Article on Repeated Mild Food Poisoning and Colitis

[Rosie]

I just saw the following article in Science Daily about a study just published in Science, one of the most prestigious journals. It is very interesting.

https://www.sciencedaily.com/releases/2 ... 143041.htm

Repeated mild food poisoning triggers chronic disease

Small bacterial infections that may go unnoticed and which the body easily clears without treatment, such as occurs during mild food poisoning, nevertheless can start a chain of events that leads to chronic inflammation and potentially life-threatening colitis. These new findings may also help identify the long-mysterious origins of inflammatory bowel disease (IBD).
The disease mechanism was linked to an acquired deficiency of intestinal alkaline phosphatase (IAP), an enzyme produced in the duodenum of the small intestine. Salmonella infection elevated neuraminidase activity in the small intestine, which in turn accelerated the molecular aging and turnover of IAP, resulting in IAP deficiency in the colon. IAP is important because its job is to remove phosphates from molecules such as the pro-inflammatory lipopolysaccharide (LPS) -- which is produced by various resident bacteria in the colon -- thereby transforming LPS from a toxic to nontoxic state.

This may help explain why MC tends to be most common in older people, as time is needed to build up enough mild infections to trigger it.

Rosie

[tex]

Very Interesting.

Thanks for posting this. I think it fits my situation prior to the onset of chronic symptoms.

Tex

[TM]

Rosie,
Thank you so much for posting this article. I’ve had a number of suspected food poisoning issues—the worst in 1982 required an IV and overnight hospitalization. At least 2 other times were confirmed by others who’d eaten the same items, and there have been others.

In addition to reinforcing my intuition about the timeline and development of my MC, it also seems to have answered a question I’ve been posing to every practitioner I’ve encountered for decades, namely: What’s the reason for my chronically LOW ALP levels? The answer’s always been the same: No need to worry about ALP unless its elevated.

Just in the past year I’ve started to see a number of articles/studies about low ALP, even suggesting supplemental ALP as a treatment for IBD. (I can provide links if anyone’s interested). I’d been planning to try to pursue this avenue with my doctor, but put it on the back burner (again) when histamine issues took precedence.

I could hardly believe the article, since it indicated a clear causal relationship and answered questions that have plagued me for years!!

Thanks!!!

[Rosie]

Wow, Terri, that is a fascinating observation about your situation! The article was talking about potential therapies, as neuraminidase inhibitors are been identified. Whether this treatment could "cure" MC and the accompanying food sensitivities after it has been triggered isn't known, but we can always hope.........

Rosie

[TM]

Here are links to some of the articles I’ve come across regarding chronically low ALP levels (serum alkaline phosphatase ≤30 IU/L) and digestive issues. I’ve also seen studies linking low ALP to other issues I’ve experienced including chondrocalcinosis, other types of arthritis and CPPD (pseudogout—like gout but involving calcium rather than uric acid crystals).

Does anyone else have low ALP? Normal range varies by lab from <30 IU/L to <40 IU/L. Mine generally ranges from the teens to the low 30’s. Based on these studies its seems like low ALP would be pretty common.

https://www.ncbi.nlm.nih.gov/pubmed/25400448
World J Gastroenterol. 2014 Nov 14;20(42):15650-6. doi: 10.3748/wjg.v20.i42.15650.
"Interplay between intestinal alkaline phosphatase, diet, gut microbes and immunity."
Estaki M1, DeCoffe D1, Gibson DL1.

https://www.ncbi.nlm.nih.gov/pubmed/19885903
Inflamm Bowel Dis. 2010 Jul;16(7):1180-6. doi: 10.1002/ibd.21161.
"Exogenous alkaline phosphatase for the treatment of patients with moderate to severe ulcerative colitis."
Lukas M1, Drastich P, Konecny M, Gionchetti P, Urban O, Cantoni F, Bortlik M, Duricova D, Bulitta M…………………………..
……….CONCLUSIONS:In this uncontrolled trial, administration of exogenous AP enzyme daily over a 7-day course to patients with UC was associated with short-term improvement in disease activity scores, with clinical effects being observed within 21 days and associated with reductions in C-reactive protein and stool calprotectin. AP enzyme treatment was well tolerated and nonimmunogenic.


tps://www.ncbi.nlm.nih.gov/pubmed/26844282
EBioMedicine. 2015 Dec 1;2(12):2016-23. doi: 10.1016/j.ebiom.2015.11.027. eCollection 2015.
A High Level of Intestinal Alkaline Phosphatase Is Protective Against Type 2 Diabetes Mellitus Irrespective of Obesity.
Malo MS1.

https://www.ncbi.nlm.nih.gov/pubmed/27083970
J Surg Res. 2016 May 1;202(1):225-34. doi: 10.1016/j.jss.2015.12.008. Epub 2015 Dec 17.
Intestinal alkaline phosphatase: a summary of its role in clinical disease.
Fawley J1, Gourlay DM2.
Author information
Abstract
Over the past few years, there is increasing evidence implicating a novel role for Intestinal Alkaline Phosphatase (IAP) in mitigating inflammatory mediated disorders. IAP is an endogenous protein expressed by the intestinal epithelium that is believed to play a vital role in maintaining gut homeostasis. Loss of IAP expression or function is associated with increased intestinal inflammation, dysbiosis, bacterial translocation and subsequently systemic inflammation. As these events are a cornerstone of the pathophysiology of many diseases relevant to surgeons, we sought to review recent research in both animal and humans on IAP's physiologic function, mechanisms of action and current research in specific surgical diseases.
Copyright © 2016 Elsevier Inc. All rights reserved.

Nutr Rev. 2014 Feb;72(2):82-94. doi: 10.1111/nure.12082. Epub 2013 Dec 9.
Intestinal alkaline phosphatase: novel functions and protective effects.
Lallès JP1.

Life Sci. 2014 Apr 1;100(2):118-24. doi: 10.1016/j.lfs.2014.02.003. Epub 2014 Feb 16.
The effect of intestinal alkaline phosphatase on intestinal epithelial cells, macrophages and chronic colitis in mice.
Lee C1, Chun J2, Hwang SW2, Kang SJ1, Im JP2, Kim JS3.
KEY FINDINGS:
IAP significantly inhibited LPS-induced inflammatory cytokine production in both IECs and peritoneal macrophages. IAP also attenuated LPS-induced NF-κB binding activity and IκBα phosphorylation/degradation in IECs. Oral administration of IAP significantly reduced the severity of colitis and down-regulated colitis-induced IκBα phosphorylation in IL-10(-/-) mice.
SIGNIFICANCE:
IAP may inhibit the activation of intestinal epithelial cells and peritoneal macrophages, and may attenuate chronic murine colitis. This finding suggests that IAP supplementation is a potential therapeutic option for inflammatory bowel disease.

http://search.proquest.com/openview/810 ... bl=2041069
Role of alkaline phosphatase in colitis in man and rats
A Tuin,1 K Poelstra,1 A de Jager-Krikken,1 L Bok,2 W Raaben,3 M P Velders,3 G Dijkstra2
Centre Groningen, The Netherlands; 3 AM-Pharma, Bunnik, The Netherlands
Revised 11 September 2008 Accepted 12 September 2008 Published Online First
13 October 2008

[Lilja]

Happy New Year, everybody!

This is hard to understand, at least for me...

"CONCLUSIONS:
In this uncontrolled trial, administration of exogenous AP enzyme daily over a 7-day course to patients with UC was associated with short-term improvement in disease activity scores, with clinical effects being observed within 21 days and associated with reductions in C-reactive protein and stool calprotectin. AP enzyme treatment was well tolerated and nonimmunogenic."

What kind of enzyme is "exogenous AP enzyme"? Would it hurt to try it? And, is it an over the counter product?

Lilja

[tex]

Hi Lilja,

AP stands for alkaline phosphatase. It's a common liver enzyme that's listed on all your comprehensive metabolic panel test results.

Here's what the Livestrong website says about treating low AP:

How to Treat Low Alkaline Phosphatase

Here's what the Mayo Clinic says about it (this is about genetic issues, and it's written for medical professionals):

Hypophosphatasia

There are alkaline phosphatase supplements available (you can probably get them on Amazon), but I have no idea how well they might work. Why on earth would you want to experiment with something like this? I thought you were in remission. My AP has been in the normal range for many years. I can't find a record where they even bothered to test for it when I was reacting. The first record I can find was from about 5 years after my symptoms began, but this was a year after I was already in remission, and my AP level was normal. It has remained normal ever since. For all I know it might have been normal when I was reacting.

Tex

[Lilja]

Thank you, Tex!
I have been in remission for quite some time, but I must have eaten something stupid during Christmas, and has been on the potty since. I will wait and see if it passes on its own.

Lilja

[tex]

I'm sorry that happened. Many of us have trouble during or after the Holidays. And the flu is spreading fast in my area.

Tex