Population Baseline of Meconium Fatty Acid Ethyl Esters Among Infants of Nondrinking Women in Jerusalem and Toronto

Chan, Daphne; Bar‐Oz, Benjamin; Pellerin, Brigitte; Paciorek, C. J.; Klein, Julia; Kapur, Bhushan; Farine, Dan; Koren, Gideon

doi:10.1097/00007691-200306000-00004

Cited by 122 publications

(132 citation statements)

References 21 publications

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“…In addition, chronic alcohol exposure induces overexpression of FAEE synthase-related genes in the pancreas and liver [152]. Thus, given the evidence that FAEEs are synthesized by individuals not exposed to exogenous ethanol [103,104] and that NAFLD/NAFPD subjects are exposed to high concentrations of EE [26-32, [65][66][67][68], it is unsurprising that FAEEs play a causative role in NAFPD pathogenesis. It is worth mentioning that the pharmacologic blockage of the hydrolysis of FAEEs to free fatty acids prevents pancreatic necrosis [153].…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, it is known that healthy subjects not exposed to exogenous ethanol have endogenous trace of FAEEs in body fluids [103,104]. As the two substrates required for FAEEs biosynthesis, ethanol [68][77] [105] and free fatty acids [13, [106][107][108][109], are significantly elevated in NASH/NAFPD body fluids, it is quite possible they are formed in toxic amounts in the pancreas and oro-gastrointestinal tract.…”

Section: Endogenous Production Of Fatty Acid Ethyl Esters (Faee)mentioning

confidence: 99%

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Nonalcoholic fatty pancreas disease as an endogenous alcoholic fatty pancreas disease

Medeiros¹,

Lima²

2016

Gastroenterol Hepatol Endosc

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Nonalcoholic fatty pancreas disease (NAFPD) is closely linked to nonalcoholic steatohepatitis (NASH), suggesting that the two conditions share a common etiopathogenetic background. In Addition, growing evidence indicates that endogenous ethanol (EE) plays a fundamental role in NASH pathogenesis. Accordingly, it is intuitively appealing to assume that EE plays also a causative role in NAFPD development. This connection is further supported by the finding that NAFPD shares with alcoholic fatty pancreas disease (AFPD) similar metabolic signaling pathways and histopathological features. However, low blood alcohol concentrations (BAC) along with the alleged inability of gut microbiota to produce toxic amounts of ethanol are the main obstacles to validate the idea of an endogenous alcoholic fatty pancreas disease (EAFPD). Here, we provide a mechanistic explanation reconciling the EAFPD hypothesis with these apparently conflicting observations. The key conclusions of our investigation are as follows. First, ethanol is a prodrug, implicating that under extensive presystemic metabolism BACs can be low and/ or absent. Second, oro-gastrointestinal microbiota may produce higher amounts of ethanol than those required to cause AFPD. Last, livers of NASH/NAFPD individuals overexpress all genes encoding alcohol-metabolizing enzymes identically to livers of patients with alcoholic hepatitis. Even more importantly, the upregulation of these genes is higher in the early steatotic stage of nonalcoholic fatty liver disease than in alcoholic hepatitis. This suggests a greater exposure of the liver, and by extension, of the pancreas, to ethanol in the former than in the latter condition. In summary, this paper provides a mechanistic framework for how NAFPD indeed may be an EAFPD.

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Section: Discussionmentioning

confidence: 99%

Section: Endogenous Production Of Fatty Acid Ethyl Esters (Faee)mentioning

confidence: 99%

Nonalcoholic fatty pancreas disease as an endogenous alcoholic fatty pancreas disease

Medeiros¹,

Lima²

2016

Gastroenterol Hepatol Endosc

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“…It has a sensitivity of 100% and a specificity of 98% for identifying children of heavy alcohol drinkers. 22 …”

Section: Laboratory Markers Of Maternal Drinkingmentioning

confidence: 99%

“…Hair analysis reveals the metabolite of cocaine, benzoylecgonine, at 5 ng/g of hair (limit of detection 0.5 ng/g). The meconium test is positive for FAEEs at 40 nmol/g (a negative result is 2 nmol/g or less 22 ) and for benzoylecgonine at 1.2 µg/g (de- Most of the body's load of ethanol is eliminated after enzyme oxidation to acetaldehyde and water. However, ethanol is also esterified with fatty acids to FAEEs, which can be found in adult blood and tissue.…”

Section: The Case Revisitedmentioning

confidence: 99%

Fetal Alcohol Spectrum Disorder

Gowsell¹,

Rodger²

2011

Encyclopedia of Clinical Neuropsychology

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CaseMs. L, a 32-year-old G5 P2 A2 (gravida 5, para 2, abortions 2) woman, is admitted to hospital because of premature rupture of membranes at an estimated 34 weeks of gestation. She has had only intermittent prenatal care and no prenatal tests. This is an unplanned pregnancy, and she is not sure of the time of conception. Her 2 older children have been in foster care since birth, because child welfare authorities assessed her ability to parent as inadequate at the time; 1 child is in the process of adoption. Although child welfare authorities have documented a history of problem drinking, the woman denies any drinking during the current pregnancy. Her physical and neurologic examinations are unremarkable. Although she has sought routine prenatal care only periodically during her pregnancy, she describes developing a desire to parent this child in recent weeks. She denies any "recent" use of alcohol or cocaine, but will not be more specific. Informed consent for drug testing is obtained; no alcohol is detected in her blood, and a urine toxic screen is negative for cocaine, heroin, amphetamines and cannabinoids. Her hemoglobin level is 130 g/L, leukocyte count is 8.5 × 10 9 /L, mean corpuscular volume is 82 fL, electrolytes and creatinine levels are normal, and gamma glutamyl transferase level is 75 (normally < 45) U/L. The woman's baby is delivered vaginally. His Apgar score is 8 at 1 minute and 10 at 5 minutes. His birth weight is 1.1 kg (below the third percentile for age) and head circumference 28.5 cm (fifth percentile for age). Findings from the physical and neurologic examinations of the baby are unremarkable, and he does not require assisted ventilation. Breastfeeding is started successfully.What aspects of this case make you concerned that this child is at risk of fetal alcohol spectrum disorder (FASD)? What additional screens or laboratory tests might further indicate the possibility of FASD? What physical and neurodevelopmental deficits might present later in life if the child has FASD?

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“…The measurement of fatty acid ethyl esters (FAEE) in hair and meconium (the fecal matter that accumulates in the fetus during pregnancy, and which is discharged soon after birth) has demonstrated significant potential as a biomarker for fetal alcohol exposure [12][13][14][15][16][17][18][19][20][21][22][23][24]. FAEE are non-oxidative metabolites of ethanol metabolism formed by the conjugation of ethanol to endogenous free fatty acids and fatty acyl-CoA, a reaction catalyzed by microsomal acyl-coA:ethanol O-aceyltransferase (AEAT) and cytosolic FAEE synthase [25,26].…”

Section: The Use Of Fatty Acid Ethyl Esters (Faee) and Advantages Of mentioning

confidence: 99%

The fatty acid ethyl esters (FAEE) hair test: emerging technology for the diagnosis of fetal alcohol spectrum disorders (FASD)

Kulaga¹,

Pragst²,

Koren³

2009

Ann Toxicol Anal

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-Aim: Fetal alcohol spectrum disorder (FASD) is the most prevalent cause of neurocognitive handicap among North American children. A serious challenge in the diagnosis of FASD is the need to document excessive maternal drinking during pregnancy, however maternal self-report is often unreliable creating a need for an objective biomarker. Methodology: Testing for xenobiotics in hair has been gaining popularity in recent years as a screening method for drug use because of its unique advantage of being non-invasive and providing a stable, long-term record of past and or chronic drug exposure. The recent advent of a hair test to measure excessive alcohol use, the FAEE hair test, has opened the door to exploring its use as a new diagnostic tool for FASD. The current article briefly reviews recent advances in research involving the FAEE hair test in this context. Conclusion: Recent advances in research involving the FAEE hair test suggest that FAEE hair analysis may be a powerful tool in detecting heavy alcohol use in the perinatal period and in FASD diagnosis.Key words: Foetal alcoholism spectrum disorder biomarker, FAEE, hair testing Résumé -Objectif : Le syndrome d'alcoolisation foetal (SAF) est en Amérique du Nord la première cause de handicaps neuro-cognitifs chez l'enfant. Quantifier la consommation excessive pendant la grossesse apparaît crucial pour le diagnostic du SAF, cependant l'information fournie par la mère elle-même apparaît souvent peu fiable, et rend né-cessaire le recours à un marqueur biologique fiable. Méthodes : La recherche de xénobiotiques dans les cheveux s'est généralisée, ces dernières années, pour détecter l'usage de produits toxiques : elle présente l'avantage de ne pas être traumatique, tout en informant de façon continue, sur de longues périodes quant à l'exposition passée ou chronique à des xénobiotiques. L'arrivée récente d'un test capillaire pour évaluer la consommation excessive d'alcool -recherche et dosage des FAAE -a posé la question de son utilisation comme nouvel outil de diagnostic du SAF. Le présent article passe en revue les avancées récentes concernant l'utilisation du test FAAE dans ce contexte. Conclusion : Les recherches relatives au test FAAE montrent que l'analyse des cheveux par ce test peut se révéler un outil puissant pour détecter la consommation d'alcool à hautes doses en période prénatale, et peut être utilisé pour le dépistage du SAF.

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Population Baseline of Meconium Fatty Acid Ethyl Esters Among Infants of Nondrinking Women in Jerusalem and Toronto

Cited by 122 publications

References 21 publications

Nonalcoholic fatty pancreas disease as an endogenous alcoholic fatty pancreas disease

Nonalcoholic fatty pancreas disease as an endogenous alcoholic fatty pancreas disease

Fetal Alcohol Spectrum Disorder

The fatty acid ethyl esters (FAEE) hair test: emerging technology for the diagnosis of fetal alcohol spectrum disorders (FASD)

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