine Marinschek, Theresa Lahousen, Willibald Wonisch, Susanne Bengesser, Mary I. Butler, Sonja Lackner, Andreas Meinitzer, Dietmar Enko, and Sabrina Mörkl
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anorexia nervosa ,oxidative stress ,total oxidative capacity ,total antioxidative capacity ,endogenous peroxidase ,antibodies against oxidized LDL ,Therapeutics. Pharmacology ,RM1-950 - Abstract
Oxidative stress describes an imbalance of reactive oxygen species (ROS) and antioxidative defence systems. Recently, the consequences of oxidative stress have become a central field of research and have been linked to the genesis of multiple psychiatric diseases. Some oxidative stress parameters have not been investigated before in anorexia nervosa (AN) patients, including the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) and polyphenols (PPm). In this cross-sectional pilot study, we evaluated these markers together with total peroxides (TOC), antioxidative capacity (TAC), endogenous peroxidase activity (EPA) and antibodies against oxidized LDL (oLAb) in serum samples of 20 patients with AN compared to 20 healthy controls. The antioxidative capacity was significantly decreased in AN patients, with a mean TAC of 1.57 mmol/L (SD: ±0.62); t (34) = −2.181, p = 0.036) compared to HC (mean = 1.91 mmol/L (SD: ±0.56), while the other investigated parameters were not significantly different between the two groups. In AN patients, TAC correlated with EPA (rsp = −0.630, p = 0.009). This study suggests that there is an antioxidative deficiency in AN patients. In this respect, there is a demand for interventional studies to determine whether antioxidants can be used as add-on therapy in the treatment of AN.
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- 2022
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11. Prospective plasma lipid profiling in individuals with and without depression
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Dietmar Enko, Wolfgang Brandmayr, Gabriele Halwachs-Baumann, Wolfgang J. Schnedl, Andreas Meinitzer, and Gernot Kriegshäuser
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Biomarkers ,Cholesterol ,Depression ,Lipids ,Triglycerides ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background So far, studies on possible association of plasma lipid levels and depressive disorder are contradictory. This prospective work aimed at assessing a plasma lipid profile in individuals with major depression and healthy controls. Methods In total, 94 patients with major depression and 152 healthy controls were included in this prospective study. After an overnight fasting state of 12 h they underwent blood drawing for triglyzerides (TG), total cholesterol, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol measurements. All participants were evaluated in a clinical interview and filled out the self-rating Beck Depression Inventory (BDI-II) scale to identify depressive symptomatology. Results Ninety-four patients with major depression showed significantly higher median (interquartile range) plasma TG levels (108.0 [75.8–154.1] vs. 84.0 [63.0–132.2] mg/dL, P = 0.014) and significantly lower HDL-cholesterol levels (55.0 [46.9–123.0] vs. 61.5 [47.4–72.6] mg/dL, P = 0.049) compared to 152 individuals without depression, respectively. Total and LDL-cholesterol concentrations were observed slightly higher in patients with major depression. Significant positive correlation was found between TG, total cholesterol and LDL-cholesterol concentrations and the BDI-II score (p = 0.027, 0.048 and 0.018), and in tendency negative correlation between HDL-cholesterol levels and the BDI-II score (P = 0.091), respectively. Conclusions Depressive individuals were found with adverse plasma lipid patterns of higher TG and lower HDL-cholesterol levels compared to healthy controls. On this basis, the authors would suggest the implementation of routine lipid measurements in order to stratify these patients by their cardiovascular risk.
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- 2018
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12. A Novel Method for the Determination of Vitamin D Metabolites Assessed at the Blood-Cerebrospinal Fluid Barrier
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Sieglinde Zelzer, Andreas Meinitzer, Markus Herrmann, Walter Goessler, and Dietmar Enko
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vitamin D metabolites ,cerebrospinal fluid ,blood-cerebrospinal fluid barrier ,liquid chromatography-tandem mass spectrometry ,biomarkers ,Microbiology ,QR1-502 - Abstract
The brain’s supply with vitamin D is poorly understood. Therefore, the present study aimed to determine 25-hydroxy vitamin D3 (25(OH)D) and 24,25-dihydroxy vitamin D (24,25(OH)2D3) in serum and cerebrospinal fluid (CSF) from individuals with intact and disturbed brain-CSF-barrier (BCB) function. In 292 pairs of serum and CSF samples the vitamin D metabolites were measured with liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). CSF/serum ratios (QALB, Q25(OH)D, Q24,25(OH)2D3) were calculated. Median (IQR) serum concentrations of 25(OH)D and 24,25(OH)2D3 were 63.8 (43.4–83.9) nmol/L and 4.2 (2.2–6.2) nmol/L. The CSF concentrations of both metabolites accounted for 3.7 and 3.3% of the respective serum concentrations. Serum 25(OH)D correlated inversely with Q25(OH)D and Q24,25(OH)2D3 implying a more efficient transport of both metabolites across the BCB when the serum concentration of 25(OH)D is low. In patients with BCB dysfunction, the CSF concentrations and the CSF/serum ratios of both vitamin D metabolites were higher than in individuals with intact BCB. The CSF concentrations of 25(OH)D and 24,25(OH)2D3 depend on BCB function and the respective serum concentrations of both metabolites. Higher vitamin D metabolite concentrations in CSF of patients with impaired BCB function may be due to passive diffusion across the BCB.
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- 2021
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13. Association between increased plasma levels of homocysteine and depression observed in individuals with primary lactose malabsorption.
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Dietmar Enko, Andreas Meinitzer, Wolfgang Brandmayr, Gabriele Halwachs-Baumann, Wolfgang J Schnedl, and Gernot Kriegshäuser
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Medicine ,Science - Abstract
BACKGROUND:Current literature proposes associations between homocysteine (HCY), folic acid (FA), vitamin B12 metabolism and depression. However, the exact underlying biological mechanisms remain unclear. This study aimed at evaluating a possible link between primary adult-type lactose malabsorption (PALM), HCY, FA and vitamin B12 metabolism and depressive disorder. METHODS:Plasma levels of HCY, FA and vitamin B12 were determined in 78 patients with PALM and 160 individuals with lactase persistence sub-grouped by the presence or absence of major depression. RESULTS:In 78 patients with PALM, the subgroup of 22 individuals with major depression showed significantly higher median (interquartile range) HCY (10.10 [8.46-12.03] vs. 8.9 [7.54-9.86] μmol/L, p = 0.029) and lower plasma FA levels (5.7 [4.68-9.14] vs. 6.95 [5.24-10.56] μmol/L, p = 0.272) compared to the subgroup of 56 individuals without depression, respectively. No such associations could be observed for those 160 individuals without PALM (i.e., lactase persistence) Plasma HCY levels were positively correlated with depressive symptoms (p = 0.052), and showed negative correlations with FA (p = < 0.001) and vitamin B12 (p = 0.029), respectively. CONCLUSION:Depressed individuals with PALM were found with significantly higher HCY and lower FA levels compared to non-depressed individuals with PALM, however, this association was absent in the subgroup of lactase persistent individuals. These findings suggest an association between increased HCY levels, lactose malabsorption and depression.
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- 2018
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14. Light Chain Myeloma with Highly Atypical Plasma Cells and Extensive Auer Rod-Like Inclusions
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Dietmar Enko and Gernot Kriegshäuser
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light chain myeloma ,plasma cells ,bone marrow aspirate ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2019
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15. Dissimilar Pain of Primary Epiploic Appendagitis and Malabsorption
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Wolfgang J Schnedl, Dietmar Enko, Sandra J Wallner-Liebmann, Sonja Lackner, and Harald Mangge
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abdominal pain ,computed tomography ,diamine oxidase ,histamine ,lactose ,Medicine - Abstract
Primary Epiploic Appendagitis (PEA) is a rare cause of acute or subacute abdominal complaints and non-migratory pain. Usually the diagnosis of PEA is made when Computed Tomography (CT) reveals characteristic figures. Nonspecific abdominal complaints including diffuse abdominal pain may be caused by carbohydrate and/or protein malabsorption. We report a case of a patient with PEA who recovered without medication or surgical treatment within a few days. Eight months later, he was diagnosed with lactose- and histamine malabsorption and Helicobacter pylori infection. The malabsorption was treated successfully with an individually-tailored diet free of culprit triggers and the Helicobacter pylori infection was eradicated. A localized non-migratory abdominal pain caused by PEA needs to be differentiated from nonspecific abdominal complaints due to malabsorption and Helicobacter pylori infection.
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- 2017
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16. Refining small intestinal bacterial overgrowth diagnosis by means of carbohydrate specificity: a proof-of-concept study
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Dietmar Enko, Gabriele Halwachs-Baumann, Robert Stolba, Harald Mangge, and Gernot Kriegshäuser
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background: Diagnosis of small intestinal bacterial overgrowth (SIBO) remains challenging. This study aimed at proving the diagnostic concept of carbohydrate-specific SIBO (cs-SIBO) using glucose, fructose and sorbitol hydrogen (H 2 )/methane (CH 4 ) breath testing (HMBT). Methods: In this study 125 patients referred to our outpatient clinic for SIBO testing were included. All individuals underwent glucose (50 g), fructose (25 g) and sorbitol (12.5 g) HMBT at 3 consecutive days. Patients with cs-SIBO (i.e. early H 2 /CH 4 peak) were given rifaximin (600 mg/day) in a 10-day treatment. HMBT results were reassessed in a subset of patients 3–6 months after antibiotic therapy. In view of cs-SIBO diagnosis, agreements between HMBT results obtained for different sugars were calculated using Cohen’s kappa (κ) with 95% confidence intervals (CIs). Results: A total of 59 (47.2%) patients presented an early H 2 /CH 4 peak with one or more sugars. Among these, 21 (16.8%), 10 (8.0%) and 7 (5.6%) individuals had a positive HMBT result with either glucose, fructose or sorbitol, respectively. Another 21 (16.8%) patients with a positive glucose HMBT result were also found positive with an early H 2 /CH 4 peak obtained after ingestion of fructose and/or sorbitol. Fair agreement was observed between glucose and fructose (κ = 0.26, p = 0.0018) and between glucose and sorbitol (κ = 0.18, p = 0.0178) HMBT results. Slight agreement was observed between fructose and sorbitol (κ = 0.03, p = 0.6955) HMBT results only. Successful antibiotic therapy with rifaximin could be demonstrated in 26/30 (86.7%) of patients as indicated by normal HMBT results and symptom remission. Conclusions: Combined glucose, fructose and sorbitol HMBT has the potential to optimize cs-SIBO diagnosis. Furthermore, the majority of patients with cs-SIBO seem to benefit from rifaximin therapy regardless of its carbohydrate specificity.
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- 2016
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17. Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption
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Dietmar Enko, Andreas Meinitzer, Harald Mangge, Gernot Kriegshäuser, Gabriele Halwachs-Baumann, Eva Z. Reininghaus, Susanne A. Bengesser, and Wolfgang J. Schnedl
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The aim of this retrospective study was to analyze the concomitant prevalence rates for lactose malabsorption (LM), fructose malabsorption (FM), and histamine intolerance (HI) in patients with so far unexplained gastrointestinal (GI) symptoms. A total of 439 outpatients, who presented unclear abdominal discomfort, underwent lactose (50 g) and fructose (25 g) hydrogen (H2) breath tests. Additionally, serum diamine oxidase (DAO) measurements were performed. Individuals with low serum DAO activity (
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- 2016
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18. Lactose Malabsorption Testing in Daily Clinical Practice: A Critical Retrospective Analysis and Comparison of the Hydrogen/Methane Breath Test and Genetic Test (C/T-13910 Polymorphism) Results
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Dietmar Enko, Erwin Rezanka, Robert Stolba, and Gabriele Halwachs-Baumann
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The aim of this study was to establish a retrospective evaluation and comparison of the hydrogen/methane (H2/CH4) breath test and genetic test (C/T−13910 polymorphism) results in lactose malabsorption testing. In total 263 consecutive patients with suspected lactose malabsorption were included in this study. They underwent the H2/CH4 breath test following the ingestion of 50 g lactose and were tested for the C/T−13910 polymorphism. In total 51 patients (19.4%) had a C/C−13910 genotype, indicating primary lactose malabsorption. Only 19 patients (7.2%) also had a positive H2/CH4 breath test. All in all 136 patients (51.69%) had a C/T−13910 and 76 patients (28.91%) a T/T−13910 genotype, indicating lactase persistence. Four patients (1.5%) with the C/T−13910 genotype and one patient (0.4%) with the T/T−13910 genotype had a positive H2/CH4 breath test result, indicating secondary lactose malabsorption. Cohen's Kappa measuring agreement between the two methods was 0.44. Twenty patients (7.6%) with a positive H2/CH4 peak within 60 minutes after lactose ingestion were classified as patients with lactose-dependent small intestinal bacterial overgrowth (SIBO). In conclusion, only moderate agreement between the breath test and the genetic test was shown. Secondary lactose malabsorption as well as preanalytical limitations of the combined H2/CH4 breath test procedure can cause discrepant results. This trial is registered with K-42-13.
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- 2014
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19. The Impact of an Algorithm-Guided Management of Preoperative Anemia in Perioperative Hemoglobin Level and Transfusion of Major Orthopedic Surgery Patients
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Dietmar Enko, Franz Wallner, Achim von-Goedecke, Christa Hirschmugl, Vinzenz Auersperg, and Gabriele Halwachs-Baumann
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
The aim of this study was to evaluate a laboratory-guided therapeutic algorithm of preoperative anemia. 335 patients with elective hip or knee arthroplasty were included in this retrospective before-after study. Group I (n= 101) underwent conventional preoperative procedures before algorithm implementation. Group II (n= 234) underwent algorithm-guided preoperative anemia management. A hemoglobin-level of 13 g/dL was the therapeutic cut-off for men and women. Reticulocyte hemoglobin content (CHr) and soluble transferrin receptor (sTfR)/log ferritin ratio were used in the form of the Thomas plot. Iron deficiency (ID) was substituted with 1000 mg iron intravenous (i.v.) and 10000 international units (I.U.) of erythropoiesis-stimulating agent (ESA) subcutaneous (s.c.) or i.v., anemia of chronic disease (ACD) (without functional ID) with 40000 I.U. ESA s.c. or i.v and additionally 200 mg iron i.v. Substituted anemic patients in Group II (n=32) showed a distinctly higher preoperative (Hb-median 13 versus 11.95 g/dL) (P
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- 2013
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20. Klinische Anwendungsbeispiele einer Next-Generation-Sequencing-basierten Multi-Genpanel-Analyse
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Dietmar Enko, Erich Schaflinger, and Daniel J. Müller
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General Medicine - Abstract
ZusammenfassungDieser Übersichtsartikel bietet einen Überblick über klinisch sinnvolle Anwendungsgebiete einer Next-Generation-Sequencing-basierten (NGS) Multi-Genpanel-Teststrategie in den Bereichen Onkologie, hereditärer Tumorsyndrome und Hämatologie. Bei soliden Tumoren (z.B. Lungenkarzinom, Kolonrektalkarzinom) trägt die Detektion somatischer Mutationen nicht nur zu einer besseren diagnostischen, sondern auch therapeutischen Stratifizierung der Betroffenen bei. Die zunehmende genetische Komplexität hereditärer Tumorsyndrome (z.B. Brust- und Ovarialkarzinom, Lynchsyndrom/Polypose) erfordert in betroffenen Familien eine Multi-Genpanel-Analyse von Keimbahnmutationen. Ein weiteres sinnvolles Indikationsgebiet einer Multi-Genpanel-Diagnostik und Prognoseabschätzung sind akute und chronische myeloische Erkrankungen. Die Kriterien der WHO-Klassifikation und des „European LeukemiaNet“-Prognosesystems der akuten myeloischen Leukämie können nur durch eine Multi-Genpanel-Teststrategie erfüllt werden.
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- 2023
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21. Impact of long-term high dietary fat intake and regular exercise on serum TMAO and microbiome composition in female rats
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Gunter Almer, Maria Donatella Semeraro, Andreas Meinitzer, Dietmar Enko, Giovanny Rodriguez Blanco, Birgit Gall, Angela Horvath, Christine Moissl-Eichinger, Holger Till, Hans-Jürgen Gruber, and Markus Herrmann
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Nutrition and Dietetics ,Medicine (miscellaneous) ,Biochemistry ,Food Science - Abstract
BACKGROUD: Trimethylamine oxide (TMAO) represents a gut metabolite and it's physiological concentration is proposed to be influenced by the abundance of precursor trimethylamine (TMA)-producing microbiota in the gut. OBJECTIVE: Lifestyle factors, such as diet and exercise, modify the microbiome, but their long-term impact on plasma TMAO and TMA production in the gut is poorly understood. METHODS: Fecal microbiome composition was analyzed and correlated with TMAO serum concentrations in female Sprague-Dawley rats that received either a healthy normal or a high-fat diet (HFD) for 10 months. Half of the animals performed regular running exercise, the other half served as sedentary controls. RESULTS: HFD consumption induced an alteration of the fecal microbiome with increased alpha diversity on ASV levels. More importantly, HFD reduced the abundance of genera containing potential TMA producers, such as certain members of Clostridia and Lachnospiraceae. In line with this observation, serum TMAO concentrations were found to be lower with HFD and to correlate with the abundance of these genera. Regular exercise also induced changes in microbiome beta diversity but had no effect on serum TMAO in female rats. CONCLUSION: A diet containing high amounts of dietary fat reduced serum TMAO, probably through a reduced intestinal abundance of TMA-producing bacteria. In contrast, regular exercise altered beta diversity of the microbiome composition, but without significant effects on serum TMAO concentrations.
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- 2023
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22. Die Bedeutung der Hochdurchsatz-Sequenzierung in der medizinisch genetischen Diagnostik und Beratung
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Erich Schaflinger and Dietmar Enko
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General Medicine - Abstract
ZusammenfassungNext-Generation-Sequencing ist ein modernes diagnostisches Hochdurchsatz-Verfahren (Multi-Gen-Analysen), durch dessen Einsatz sowohl hereditäre Krebserkrankungen (Tumordispositionssyndrome, Keimbahndiagnostik) als auch somatische Alterationen in Tumoren besser abgeklärt werden können. Der breitere Einsatz dieser Technologie im medizinischen Alltag zeigt das tatsächliche Ausmaß der interindividuellen genetischen Variabilität. Wichtige Bedeutung hat dieses Verfahren für die Untersuchung von heterogenen genetischen Erkrankungen (z. B. Tumorerkrankungen, neurodegenerativen und -muskulären Erkrankungen) erlangt. Weitere Indikationsgebiete stellen die Pharmakogenetik sowie die nicht invasive Pränataldiagnostik dar. Es ist zu erwarten, dass dieses diagnostische Mittel eine breite klinische Anwendung finden wird. Mit der rasanten Zunahme und Komplexität genetischer Dateninformationen nimmt die richtige Interpretation und Übermittlung der Befunde in der humangenetischen Beratung (Keimbahndiagnostik) einen hohen Stellenwert ein. Die genetische Beratung muss entsprechend neu ausgerichtet und adaptiert werden.
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- 2022
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23. Development of a two-dimensional liquid chromatography-tandem mass-spectrometry method for the determination of vitamin D2 in mushrooms
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Sieglinde Zelzer, Andreas Meinitzer, Dietmar Enko, Markus Herrmann, and Walter Goessler
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Tandem Mass Spectrometry ,Food ,Ergocalciferols ,Biochemistry ,Chromatography, Liquid ,Analytical Chemistry - Abstract
Abstract Different foods, especially mushrooms, are a valuable source of vitamin D2. However, published concentrations in mushrooms show large variabilities. One reason for this is certainly the high biological variability caused by growth conditions, and another could also be found in the analytical methodology. Therefore, this study aimed to develop a sensitive and highly selective two-dimensional liquid chromatography mass spectrometry (LC–MS/MS) method for vitamin D2 analysis in mushrooms. After validation, the method was applied to four different mushroom species. The developed method with a one-step extraction procedure showed a limit of detection of 0.01 µg vitamin D2/g dry mass (DM), a limit of quantification of 0.05 µg vitamin D2/g DM, and recovery rates between 87.6 and 94.8%. The total run time including the re-equilibration of the columns for the next injection was 7.5 min. After adding increased concentrations of pure substance to Pleurotus ostreatus, Lentinula edodes, and brown and white button mushrooms the standard addition plot showed excellent correlation coefficients (R2) of > 0.9994. Mean vitamin D2 concentrations were observed at 0.122 ± 0.007, 0.074 ± 0.005, 0.099 ± 0.007, and 0.073 ± 0.005 µg/g DM. The coefficient of variation (CV) was between 5.1 and 7.6%. This well-optimized, sensitive LC–MS/MS method, with a fast and simple sample preparation and a short run time, can be applied to future studies especially in different mushroom species with variable growing conditions. This will improve our knowledge about the vitamin D2 content in mushrooms. Graphical abstract
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- 2022
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24. Vitamin D metabolism in living kidney donors before and after organ donation
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Dietmar, Enko, Andreas, Meinitzer, Sieglinde, Zelzer, Markus, Herrmann, Katharina, Artinger, Alexander R, Rosenkranz, and Sabine, Zitta
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Tissue and Organ Procurement ,Ergocalciferols ,Biochemistry (medical) ,Clinical Biochemistry ,Humans ,General Medicine ,Vitamin D ,Kidney ,Kidney Transplantation ,Calcifediol ,Cholecalciferol - Abstract
Objectives Living kidney donors provide a unique setting to study functional and metabolic consequences after organ donation. Since the lack of data of the homoeostasis of numerous vitamin D metabolites in these healthy subjects, the aim of this study was to assess the vitamin D metabolism before and after kidney donation. Methods We investigated the 25-dihydroxyvitamin D2 (25[OH]D2), 25-dihydroxyvitamin D3 (25[OH]D3), 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), 24,25-dihydroxyvitamin D3 (24,25[OH]2D3), 25,26-dihydroxyvitamin D3 (25,26[OH]2D3), and the native vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) in a well characterized study cohort of 32 healthy living kidney donors before and after organ donation. Results Thirty-two healthy subjects after kidney donation had significantly lower median (interquartile range) 1,25(OH)2D3 serum concentrations (88.6 [62.6–118.8] vs. 138.0 [102.6–152.4] pmol/L, p2 serum levels (1.80 [1.19–2.19] vs. 1.11 [0.74–1.59] nmol/L, p=0.019) than before donation. Similar serum concentrations of 25(OH)D3 and 25,26(OH)2D3 were observed before and after donation. The 24,25(OH)2D3 blood levels distinctly decreased after organ donation (4.1 [2.3–5.3] vs. 5.3 [2.2–6.9] nmol/L, p=0.153). Native vitamin D2 (0.10 [0.08–0.14] vs. 0.08 [0.06–0.12] nmol/L, p=0.275) was slightly increased and vitamin D3 (1.6 [0.6–7.2] vs. 2.5 [0.9–8.6] nmol/L, p=0.957) decreased after kidney donation. Conclusions Living kidney donors were found with decreased 1,25(OH)2D3 and 24,25(OH)2D3, increased 25(OH)D2 and consistent 25(OH)D3 and 25,26(OH)2D3 serum concentrations after organ donation. The current study advances the understanding on vitamin D metabolism suggesting that altered hydroxylase-activities after donation is accompanied by compensatory elevated dietary-related 25(OH)D2 blood concentrations.
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- 2022
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25. Development of a liquid chromatography mass spectrometry method for the determination of vitamin K1, menaquinone-4, menaquinone-7 and vitamin K1-2,3 epoxide in serum of individuals without vitamin K supplements
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Andreas, Meinitzer, Dietmar, Enko, Sieglinde, Zelzer, Florian, Prüller, Nerea, Alonso, Eva, Fritz-Petrin, and Markus, Herrmann
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Vitamin K ,Tandem Mass Spectrometry ,Biochemistry (medical) ,Clinical Biochemistry ,Phenprocoumon ,Epoxy Compounds ,Humans ,Vitamin K 2 ,Vitamin K 1 ,General Medicine ,Chromatography, High Pressure Liquid ,Chromatography, Liquid - Abstract
Objectives Vitamin K and metabolites have a beneficial role in blood coagulation, bone metabolism and growth. However, the determination of vitamin K concentrations in the blood in patients consuming a diet with naturally occurring vitamin K is currently challenging. We aim to develop a cost-effective and rapid method to measure vitamin K metabolites with potential application for clinics and research. Methods We developed a simple liquid chromatography-tandem mass spectrometric (LC-MS/MS) method for the determination of vitamin K1, menaquinone-4 (MK-4), menaquinone-7 (MK-7) and vitamin K1-2,3 epoxide in human serum and validated the method in a study cohort of 162 patients tested for carbohydrate malabsorption and in 20 patients with oral phenprocoumon intake. Results The overall precision (CVs) ranged between 4.8 and 17.7% in the specified working range (0.06–9.0 nmol/L for all analytes except for MK-7 with 0.04–6.16 nmol/L). In the malabsorption cohort samples, measured values were obtained for all different vitamin K metabolites except for vitamin K1-2,3 epoxide. This metabolite could be detected only in patients with phenprocoumon intake. The good performance of the method is especially achieved by the interaction of three factors: the use of lipase in the sample preparation, the use of an atypical fluorinated reversed phase column, and a logarithmic methanol gradient. Conclusions The described method is able to determine the concentration of four vitamin K metabolites in a time-efficient, simple and cost-effective manner. It can be suitable for both routine clinics and research.
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- 2022
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26. Assessment of tryptophan and kynurenine as prognostic markers in patients with SARS-CoV-2
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Simon Michaelis, Sieglinde Zelzer, Wolfgang J. Schnedl, Andreas Baranyi, Andreas Meinitzer, and Dietmar Enko
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SARS-CoV-2 ,Biochemistry (medical) ,Clinical Biochemistry ,Tryptophan ,COVID-19 ,Humans ,General Medicine ,Prognosis ,Biochemistry ,Article ,Kynurenine - Abstract
Background Immune dysregulation and inflammation in patients with SARS-CoV-2 is associated with a poor clinical outcome. We investigated the value of the inflammatory markers tryptophan and kynurenine in predicting the survival outcome of patients with SARS-CoV-2. Methods The study included 252 inpatients with a SARS-CoV-2 infection hospitalized between August 2020 and April 2021. Two groups were generated based on disease survival (survival group: n = 199; deceased group: n = 53). Plasma concentrations of tryptophan, kynurenine and interleukin-6 (IL-6) were measured on admission. In a subset of patients (n = 105; 81 survivors and 24 deceased) concentrations of tryptophan and kynurenine were checked 7 days after admission. The kynurenine/tryptophan ratio (TRP/KYN ratio) was calculated. Results On admission, the deceased group showed significantly higher concentrations of kynurenine and a significantly higher KYN/TRP ratio compared to the survival group (p-values
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- 2022
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27. <scp> ABCB1 </scp> Gene Variants and Antidepressant Treatment Outcomes: A Systematic Review and Meta‐Analysis Including Results from the <scp>CAN‐BIND</scp> ‐1 Study
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Leen Magarbeh, Claudia Hassel, Maximilian Choi, Farhana Islam, Victoria S. Marshe, Clement C. Zai, Rayyan Zuberi, Roseann S. Gammal, Xiaoyu Men, Maike Scherf‐Clavel, Dietmar Enko, Benicio N. Frey, Roumen Milev, Claudio N. Soares, Sagar V. Parikh, Franca Placenza, Stephen C. Strother, Stefanie Hassel, Valerie H. Taylor, Francesco Leri, Pierre Blier, Faranak Farzan, Raymond W. Lam, Gustavo Turecki, Jane A. Foster, Susan Rotzinger, Stefan Kloiber, James L. Kennedy, Sidney H. Kennedy, Chad A. Bousman, and Daniel J. Müller
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Pharmacology ,Pharmacology (medical) - Published
- 2023
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28. [The Impact of Next-Generation Sequencing on Medical Genetic Diagnostics and Counseling]
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Erich, Schaflinger and Dietmar, Enko
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Counseling ,Pregnancy ,Genetics, Medical ,Neoplasms ,High-Throughput Nucleotide Sequencing ,Humans ,Female ,Genetic Counseling ,Genetic Testing - Abstract
Next-generation sequencing is a modern diagnostic high-throughput method (multi-gene analysis) that can be used to better diagnose both hereditary cancers (tumor disposition syndromes, germline diagnostics) and somatic mutations in tumors. The broad usage of this technology in daily clinical practice demonstrates the real interindividual genetic variability. This method has great importance for the investigation of heterogeneous genetic diseases (e. g. tumors, neurodegenerative and neuromuscular diseases). Further indications are pharmacogenetics and non-invasive prenatal diagnosis. It can be expected that this diagnostic tool will find wide clinical application. With the rapid increase and complexity of genetic data information, the correct interpretation and transmission of the results in the human genetic counseling (germline diagnostics) is of great importance. The genetic counseling must be realigned and adapted accordingly in daily clinical practice.Next-Generation-Sequencing ist ein modernes diagnostisches Hochdurchsatz-Verfahren (Multi-Gen-Analysen), durch dessen Einsatz sowohl hereditäre Krebserkrankungen (Tumordispositionssyndrome, Keimbahndiagnostik) als auch somatische Alterationen in Tumoren besser abgeklärt werden können. Der breitere Einsatz dieser Technologie im medizinischen Alltag zeigt das tatsächliche Ausmaß der interindividuellen genetischen Variabilität. Wichtige Bedeutung hat dieses Verfahren für die Untersuchung von heterogenen genetischen Erkrankungen (z. B. Tumorerkrankungen, neurodegenerativen und -muskulären Erkrankungen) erlangt. Weitere Indikationsgebiete stellen die Pharmakogenetik sowie die nicht invasive Pränataldiagnostik dar. Es ist zu erwarten, dass dieses diagnostische Mittel eine breite klinische Anwendung finden wird. Mit der rasanten Zunahme und Komplexität genetischer Dateninformationen nimmt die richtige Interpretation und Übermittlung der Befunde in der humangenetischen Beratung (Keimbahndiagnostik) einen hohen Stellenwert ein. Die genetische Beratung muss entsprechend neu ausgerichtet und adaptiert werden.
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- 2022
29. Early cerebrospinal fluid infiltration in TP53-mutated blastic plasmacytoid dendritic cell neoplasm
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Simon Michaelis, Angelika Pichler, Christine Beham-Schmid, Ingeborg Stelzer, Laurenz Schöffmann, Christoph Tinchon, and Dietmar Enko
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Hematology ,General Medicine - Published
- 2022
30. Alteration of the kynurenine pathway is inversely associated with the humoral immune response in patients with SARS-CoV-2
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Simon Michaelis, Sieglinde Zelzer, Christopher Schneider, Wolfgang J. Schnedl, Andreas Baranyi, Andreas Meinitzer, Markus Herrmann, and Dietmar Enko
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SARS-CoV-2 ,Biochemistry (medical) ,Clinical Biochemistry ,Tryptophan ,Humans ,COVID-19 ,General Medicine ,Biochemistry ,Kynurenine ,Immunity, Humoral - Abstract
The scale and the course of antibody production in patients with SARS-CoV-2 is highly variable. Factors involved in the immune regulation during the infection may play a major role in the antibody response. We investigated the relationship between the inflammatory markers of the kynurenine pathway and the concentration of antibodies against SARS-CoV-2 in infected patients 8 - 11 days after admission.The study included 72 SARS-CoV-2 - positive inpatients hospitalized between August 2020 and April 2021. The plasma concentrations of tryptophan, kynurenine, anti-SARS-CoV-2 antibodies and the leucocyte count were measured 8 - 11 days after admission. The kynurenine/tryptophan ratio (KYN/TRP ratio) was calculated. Tertiles based on the values for tryptophan, kynurenine, KYN/TRP ratio and the leucocytes were generated.Statistically significant correlations were observed between anti-SARS-CoV-2 antibodies and tryptophan, kynurenine, KYN/TRP ratio and the leucocytes (p-values 0.001-0.007). The high kynurenine and KYN/TRP ratio tertiles showed significantly lower antibody titers compared to the low tertiles (p-values 0.017 and 0.001). The low tryptophan and leucocytes tertiles showed significantly lower antibody titers compared to the high tertiles (p-values 0.001 and 0.008).Patients with higher activation levels of the kynurenine pathway tended to develop lower anti-SARS-CoV-2 antibody titers.
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- 2022
31. Implementation of a Dual-Column Liquid Chromatography-Tandem Mass-Spectrometry Method for the Quantification of Isavuconazole in Clinical Practice
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Sieglinde Zelzer, Andreas Meinitzer, Dietmar Enko, Robert Krause, and Markus Herrmann
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Coefficient of determination ,Dual column ,therapeutic drug monitoring ,Triazole ,01 natural sciences ,liquid chromatography-tandem mass-spectrometry ,03 medical and health sciences ,chemistry.chemical_compound ,Liquid chromatography–mass spectrometry ,medicine ,0303 health sciences ,Chromatography ,medicine.diagnostic_test ,030306 microbiology ,isavuconazole ,010401 analytical chemistry ,Sample stability ,0104 chemical sciences ,Triple quadrupole mass spectrometer ,Clinical Practice ,triazole ,chemistry ,Therapeutic drug monitoring ,Medicine ,Original Article ,antifungal agents - Abstract
Objectives Therapeutic drug monitoring (TDM) of isavuconazole, which is a novel broad-spectrum antimycoticum against invasive fungal infections, ensures an effective exposure of the drug and minimizes the risk of toxicity. This study is aimed at evaluating the analytical performance of a dual-column liquid chromatography-tandem mass-spectrometry (LC-MS/MS) method for isavuconazole quantification. Materials and Methods The method was performed on a Voyager TSQ Quantum triple quadrupole instrument equipped with an Ultimate 3000 chromatography system (Thermo Fisher Scientific, San Jose, California, United States). Analytical and preanalytical requirements of the isavuconazole LC-MS/MS method were evaluated. Sample stability measurements were performed at room temperature (RT) and in serum tubes with separator gel. Results The isavuconazole LC-MS/MS method was linear over the concentration range of 0.2 to 12.8 mg/L. The coefficient of determination (r 2) always exceeded 0.999. Within- and between-run precision ranged between 1.4 to 2.9% and 1.5 to 3.0%, the recovery between 93.9 and 102.7%. At RT, serum samples were stable for 3 days. Isavuconazole serum concentrations were significantly lower after incubation (18 hours) in serum tubes with separator gel at RT. Conclusion The dual-column isavuconazole LC-MS/MS is a reliable tool for the TDM of isavuconazole. Serum samples are stable for at least 3 days and should be collected in tubes without separator gel.
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- 2021
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32. Concomitant immune thrombocytopenia and bone marrow hemophagocytosis in a patient with SARS-CoV-2
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Angelika Pichler, Christoph Tinchon, Ingeborg Stelzer, Simon Michaelis, and Dietmar Enko
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Biochemistry (medical) ,Clinical Biochemistry ,General Medicine ,Immune thrombocytopenia ,medicine.anatomical_structure ,Concomitant ,Immunology ,Bone Marrow Diseases ,Medicine ,Bone marrow ,Hemophagocytosis ,business - Published
- 2021
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33. Serum Diamine Oxidase Values, Indicating Histamine Intolerance, Influence Lactose Tolerance Breath Test Results
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Wolfgang J. Schnedl, Nathalie Meier-Allard, Simon Michaelis, Sonja Lackner, Dietmar Enko, Harald Mangge, and Sandra J. Holasek
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Blood Glucose ,Nutrition and Dietetics ,Breath Tests ,irritable bowel syndrome ,diamine oxidase ,exhaled hydrogen ,food intolerance ,lactose intolerance ,Humans ,Lactose ,Amine Oxidase (Copper-Containing) ,Histamine ,Retrospective Studies ,Food Science - Abstract
Lactose intolerance (LIT) is one of the major causes of irritable bowel syndrome (IBS) spectrum complaints. Differences in inadequate lactose digestion are described as various LIT phenotypes with basically unknown pathophysiology. In LIT patients, we retrospectively assessed the effect of histamine intolerance (HIT) on expiratory hydrogen (H2) during H2 lactose breath tests. In a retrospective evaluation of charts from 402 LIT patients, 200 patients were identified as having only LIT. The other 202 LIT patients were found to additionally have diamine oxidase (DAO) values of 20 parts per million (ppm), but a blood glucose (BG) increase of >20 mg/dL, (2) LIT with an H2 increase of 20 ppm in combination with a BG increase of 20 ppm and BG < 20 mg/dL patients with LIT and HIT (p = 0.007). This diagnostic group also showed a significant higher number of patients (p = 0.012) and a significant higher number of patients with gastrointestinal (GI) symptoms during H2 breath tests (p < 0.001). Therefore, low serum DAO values, indicating HIT, influence results of lactose tolerance breath tests.
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- 2022
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34. Diagnosis of hepatic nuclear factor 1A monogenic diabetes mellitus (HNF1A-MODY) impacts antihyperglycemic treatment
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Harald Mangge, Michael Schenk, Sandra Holasek, Wolfgang J. Schnedl, and Dietmar Enko
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Adult ,endocrine system ,Pediatrics ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Hypoglycemia ,Maturity onset diabetes of the young ,03 medical and health sciences ,0302 clinical medicine ,Diabetes management ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,Hepatocyte Nuclear Factor 1-alpha ,030212 general & internal medicine ,Genetic testing ,Monogenic Diabetes ,medicine.diagnostic_test ,business.industry ,Insulin ,General Medicine ,medicine.disease ,HNF1A ,Diabetes Mellitus, Type 1 ,Sulfonylurea Compounds ,Diabetes Mellitus, Type 2 ,Mutation ,business - Abstract
Monogenic mutations of the hepatocyte nuclear factor 1 homeobox A maturity onset diabetes of the young (HNF1A-MODY) is characterized by early onset, typically before the age of 25 years. Patients are often not clinically recognized; however, the identification of HNF1A-MODY patients is crucial because they require different antihyperglycemic medical treatment than patients with type 1 or type 2 diabetes mellitus. We describe two adult patients with monogenic diabetes, both identified as HNF1A-MODY, genetically c.815G>A, p.Arg272His and c675delC, p.Ser225Argfs*8, respectively. They were misdiagnosed as having type 1 diabetes mellitus, and consequently, initiating insulin therapy led to hypoglycemia and unstable blood glucose control. Usually, sulfonylureas represent the basis of antidiabetic treatment in patients with HNF1A-MODY; however, all medical personnel involved in diabetes care should be aware of monogenic diabetes mellitus and the possibilities for genetic testing. The patients observed have shown the necessity of the identification and appropriate genetic diagnosis of HNF1A-MODY in order to discontinue insulin therapy and to initiate adjusted diabetes management.
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- 2020
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35. Considering histamine in functional gastrointestinal disorders
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Dietmar Enko and Wolfgang J. Schnedl
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medicine.medical_specialty ,Malabsorption ,Glutens ,Gastrointestinal Diseases ,030309 nutrition & dietetics ,Population ,Lactose ,Food Intolerance ,Gastroenterology ,Industrial and Manufacturing Engineering ,03 medical and health sciences ,chemistry.chemical_compound ,Lactose Intolerance ,0404 agricultural biotechnology ,Internal medicine ,Humans ,Medicine ,Food components ,education ,chemistry.chemical_classification ,0303 health sciences ,Gastrointestinal tract ,education.field_of_study ,business.industry ,04 agricultural and veterinary sciences ,General Medicine ,medicine.disease ,040401 food science ,Gluten ,Food intolerance ,chemistry ,Diamine oxidase ,business ,Histamine ,Food Science - Abstract
In westernized countries, adverse reactions to ingested foods are reported to affect up to 20% of the population. Functional, nonspecific, non-allergic gastrointestinal complaints are mainly due to the intolerance/malabsorption of carbohydrates (lactose and fructose), proteins (gluten), and biogenic amines (histamine). Food intolerance/malabsorption is defined by one or several of the above mentioned food components not being degraded and/or absorbed properly within the gastrointestinal tract. Food intolerance/malabsorption causes variable, functional, nonspecific, non-allergic gastrointestinal and extra-intestinal complaints, and a detailed diagnostic workup for all possible etiologic factors in individual patients is essential. Usually, evaluation for histamine intolerance is not included in differential diagnoses of patients with functional, nonspecific, non-allergic gastrointestinal complaints. A targeted dietary intervention for single or possibly combined intolerance/malabsorption is required. In this article, we review currently discussed differential diagnoses and available tests for intolerance/malabsorption. Accordingly, we aim to outline why including histamine and, histamine intolerance, should be considered in differential diagnoses of patients with functional, nonspecific, non-allergic gastrointestinal complaints.
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- 2020
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36. Fecal Calprotectin Elevations Associated with Food Intolerance/Malabsorption Are Significantly Reduced with Targeted Diets
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Wolfgang J. Schnedl, Simon Michaelis, Dietmar Enko, and Harald Mangge
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Nutrition and Dietetics ,Food Science - Abstract
Inflammatory bowel disease (IBD) involves two clinically defined entities, namely Crohn’s disease and ulcerative colitis. Fecal calprotectin (FCAL) is used as a marker to distinguish between organic IBD and functional bowel disease in disorders of the irritable bowel syndrome (IBS) spectrum. Food components may affect digestion and cause functional abdominal disorders of the IBS spectrum. In this retrospective study, we report on FCAL testing to search for IBD in 228 patients with disorders of the IBS spectrum caused by food intolerances/malabsorption. Included were patients with fructose malabsorption (FM), histamine intolerance (HIT), lactose intolerance (LIT), and H. pylori infection. We found elevated FCAL values in 39 (17.1%) of 228 IBS patients with food intolerance/malabsorption and H. pylori infection. Within these, fourteen patients were lactose intolerant, three showed fructose malabsorption, and six had histamine intolerance. The others had combinations of the above conditions: five patients had LIT and HIT, two patients had LIT and FM, and four had LIT and H. pylori. In addition, there were individual patients with other double or triple combinations. In addition to LIT, IBD was suspected in two patients due to continuously elevated FCAL, and then found via histologic evaluation of biopsies taken during colonoscopy. One patient with elevated FCAL had sprue-like enteropathy caused by the angiotensin receptor-1 antagonist candesartan. When screening for study subjects concluded, 16 (41%) of 39 patients with initially elevated FCAL agreed to voluntarily control FCAL measurements, although symptom-free and -reduced, following the diagnosis of intolerance/malabsorption and/or H. pylori infection. After the initiation of a diet individualized to the symptomatology and eradication therapy (when H. pylori was detected), FCAL values were significantly lowered or reduced to be within the normal range.
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- 2023
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37. TMAO (trimethylamine n-oxide) as a potential biomarker of individual severe stress perception in posttraumatic stress disorder (PTSD)-vulnerable patients after acute myocardial infarction
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Heimo Traninger, D Von Lewinski, Andreas Baranyi, H P Rotenhaeusler, Andreas Meinitzer, Barbara Obermayer-Pietsch, Leonhard Harpf, Dietmar Enko, C. Braun, Hanns Harpf, Melanie Schweinzer, Omid Amouzadeh-Ghadikolai, and F Von Lewinski
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medicine.medical_specialty ,business.industry ,Trimethylamine N-oxide ,medicine.disease ,behavioral disciplines and activities ,Stress perception ,Posttraumatic stress ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Potential biomarkers ,mental disorders ,medicine ,Cardiology ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Acute myocardial infarction is not only a somatic disease but potentially triggers psychological effects, too. Post-traumatic stress disorder (PTSD) is a common stress-related disorder. It is characterized by numerous symptoms, such as flashbacks, intrusions, nightmares and severe anxiety, as well as uncontrollable, intense and disturbing thoughts and feelings related to the traumatic experience. However, with regard to the development of PTSD, individual stress perception might be crucial since not every serious traumatic experience leads to PTSD. To date, almost no biological correlates of an individual's perception of stress have been identified as being associated with the long-term development of PTSD. Objective The aim of the study was to determine whether blood levels of TMAO vary immediately after AMI (1) in patients with or without depression, and (2) in patients with AMI induced PTSD symptomatology (subsyndromal PTSD and full PTSD). Furthermore, we investigated whether TMAO is a potential biomarker that might be useful in the prediction of PTSD symptomatology in the long term. Method A total of 114 AMI patients were assessed with standardized clinical psychiatric interviews based on the Hamilton Depression Scale (HAMD-17) after admission to the hospital and 6 months later. In addition, the CAPS-5 was used to explore PTSD symptoms (subsyndromal PTSD and full PTSD) 6 months after AMI. To assess patients' TMAO status, serum samples were collected at hospitalization and 6 months after AMI. Results Study participants with post-myocardial infarction PTSD symptomatology (subsyndromal PTSD and full PTSD) had significantly higher TMAO levels immediately after AMI than patients without PTSD symptoms (ANCOVA: TMAO (PTSD x time), F = 4.544, df = 1, p=0.035). In contrast, depressive symptomatology 6 months after AMI had no influence on TMAO levels (TMAO (depression x time), F = 0.083, df = 1, p=0.774). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO becomes a significant predictor of PTSD symptomatology. Conclusions An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increased gut permeability to trimethylamine (TMA), the precursor of TMAO. Thus, elevated TMAO might be a biological correlate for stress that is associated with vulnerability to PTSD and might help to identify patients at increased risk. Funding Acknowledgement Type of funding sources: None.
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- 2021
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38. Comparison of two LC-MS/MS methods for the quantification of 24,25-dihydroxyvitamin D3 in patients and external quality assurance samples
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Stéphanie Peeters, Walter Goessler, Markus Herrmann, Andreas Meinitzer, Sieglinde Zelzer, Etienne Cavalier, Dietmar Enko, Caroline Le Goff, and Chiara Calaprice
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Accuracy and precision ,Chromatography ,24,25-Dihydroxyvitamin D 3 ,business.industry ,Biochemistry (medical) ,Clinical Biochemistry ,General Medicine ,Serum samples ,Mass spectrometry ,Specimen Handling ,Tandem Mass Spectrometry ,Lc ms ms ,Medicine ,Humans ,In patient ,Sample preparation ,Hospital patients ,Vitamin D ,business ,Quality assurance ,Chromatography, Liquid - Abstract
Objectives In-house developed liquid-chromatography mass spectrometry (LC-MS/MS) methods are used more and more frequently for the simultaneous quantification of vitamin D metabolites. Among these, 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) is of clinical interest. This study assessed the agreement of this metabolite in two validated in-house LC-MS/MS methods. Methods 24,25(OH)2D3 was measured in 20 samples from the vitamin D external quality assurance (DEQAS) program and in a mixed cohort of hospital patients samples (n=195) with the LC-MS/MS method at the Medical University of Graz (LC-MS/MS 1) and at the University of Liège (LC-MS/MS 2). Results In DEQAS samples, 24,25(OH)2D3 results with LC-MS/MS 1 had a proportional bias of 1.0% and a negative systemic difference of −0.05%. LC-MS/MS 2 also showed a proportional bias of 1.0% and the negative systemic bias was −0.22%. Comparing the EQA samples with both methods, no systemic bias was found (0.0%) and the slope was 1%. The mean difference of 195 serum sample measurements between the two LC-MS/MS methods was minimal (−0.2%). Both LC-MS/MS methods showed a constant bias of 0.31 nmol/L and a positive proportional bias of 0.90%, respectively. Conclusions This study is the first to assess the comparability of 24,25(OH)2D3 concentrations in a mixed cohort of hospitalized patients with two fully validated in-house LC-MS/MS methods. Despite different sample preparation, chromatographic separation and ionization, both methods showed high precision measurements of 24,25(OH)2D3. Furthermore, we demonstrate the improvement of accuracy and precision measurements of 24,25(OH)2D3 in serum samples and in the DEQAS program.
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- 2021
39. Associations between tryptophan and iron metabolism observed in individuals with and without iron deficiency
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Markus Herrmann, Harald Mangge, Sieglinde Zelzer, Wolfgang J. Schnedl, Sandra Holasek, Julian Wenninger, Andreas Meinitzer, and Dietmar Enko
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0301 basic medicine ,Erythrocyte Indices ,Male ,Reticulocytes ,lcsh:Medicine ,chemistry.chemical_compound ,Hemoglobins ,0302 clinical medicine ,lcsh:Science ,chemistry.chemical_classification ,Aged, 80 and over ,Multidisciplinary ,biology ,medicine.diagnostic_test ,Anemia, Iron-Deficiency ,Transferrin ,Tryptophan ,Iron deficiency ,Middle Aged ,Serum iron ,Regression Analysis ,Female ,Adult ,medicine.medical_specialty ,Adolescent ,Anemia ,Iron ,Article ,03 medical and health sciences ,Young Adult ,Internal medicine ,Receptors, Transferrin ,medicine ,Humans ,Soluble transferrin receptor ,Aged ,Transferrin saturation ,lcsh:R ,Diagnostic markers ,Translational research ,medicine.disease ,Ferritin ,030104 developmental biology ,Endocrinology ,chemistry ,Ferritins ,biology.protein ,lcsh:Q ,030217 neurology & neurosurgery ,Kynurenine ,Biomarkers - Abstract
Current literature proposes associations between tryptophan metabolism and anaemia. However, study cohorts are rather small and final conclusions are still lacking. Here, we evaluated potential associations of tryptophan, kynurenine, and kynurenic acid with indicators of iron metabolism (i.e., mean corpuscular volume, mean corpuscular haemoglobin, ferritin, transferrin saturation, serum iron, transferrin, soluble transferrin receptor, reticulocyte haemoglobin) and haemoglobin in 430 individuals grouped by the presence or absence of iron deficiency or anaemia. Indicators of tryptophan metabolism were positively correlated with haemoglobin and markers of iron metabolism (p-values
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- 2019
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40. Evaluation of symptoms and symptom combinations in histamine intolerance
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Sonja Lackner, Harald Mangge, Dietmar Enko, Sandra Holasek, Michael Schenk, and Wolfgang J. Schnedl
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Abdominal pain ,medicine.medical_specialty ,Constipation ,Malabsorption ,lcsh:Medicine ,Bloating ,Internal medicine ,medicine ,lcsh:RC799-869 ,Irritable bowel syndrome ,Gastrointestinal diseases ,Diamine oxidase ,business.industry ,lcsh:R ,Gastroenterology ,Functional Bowel Disorders ,medicine.disease ,Food intolerance ,Diarrhea ,Postprandial ,Original Article ,lcsh:Diseases of the digestive system. Gastroenterology ,medicine.symptom ,business ,Gluten ,Histamine - Abstract
Background/Aims Food intolerance/malabsorption, particularly histamine intolerance (HIT), may cause nonspecific functional gastrointestinal and extraintestinal symptoms. We evaluated gastrointestinal and extraintestinal symptoms in patients with HIT. Methods In an analysis of outpatients’ charts we identified 133 patients, who presented with recurring nonspecific functional gastrointestinal, extraintestinal symptoms, and a diamine oxidase value
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- 2019
41. Diamine oxidase supplementation improves symptoms in patients with histamine intolerance
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Florian Forster, Dietmar Enko, Harald Mangge, Michael Schenk, Wolfgang J. Schnedl, and Sonja Lackner
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0106 biological sciences ,Gastrointestinal ,medicine.medical_specialty ,Malabsorption ,01 natural sciences ,Applied Microbiology and Biotechnology ,Gastroenterology ,Histamine intolerance ,Article ,chemistry.chemical_compound ,0404 agricultural biotechnology ,Oral supplements ,010608 biotechnology ,Internal medicine ,medicine ,In patient ,Diamine oxidase ,Extra-intestinal ,Symptom intensity ,business.industry ,Symptom severity ,04 agricultural and veterinary sciences ,040401 food science ,chemistry ,business ,Histamine ,Food Science ,Biotechnology - Abstract
Histamine intolerance (HIT) is thought to be caused by a disproportionate amount of histamine in the body. The enzyme diamine oxidase (DAO) is considered for the gastrointestinal degradation of histamine. For this open-label interventional pilot study, we identified 28 patients with HIT. For 4 weeks, they were instructed to take DAO capsules before meals. Then, throughout a follow-up period, they were instructed not to take the DAO. We used a questionnaire that included 22 symptoms, which were divided into 4 categories, as well as a symptom severity score. All symptoms improved significantly during the oral supplementation of DAO. During the follow-up period, without DAO supplementation, the symptoms sum scores increased again. The symptom intensity score was reduced for all symptoms. We have demonstrated, a significant reduction of every HIT-related symptom and its intensity due to DAO oral supplements. The ClinicalTrials.gov identifier (NCT number) is NCT03298568.
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- 2019
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42. Reverse-hybridization resolves a rare HFE genotype untypable by real-time PCR and melting curve analysis in a patient with hyperferritinemia and alcoholic liver disease
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Michael Novy, Dietmar Enko, Gernot Kriegshäuser, and Christian Oberkanins
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Alcoholic liver disease ,Real-time polymerase chain reaction ,business.industry ,Biochemistry (medical) ,Clinical Biochemistry ,Genotype ,medicine ,Reverse hybridization ,General Medicine ,medicine.disease ,business ,Molecular biology ,Melting curve analysis - Published
- 2019
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43. Iron status determination in individuals with Helicobacter pylori infection: conventional vs. new laboratory biomarkers
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Dietmar Enko, Sieglinde Zelzer, Günter Fauler, Helga Wagner, Julia Wögerer, Wolfgang J. Schnedl, Gabriele Halwachs-Baumann, Herrmann Markus, Gernot Kriegshäuser, Andreas Meinitzer, and Harald Mangge
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Adult ,Male ,Helicobacter pylori infection ,medicine.medical_specialty ,Iron ,Clinical Biochemistry ,Gastroenterology ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Receptors, Transferrin ,medicine ,Humans ,Soluble transferrin receptor ,Breath test ,Anemia, Iron-Deficiency ,medicine.diagnostic_test ,biology ,business.industry ,Transferrin saturation ,Biochemistry (medical) ,General Medicine ,Iron deficiency ,Middle Aged ,Helicobacter pylori ,medicine.disease ,biology.organism_classification ,Anti-Bacterial Agents ,Ferritin ,Logistic Models ,Breath Tests ,030220 oncology & carcinogenesis ,Ferritins ,biology.protein ,Female ,030211 gastroenterology & hepatology ,Hemoglobin ,business ,Biomarkers - Abstract
Background Helicobacter pylori has been associated with iron deficiency (ID). This study is aimed at investigating ID with conventional (ferritin, transferrin saturation [TSAT]) and new biomarkers (soluble transferrin receptor [sTfR], sTfR/log ferritin, reticulocyte hemoglobin content [CHr], hepcidin-25) in patients sub-grouped by the presence or absence of H. pylori infection. Methods In total, 200 consecutive outpatients, who were referred for the H. pylori 13C-urea breath test (13C-UBT), underwent blood testing for ID. Additionally, Thomas-plot (TP)-analyses (sTfR/log ferritin, CHr) were calculated. Results Fifty-three and 147 individuals were found with and without H. pylori infection, respectively. Patients with H. pylori infection showed a higher sTfR concentration (pH. pylori infection and 63/147 (42.9%) without H. pylori infection showed ID. Based on TP-analyses, 10/53 (18.9%) patients with and 17/147 (11.6%) without H. pylori infection were identified with ID. Completed eradication therapy tended to be associated with functional ID. Conclusions Helicobacter pylori infection was associated with significantly higher plasma sTfR concentrations and sTfR/log ferritin ratios. Patients with H. pylori eradication therapy were more often detected with functional ID compared to patients without eradication therapy, when using the new biomarkers.
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- 2019
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44. Assessment of trimethylamine N-oxide (TMAO) as a potential biomarker of severe stress in patients vulnerable to posttraumatic stress disorder (PTSD) after acute myocardial infarction
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Dietmar Enko, Hans-Bernd Rothenhäusler, Andreas Meinitzer, Hanns Harpf, Omid Amouzadeh-Ghadikolai, Leonhard Harpf, Barbara Obermayer-Pietsch, Dirk von Lewinski, Celine K Braun, Melanie Schweinzer, Andreas Baranyi, and Heimo Traninger
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Male ,050103 clinical psychology ,Trastorno de estrés postraumático (TEPT) ,RC435-571 ,Myocardial Infarction ,Trimethylamine N-oxide ,氧化三甲胺 (TMAO) ,Stress Disorders, Post-Traumatic ,chemistry.chemical_compound ,0302 clinical medicine ,Depresión ,肠胃渗透性 ,Medicine ,急性心肌梗塞 ,Myocardial infarction ,Psychiatry ,Clinical Research Article ,05 social sciences ,Middle Aged ,depression ,Cardiology ,Biomarcador ,biomarker ,Female ,gut permeability ,N-óxido de trimetilamina (TMAO) ,Infarto agudo del miocardio ,Research Article ,medicine.medical_specialty ,创伤后应激障碍 (PTSD) ,acute myocardial infarction ,抑郁 ,behavioral disciplines and activities ,03 medical and health sciences ,Methylamines ,生物标志物 ,Internal medicine ,mental disorders ,Permeabilidad intestinal ,Humans ,0501 psychology and cognitive sciences ,In patient ,cardiovascular diseases ,business.industry ,medicine.disease ,posttraumatic stress disorder (PTSD) ,030227 psychiatry ,Posttraumatic stress ,chemistry ,Potential biomarkers ,Trimethylamine N-oxide (TMAO) ,business ,Biomarkers - Abstract
Background: Posttraumatic stress disorder (PTSD) is a frequently observed stress-related disorder after acute myocardial infarction (AMI) and it is characterized by numerous symptoms, such as flashbacks, intrusions and anxiety, as well as uncontrollable thoughts and feelings related to the trauma. Biological correlates of severe stress might contribute to identifying PTSD-vulnerable patients at an early stage. Objective: Aims of the study were (1) to determine whether blood levels of trimethylamine N-oxide (TMAO) vary immediately after AMI in patients with/without AMI-induced PTSD symptomatology, (2) to investigate whether TMAO is a potential biomarker that might be useful in the prediction of PTSD and the PTSD symptom subclusters re-experiencing, avoidance and hyperarousal, and (3) to investigate whether TMAO varies immediately after AMI in patients with/without depression 6 months after AMI. Method: A total of 114 AMI patients were assessed with the Hamilton-Depression Scale after admission to the hospital and 6 months later. The Clinician Administered PTSD Scale for DSM-5 was used to explore PTSD-symptoms at the time of AMI and 6 months after AMI. To assess patients’ TMAO status, serum samples were collected at hospitalization and 6 months after AMI. Results: Participants with PTSD-symptomatology had significantly higher TMAO levels immediately after AMI than patients without PTSD-symptoms (ANCOVA: TMAO(PTSD x time), F = 4.544, df = 1, p = 0.035). With the inclusion of additional clinical predictors in a hierarchical logistic regression model, TMAO became a significant predictor of PTSD-symptomatology. No significant differences in TMAO levels immediately after AMI were detected between individuals with/without depression 6 months after AMI. Conclusions: An elevated TMAO level immediately after AMI might reflect severe stress in PTSD-vulnerable patients, which might also lead to a short-term increase in gut permeability to trimethylamine, the precursor of TMAO. Thus, an elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD., HIGHLIGHTS An elevated TMAO level might be a biological correlate for severe stress that is associated with vulnerability to PTSD.
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- 2021
45. Histamine Intolerance Originates in the Gut
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Dietmar Enko and Wolfgang J. Schnedl
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0301 basic medicine ,medicine.medical_specialty ,food malabsorption ,diamine oxidase ,lcsh:TX341-641 ,biogenic amines ,Review ,Gastroenterology ,Histamine intolerance ,Diagnosis, Differential ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Intestinal Mucosa ,food intolerance ,Anamnesis ,Nutrition and Dietetics ,business.industry ,medicine.disease ,histamine ,gastrointestinal ,Food intolerance ,030104 developmental biology ,chemistry ,Gastrointestinal disorder ,Clinical diagnosis ,Dietary Supplements ,030211 gastroenterology & hepatology ,FUNCTIONAL GASTROINTESTINAL COMPLAINTS ,Amine Oxidase (Copper-Containing) ,Diamine oxidase ,business ,lcsh:Nutrition. Foods and food supply ,Histamine ,Food Science - Abstract
Histamine intolerance (HIT) is assumed to be due to a deficiency of the gastrointestinal (GI) enzyme diamine oxidase (DAO) and, therefore, the food component histamine not being degraded and/or absorbed properly within the GI tract. Involvement of the GI mucosa in various disorders and diseases, several with unknown origin, and the effects of some medications seem to reduce gastrointestinal DAO activity. HIT causes variable, functional, nonspecific, non-allergic GI and extra-intestinal complaints. Usually, evaluation for HIT is not included in differential diagnoses of patients with unexplained, functional GI complaints or in the here-listed disorders and diseases. The clinical diagnosis of HIT is challenging, and the thorough anamnesis of all HIT-linked complaints, using a standardized questionnaire, is the mainstay of HIT diagnosis. So far, DAO values in serum have not been established to correlate with DAO activity in the gut, but the diagnosis of HIT may be supported with determination of a low serum DAO value. A targeted dietary intervention, consisting of a histamine-reduced diet and/or supplementation with oral DAO capsules, is helpful to reduce HIT-related symptoms. This manuscript will present why histamine should also be taken into account in the differential diagnoses of patients with various diseases and disorders of unknown origin, but with association to functional gastrointestinal complaints. In this review, we discuss currently increasing evidence that HIT is primarily a gastrointestinal disorder and that it originates in the gut.
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- 2021
46. Stability of SARS-CoV-2 RNA in FTA card spot-prep samples derived from nasopharyngeal swabs
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Dietmar Enko, Peter Panhofer, Gernot Kriegshäuser, Luftar Reçi, and Christina Maria Leb
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Diagnostic Tests, Routine ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Biochemistry (medical) ,Clinical Biochemistry ,RNA ,COVID-19 ,General Medicine ,Virology ,Specimen Handling ,Nasopharynx ,Medicine ,Humans ,RNA, Viral ,business - Published
- 2021
47. Aggressive NK-cell leukemia with hemophagocytosis in a Caucasian patient
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Simon Michaelis, Dietmar Enko, Christoph Tinchon, Ingeborg Stelzer, Angelika Pichler, and Laurenz Schöffmann
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Oncology ,medicine.medical_specialty ,Text mining ,Hematology ,business.industry ,Aggressive NK-cell leukemia ,Internal medicine ,medicine ,General Medicine ,Hemophagocytosis ,business ,medicine.disease - Published
- 2021
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48. The blood-cerebrospinal fluid barrier, an important regulator of vitamin D metabolite concentrations in the central nervous system
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Zelzer, Sieglinde, primary, Andreas, Meinitzer, additional, Markus, Herrmann, additional, Walter, Goessler, additional, and Dietmar, Enko, additional
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- 2021
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49. Increasing Expiratory Hydrogen in Lactose Intolerance Is Associated with Additional Food Intolerance/Malabsorption
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Sonja Lackner, Harald Mangge, Nathalie Meier-Allard, Dietmar Enko, Sandra Holasek, and Wolfgang J. Schnedl
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Adult ,Male ,medicine.medical_specialty ,Malabsorption ,diamine oxidase ,Adolescent ,Gastrointestinal Diseases ,Fructose malabsorption ,lcsh:TX341-641 ,Fructose ,Histamine intolerance ,Gastroenterology ,Food Intolerance ,Article ,fructose malabsorption ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Breath test ,Aged, 80 and over ,Lactose intolerance ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Significant difference ,Middle Aged ,medicine.disease ,Diet ,Food intolerance ,lactose intolerance ,Breath Tests ,Exhalation ,030211 gastroenterology & hepatology ,Female ,histamine intolerance ,Amine Oxidase (Copper-Containing) ,business ,Hydrogen breath test ,lcsh:Nutrition. Foods and food supply ,Food Science ,Histamine ,Hydrogen ,hydrogen breath test - Abstract
Single and/or combined food intolerance/malabsorption may cause nonspecific, functional gastrointestinal (GI) complaints. In lactose-intolerant patients we evaluated the influence of additional food intolerance/malabsorption with hydrogen (H2) breath tests. In a retrospective analysis of charts from 279 lactose-intolerant patients, we found 128 patients with only lactose intolerance (LIT). Then, we identified 106 LIT patients with additional histamine intolerance (HIT). Additionally, 45 LIT and HIT patients also had fructose malabsorption (FM). A hydrogen (H2) breath test was performed to evaluate LIT and FM. A serum diamine oxidase value of <, 10 U/mL and a response to a histamine-reduced diet was used to identify HIT. Using pairwise comparison with the Kruskal&ndash, Wallis test to associate the area under the curve (AUC) of LIT patients and, LIT with HIT, to LIT with HIT and FM it was found, that the exhaled hydrogen values were significantly higher in patients with two-fold and triple combined food intolerance/malabsorption (p <, 0.004 and p <, 0.001, respectively). Within the pool of 170 LIT patients with >, 20 ppm increase of expiratory H2 from baseline, there were 74 LIT-only patients, 60 LIT with HIT patients, and 36 LIT patients with additional HIT and FM. With the Kruskal&ndash, Wallis test AUCs demonstrated a significant difference between all three groups (p = 0.024). In patients with LIT, the presence of additional food intolerance/malabsorption, significantly increases expiratory H2 values. We demonstrate evidence, which may suggest HIT to embody an own GI disorder as food intolerance/malabsorption.
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- 2020
50. Comparison of the reliability of Gram-negative and Gram-positive flags of the Sysmex UF-5000 with manual Gram stain and urine culture results
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Markus Herrmann, Martin Tötsch, Dietmar Enko, Michael Böckl, Andreas Meinitzer, Michael Gehrer, Wolfgang J. Schnedl, and Ingeborg Stelzer
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030213 general clinical medicine ,medicine.medical_specialty ,Urinalysis ,Urinary system ,Clinical Biochemistry ,Youden's J statistic ,Bacteriuria ,Urine ,030204 cardiovascular system & hematology ,Gastroenterology ,Sensitivity and Specificity ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Internal medicine ,Medicine ,Humans ,Gram ,medicine.diagnostic_test ,Bacteria ,business.industry ,Biochemistry (medical) ,Reproducibility of Results ,General Medicine ,Gold standard (test) ,medicine.disease ,Flow Cytometry ,Gram staining ,Urinary Tract Infections ,business ,Emblems and Insignia - Abstract
Objectives Recently, the fully automated flow cytometry-based UF-5000 (Sysmex Corboration, Kobe, Japan) urine sediment analyzer was developed providing bacteria (BACT) info flags for more accurate bacterial discrimination of urinary tract infections (UTIs). This study aimed to compare the reliability of the UF-5000 BACT-info flags with manual Gram stain and urine culture as the gold standard method. Methods A total of 344 urine samples were analyzed on the UF-5000 and compared with manual microscopic Gram stain and urine cultures. Agreement was assessed by Cohen’s kappa (κ) analysis. The Youden index was used to determine the optimal BACT and white blood cell (WBC) cut-off points for discriminating positive and negative urine cultures. Results Overall 98/344 (28.5%) samples were urine culture positive at a cut-off of ≥105 CFU/mL. “Gram-negative?” UF-5000 BACT-Info flags showed a better concordance of 25/40 (62.5%) with urine culture compared to Gram stain with 30/50 (60%). The results for UF-5000 discrimination of Gram-positive and Gram-negative microorganisms demonstrated a substantial (κ = 0.78) and fair (κ = 0.40) agreement with urine culture. Optimal cut-off points detecting positive urine cultures were 135 BACT/µL (sensitivity [SE]: 92.1%, specificity [SP]: 85.4%, positive predictive value [PPV]: 71%, negative predictive value [NPV]: 96%) and 23 WBC/µL (SE: 73.5%, SP: 84.1%, PPV: 65%, NPV: 89%). Conclusions The UF-5000 analyzer (Sysmex) is a reliable diagnostic tool for UTI screening. The displayed BACT-Info flags allow a quick diagnostic orientation for the clinician. However, the authors suggest verifying the automated Gram categories with urine culture.
- Published
- 2020
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