Manganese and Parenteral Nutrition

Aschner, Judy L.; Maitre, Nathalie L.

doi:10.1039/9781782622383-00403

Cited by 4 publications

(4 citation statements)

References 109 publications

(125 reference statements)

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“…Clinically manifest signs of manganism have also been reported after parenteral exposure to manganese. For example, features of parkinsonism were observed in patients receiving long‐term parenteral nutrition supplemented with manganese . Similar neurological symptoms were observed in subjects consuming self‐made ephedrone, an injectable drug commonly contaminated with manganese due to the production with potassium permanganate …”

Section: Possible Health Effectsmentioning

confidence: 70%

“…Elevated manganese levels in the body, for example, in brain, hair, and blood were generally observed in the above mentioned subgroups that were exposed via inhalation or parenterally …”

Section: Possible Health Effectsmentioning

confidence: 94%

“…The primary advantage of using manganese brain levels as a biomarker is the detection of manganese in the suspected target tissue. Elevated manganese levels in brain regions have been observed after recent inhalation exposure in occupational settings, in patients suffering from cholestatic liver disease and as a consequence of recent parenteral exposure to manganese, for example, after prolonged total parenteral nutrition with manganese‐enriched nutrition solutions . Manganese levels in whole blood, but not in plasma or urine, were generally correlated with manganese levels in the globus pallidus.…”

Section: Manganese In the Human Bodymentioning

confidence: 99%

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Dietary Manganese Exposure in the Adult Population in Germany—What Does it Mean in Relation to Health Risks?

Sachse

Kolbaum

Ziegenhagen

et al. 2019

Molecular Nutrition Food Res

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Manganese is both an essential nutrient and a potential neurotoxicant. Therefore, the question arises whether the dietary manganese intake in the German population is on the low or high side. Results from a pilot total diet study in Germany presented here reveal that the average dietary manganese intake in the general population in Germany aged 14–80 years is about 2.8 mg day−1 for a person of 70 kg body weight. This exposure level is within the intake range of 2–5 mg per person and day as recommended by the societies for nutrition in Germany, Austria, and Switzerland. No information on the dietary exposure of children in Germany can be provided so far. Although reliable information on health effects related to oral manganese exposure is limited, there is no indication from the literature that these dietary intake levels are associated with adverse health effects either by manganese deficiency or excess. However, there is limited evidence that manganese taken up as a highly bioavailable bolus, for example, uptake via drinking water or food supplements, could pose a potential risk to human health—particularly in certain subpopulations—when certain intake amounts, which are currently not well defined, are exceeded.

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Section: Possible Health Effectsmentioning

confidence: 70%

“…Elevated manganese levels in the body, for example, in brain, hair, and blood were generally observed in the above mentioned subgroups that were exposed via inhalation or parenterally …”

Section: Possible Health Effectsmentioning

confidence: 94%

Section: Manganese In the Human Bodymentioning

confidence: 99%

See 1 more Smart Citation

Dietary Manganese Exposure in the Adult Population in Germany—What Does it Mean in Relation to Health Risks?

Sachse

Kolbaum

Ziegenhagen

et al. 2019

Molecular Nutrition Food Res

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“… 125 Chronic exposure to Mn can lead to accumulated stores in the body, which may release Mn into the blood circulation, opening up the possibility that blood Mn may also act as a measure of more long-term exposure. 126 …”

Section: Discussionmentioning

confidence: 99%

Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants

McBride,

Bhattacharya,

Sucharew

et al. 2024

Environ Health Perspect

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Background: Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance. Objectives: This study investigated the associations between childhood and adolescent Mn biomarkers and adolescent postural balance in participants from the longitudinal Marietta Communities Actively Researching Exposures Study (CARES) cohort. Methods: Participants were recruited into CARES when they were 7–9 y old, and reenrolled at 13–18 years of age. At both time points, participants provided samples of blood, hair, and toenails that were analyzed for blood Mn and lead (Pb), serum cotinine, hair Mn, and toenail Mn. In adolescence, participants completed a postural balance assessment. Greater sway indicates postural instability (harmful effect), whereas lesser sway indicates postural stability (beneficial effect). Multivariable linear regression models were conducted to investigate the associations between childhood and adolescent Mn biomarkers and adolescent postural balance adjusted for age, sex, height–weight ratio, parent/caregiver intelligence quotient, socioeconomic status, blood Pb, and serum cotinine. Results: CARES participants who completed the adolescent postural balance assessment ( ) were 98% White and 54% female and had a mean age of 16 y (range: 13–18 y). In both childhood and adolescence, higher Mn biomarker concentrations were significantly associated with greater adolescent sway measures. Supplemental analyses revealed sex-specific associations; higher childhood Mn biomarker concentrations were significantly associated with greater sway in females compared with males. Discussion: This study found childhood and adolescent Mn biomarkers were associated with subclinical neuromotor effects in adolescence. This study demonstrates postural balance as a sensitive measure to assess the association between Mn biomarkers and neuromotor function. https://doi.org/10.1289/EHP13381

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Use of Total Parenteral Nutrition (TPN) as a Vehicle for Drug Delivery

Bakrey,

Shivgotra,

Abdu

et al. 2024

CDT

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Total Parenteral Nutrition (TPN) is a method of providing nutrients directly into the bloodstream for individuals who are unable to meet their nutritional needs through the normal digestive process or gastrointestinal system. It provides macronutrients and micronutrients in a single container, reducing handling and contamination risks and making it more cost-effective. TPN has the potential to be used as a drug delivery system, with applications in combination therapies, personalized medicine, and integrating advanced technologies. It can enhance drug dosage precision and provide nutritional assistance, potentially reducing hospitalization and improving patient outcomes. However, implementing new applications requires thorough testing and regulatory approval. TPN could be particularly useful in pediatric and geriatric care and could also contribute to global health by combating malnutrition in areas with limited medical resources. Healthcare professionals prepare a sterile solution tailored to each patient's nutritional needs, and administration involves a central venous catheter. However, the simultaneous administration of medications with PN admixtures can result in pharmacological incompatibility, which can impact the stability of the oil-in-water system. The European Society for Clinical Nutrition and Metabolism and the American Society for Parenteral and Enteral Nutrition recommendations advise against including non-nutrient drugs in PN admixtures due to safety concerns. This review focuses on the utilization of Total Parenteral Nutrition (TPN) as a method for delivering drugs. It discusses the benefits and difficulties associated with its commercial application and offers suggestions for future research endeavors.

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Manganese and Parenteral Nutrition

Cited by 4 publications

References 109 publications

Dietary Manganese Exposure in the Adult Population in Germany—What Does it Mean in Relation to Health Risks?

Dietary Manganese Exposure in the Adult Population in Germany—What Does it Mean in Relation to Health Risks?

Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants

Use of Total Parenteral Nutrition (TPN) as a Vehicle for Drug Delivery

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