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77 Cards in this Set
- Front
- Back
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What is include in the 1st line of defence |
Skin, GIT, Lungs |
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What is included in the 2nd line of defence |
Gut barrier, microbiota, Gut associated lymphoid tissue (GALT) |
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List some roles of the Gut Microbiota |
Promote vitamin Synthesis prevent pathogenic bacteria colonisation Promate SCFA synthesis Metabolise carcinogenic substances |
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How much blood does the liver detoxify every minute |
2L |
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What percentage of bacteria and toxins is cleared from the blood in the first pass of the liver |
99% |
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What are the main pathways for the broken down compounds generated by the liver excreted by |
Urine and Bile (faeces) |
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How much bile does the liver produce each day |
1L |
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what does bile serve as a carrier for |
toxic substances |
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what is excess bile absorbed by to be excreted |
fibre |
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Describe phase 1 of liver detoxification |
breaks down toxins and chemicals into metabolites. The intermediated metabolites can be more easily cleared via the phase two detox system |
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describe the phase two detoxification system |
involves conjugation of intermediate metabolites with a variety of different enzymes. The conjugation reaction either neutralises the intermediate metabolite making it more soluble or facilities elimination through bile |
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List the 6 phase II pathways |
Glutathione conjugation Amino Acid conjugation Methylation Acetylation Glucuronidation |
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Why is supporting phase one detoxification important |
to ensure all absorbed chemicals are processed adequately and are not allowed to excessively flood through the body |
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How many enzymes make up cytochrome P450 |
50-100 - each detoxifying a certain chemical |
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What does Cytochrome P450 do to toxins |
chemically transforms them into a water soluble form for excretion via kidneys or into a more chemically active form to be metabolised by Phase II |
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List 3 things P450 enyzmes are influenced by |
Genetics Toxic Exposure |
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List the Enzymes, Co-factors and Nutrients required for Phase I |
B2,B3,B6, Folate, B12, Glutathione, BCAA's (Glycine, Leucine, Isoleucine, Valine) |
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What free radical does Phase I produce |
Superoxide |
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List the Inducers (overactivity) for phase I |
Caffeine Nicotine Alcohol Paint Fumes Exhaust Fumes |
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List the Inhibitors for Phase I |
Vitamin & mineral deficiencies Gut endotoxins |
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List the nutrients utilized during phase one detoxification (regulates/activates) |
Cu, Mg, Zn, Vit C (Ascorbate), B1, B2, B3, B6 (pyridoxine), glutathione, bioflavonoids, folic acid & B12, Fe, BCAA's, Caraway, dill seeds, oranges and tangerines (limonene), Brassicas, High Protein diet
Bold = primary |
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List the nutrients utilized during phase one detoxification (lowers phase I) |
Grapefruit - Naringenin Red Chilli - Capsaicin Clove Oil - Eugenol Calendula officinalis
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what is the association between the balance of Phase I and Phase II |
The phases must be in balance so that the intermediates can be conjugated by phase II |
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Under active phase I can manifest itself as intolerance to what |
Caffeine |
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How do drugs interact with the cytochrome P450 system |
by inhibition or induction |
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What are the most important enzymes in terms of interactions |
CYP1A2, CYP2D6, CYP3A4 |
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How does supporting phase II detoxification affect the body |
greater protection of cells and tissues against intermediate metabolites, endogenous carcinogenic intermediates and ROS. |
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Define the Sulphation pathway |
Sulphation is the process by which intermediate metabolites from the compounds contained below are conjugated with sulphur containing compounds |
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Name 2 Drugs and 2 Endogenous compounds that are metabolised by the sulphation pathway |
Drug - Acetaminophen, Methyl Dopa Endogenous - Estrogen, Cortisol |
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List the Primary Nutrients for Sulphation |
B6 (Pyridoxine) Molybdenum |
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Define Glucuronidation |
Glucuronic acid conjugation |
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List 2 Drugs and 2 Endogenous compounds metabolised by glucuronidation |
Drug - Salicylates, Morphine |
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List the Nutrient cofactor for glucuronidation |
Glucuronic Acid |
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Define Glutathione Conjugation |
Glutathione conjugation is the primary phase II pathway |
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List 2 Drugs and 2 endogenous compounds metabolised by glutathione conjugation |
Drug - Penicillin, Tetracycline |
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List the nutrient cofactors for glutathione conjugation |
Glutathione Cysteine Glutamine Methionine B2 Vitamin C Selenium Zinc |
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Define Acetylation |
Acetylation requires the conjugation of a specific intermediate metabolite with Acetyl CoA |
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List 2 Drugs and 2 Endogenous compounds metabolised by Acetylation |
Drug - Clonazepam (Rivotril), Dapsone |
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List the nutrient cofactors for Acetylation |
B1, B2, B3,B5, Lipoic Acid, Vitamin C |
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Define Amino Acid Conjugation |
Several Amino Acids are involved within the conjugation of the following intermediate metabolites. The amino acids include glycine (most important), taurine, glutamine, arginine and ornithine |
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List 2 drugs and 2 endogenous compounds metabolised by amino acid conjugation |
Drugs - Salicylates (glycine), Propionic Acid (Taurine) Endogenous - Bile Acids, Cinnamics Acids |
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list the nutrient cofactors for Amino Acid Conjugation |
Glycine, Taurine, Glutamine, Arginine, Ornithine |
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Define methylation |
methylation is a naturally occurring metabolic process where intermediate metabolites are conjugated with methyl groups |
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List 2 drug and 2 endogenous compounds metabolised by methylation |
Drug - Thiouracil, Isoetharine Endogenous - Dopamine, Epinephrine |
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List the nutrient cofactors for methylation |
SAMe Methionine Choline B12 Folic Acid Dimethyl - glycine (DMG) Trimethyl - glycine (TMG) |
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List the inducers of Phase II |
Cigarette smoking
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List the inhibitors of Phase II |
Low protein diet Tartrazine (yellow food dye) Aspirin |
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Primary Induces of Phase II |
Glutathione Conjugation: Brassicas, Limonene Amino Acid conjugation: Glycine Acetylation: B5 supports pathway Glucuronidation: Fish oils, smoking, OCP, Phenobarbital, Limonene |
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Primary Inhibitors of Phase II |
Glutathione conjugation: Selenium, B2, glutathione and zinc deficiencies Amino Acid conjugation: Low protein diet Methylation: Folate or B12 deficiency Sulphation: NSAID's, Tartrazine, Molybdenum deficiency Acetylation: B2, B5 or C deficiency Glucoronidation: Aspirin, probenecid |
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Primary nutrients of r Phase II detox |
Amino Acids - Arginine, Cysteine, glutamine, glycine, methionine, taurine, orthinine
Vitamins- Ascorbate, Thiamin, Riboflavin, Niacin, Pantothenic Acid, Pyridoxine, Alpha-lipoic acid, Foalte, B12, betaine and choline
minerals and other nutrients Mg, Mb, S-adenosyl-methionine (SAMe), glucuronic acid, N-acetyl Cysteine (NAC) |
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What is methylation required for |
Neurotransmitter Synthesis DNA repair |
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What is the carrier of methyl groups in the body |
S-adenosyl methionine |
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Define Homocysteine |
an amino acid not used in protein synthesis, but instead arises during metabolism of the amino acid methionine. Homocysteine is likely toxin to many cells, such as those lining blood vessels. |
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What condition is a genetic error where metabolism in which cystathione sunthetase is deficient and results in accumulation of homocysteine |
homocysteinuria |
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Elevated homocysteine is associated with risk of what |
Cardiovascular disease venous thrombosis cerebrovascular disease kidney stones osteoporosis Alzheimer's disease dementia depression multiple sclerosis mental retardation psoriasis high cholesterol - initiates oxidation of LDL's |
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What lifestyle and metabolic factors are associated with hyper-homocysteinaemia |
Folate, B6. B12 deficiency methionine metabolism smoking coffee consumption aging process diabetes mellitus (type 2) low thyroid function drugs (methotrexate, nitrous oxide, azaribine) |
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Substances that help decrease homocysteine levels |
B12, Folate, B6 |
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The conversion of what is difficult for alcoholics resulting in a raised brain concentration of acetaldehyde |
acetaldehyde -> acetate |
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Alcohol dehydrogenase is dependant on what |
B3 and Zinc |
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Aldehyde dehydrogenase is dependent on what |
B3 |
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What enzyme is inhibited by alcohol |
delta-6-desaturase |
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What does delta-6-desaturase do |
allows conversion of linoleic acid to gamma linolenic acid |
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What has been shown to be beneficial for alcohol withdrawal |
PGE1 |
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Alcohol affects the small intestines what can occur as a result of this |
Bacterial dysbiosis Malnutritoon Allergy Irritable bowl Autoimmune disease Hepatic stress inflammatory process |
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What effect do these endotoxins have on the immune system |
Increase in inflammatory cytokines IL1, IL6, TNFalpha, hepatic dysfunction - deconjugating molecules and hormonal disturbances |
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What nutrients are used for management of alcohol detoxification |
B1, B3, B Complex, Choline, A, C, E, Mg, Phosphorus, Se, Zinc, Carnitine, Glutamine, Taurine, Tryptophan, Glutathione, EPA |
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Alcohol addication is thought to be associated with what |
morphine like substance that arises from acetaldehyde and dopamine production within the brain |
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What nutrient can help metabolise alcohol and acetaldehyde |
B3 |
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What amino acid is used for relieving alcohol detoxification |
Glutamine |
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What substance is used to maintain the brains endogenous supply of opiate substances |
Phenylalanine |
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Why is Carnitine important in biochemical considerations of alcohol detox |
it reverses alcohol induced fatty livers |
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List the causes of cirrhosis |
heavy alcohol use some drugs, medicines, harmful chemicals Infections chronic hepatitis B, C, D autoimmune hepatitis Non-alcoholic fatty liver disease (often from obesity) diseases that damage or destroy bile ducts |
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Nutritional management of liver disease |
maintain/improve nutritional status prevent further damage Prevent or alleviate hepatic encephalopathy and other metabolic disturbances amenable to nutritional treatment Alkalise the body to reduce acidity cause by alcohol consumption |
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Liver disease and cirrhosis are associated with depletion of what |
endogenous glutathione |
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What substance is shown to be beneficial for non alcoholic fatty liver disease |
N-Acetylcysteine and |
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What substances was shown beneficial for non-alcoholic steatohepatitis |
L-Carnitine |
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Nutritional management of Liver disease (12) |
1. 5-6 small meals per day (high complex carbs, low in total fat, moderate in protein) Minimise consumption of refined carbs 2. reduce exposure to drugs, alcohol and steroidal substances 3. Improve bowel digestion (digestive enzymes and high fibre) 4. increase intake of lipotropic nutrients (methionine, choline, inositol, TMG, B12, B6, Folate) 5. Normalise mineral status (Zn, Mg, Mn, Se, Chromium) 6. Increase intake of EFAs (important for normalising liver haemodynamics) 7. Avoid exposure to toxic compounds 8. Apple Cider Vinegar (1 tsp in water) with every meal should be taken to improve gastric digestion 9. Avoid foods that may cause food sensitivity 10.. Increase intake of BCAA's valine, isoleucine and leucine 11. Vitamin B6 intake must be 100mg per day as it is deactivated by the liver dephosphatase enzymes 12. Lipoic acid supplementation improves liver regeneration after toxic damage 1 |
