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1.
Primary hyperammonaemia: Current diagnostic and therapeutic strategies.
Häberle, J
Journal of mother and child. 2020;(2):32-38
Abstract
Primary hyperammonaemia is a term to describe an elevation of ammonia in blood or plasma due to a defect within the urea cycle, which is the pathway responsible for ammonia detoxification and arginine biosynthesis. Urea cycle disorders (UCDs) are rare diseases caused by genetic defects affecting any of the six enzymes or two transporters that are directly involved in the urea cycle function.The clinical situation is variable and largely depends on the time of onset. Newborns who are often affected by hyper-ammonaemic encephalopathy carry a potential risk of severe brain damage, which may lead to death. Outside the neonatal period, symptoms are very unspecific but most often neurological (with wide variability), psychiatric and/or gastrointestinal. Early identification of patients is extremely important to start effective treatment modalities immediately. The acute management includes detoxification of ammonia, which often requires extracorporeal means such as haemodialysis, and the use of intravenous drugs that work as nitrogen scavengers. Long-term management of patients with UCDs consists of a low-protein diet, which needs to be balanced and supplemented to avoid deficiencies of essential amino acids, trace elements or vitamins and the use of nitrogen scavengers.The reader will find here a brief overview describing the most relevant aspects of the clinical management of UCDs in an attempt to raise awareness for this important group of rare diseases.
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2.
Mechanistic insight, diagnosis, and treatment of ammonia-induced hepatic encephalopathy.
Fiati Kenston, SS, Song, X, Li, Z, Zhao, J
Journal of gastroenterology and hepatology. 2019;(1):31-39
Abstract
Hepatic encephalopathy is a neuropsychological syndrome due to biochemical disturbance of brain function in advanced liver disease patients. Diagnosis and treatment of the condition is very demanding and has negative toll on finances with increased healthcare utilization. The pathophysiology is not completely understood; however, there is evidence that ammonia plays an important role in the etiology. Conventional methods of solely relying on blood ammonia level to diagnose hepatic encephalopathy did not help much; likewise, the use of lactulose alone in treating hepatic encephalopathy has also been discouraged. This paper analyzed the current knowledge regarding the mechanism of how ammonia disrupts the normal brain function as well as the use of latest diagnosing tools including those under development to evaluate the neuropsychiatric state of patients and their quality of life. The efficacies of lactulose and rifaximin combination for short-term and long-term treatment in addition to nutritional interventions and other drugs undergoing clinical trials were also reviewed.
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3.
The roles of free ammonia (FA) in biological wastewater treatment processes: A review.
Liu, Y, Ngo, HH, Guo, W, Peng, L, Wang, D, Ni, B
Environment international. 2019;:10-19
Abstract
Free ammonia (FA) can pose inhibitory and/or biocidal effects on a variety of microorganisms involved in different biological wastewater treatment process, which is widely presented in wastewater treatment plants (WWTPs) due to the high levels of ammonium in the systems. This review article gives the up-to-date status on several essential roles of FA in biological wastewater treatment processes: the impacts of FA, mechanisms of FA roles, modeling of FA impacts, and implications of FA for wastewater treatment. Specifically, the impacts of FA on both wastewater and sludge treatment lines were firstly summarized, including nitrification, denitrification, anaerobic ammonium oxidation (Anammox), enhanced biological phosphorus removal and anaerobic processes. The involved mechanisms were then analyzed, which indicated FA inhibition can slow specific microbial activities or even reconfigure the microbial community structure, likely due to negative impacts of FA on intracellular pH, specific enzymes and extracellular polymeric substances (EPS), thus causing cell inactivation/lysis. Mathematical models describing the impact of FA on both wastewater and sludge treatment processes were also explored to facilitate process optimization. Finally, the key implications of FA were identified, that is FA can be leveraged to substantially enhance the biodegradability of secondary sludge, which would further improve biological nutrient removal and enhance renewable energy production.
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4.
Sarcopenia: Ammonia metabolism and hepatic encephalopathy.
Jindal, A, Jagdish, RK
Clinical and molecular hepatology. 2019;(3):270-279
Abstract
Sarcopenia (loss of muscle mass and/or strength) frequently complicates liver cirrhosis and adversely affects the quality of life; cirrhosis related liver decompensation and significantly decreases wait-list and post-liver transplantation survival. The main therapeutic strategies to improve or reverse sarcopenia include dietary interventions (supplemental calorie and protein intake), increased physical activity (supervised resistance and endurance exercises), hormonal therapy (testosterone), and ammonia lowering agents (L-ornithine L-aspartate, branch chain amino acids) as well as mechanistic approaches that target underlying molecular and metabolic abnormalities. Besides other factors, hyperammonemia has recently gained attention and increase sarcopenia by various mechanisms including increased expression of myostatin, increased phosphorylation of eukaryotic initiation factor 2a, cataplerosis of α ketoglutarate, mitochondrial dysfunction, increased reactive oxygen species that decrease protein synthesis and increased autophagy-mediated proteolysis. Sarcopenia contributes to frailty and increases the risk of minimal and overt hepatic encephalopathy.
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5.
Microbial taxonomic, nitrogen cycling and phosphorus recycling community composition during long-term organic greenhouse farming.
Ding, GC, Bai, M, Han, H, Li, H, Ding, X, Yang, H, Xu, T, Li, J
FEMS microbiology ecology. 2019;(5)
Abstract
Understanding the interplay between the farming system and soil microbiomes could aid the design of a sustainable and efficient farming system. A comparative greenhouse experiment consisting of organic (ORG), integrated (INT) and conventional (CON) farming systems was established in northern China in 2002. The effects of 12 years of organic farming on soil microbiomes were explored by metagenomic and 16S rRNA gene amplicon sequencing analyses. Long-term ORG shifted the community composition of dominant phyla, especially Acidobacteria, increased the relative abundance of Ignavibacteria and Acidobacteria Gp6 and decreased the relative abundance of Nitrosomonas, Bacillus and Paenibacillus. Metagenomic analysis further revealed that relative abundance of ammonia oxidizing microorganisms (Bacteria and Archaea) and anaerobic ammonium oxidation bacteria decreased during ORG. Conversely, the relative abundance of bacteria-carrying periplasmic nitrate reductases (napA) was slightly higher for ORG. Long-term organic farming also caused significant alterations to the community composition of functional groups associated with ammonia oxidation, denitrification and phosphorus recycling. In summary, this study provides key insights into the composition of soil microbiomes and long-term organic farming under greenhouse conditions.
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6.
Ammonia Inhalation Does Not Increase Deadlift 1-Repetition Maximum in College-Aged Male and Female Weight Lifters.
Vigil, JN, Sabatini, PL, Hill, LC, Swain, DP, Branch, JD
Journal of strength and conditioning research. 2018;(12):3383-3388
Abstract
Vigil, JN, Sabatini, PL, Hill, LC, Swain, DP, and Branch, JD. Ammonia inhalation does not increase deadlift 1-repetition maximum in college-aged male and female weight lifters. J Strength Cond Res 32(12): 3392-3397, 2018-Ammonia inhalant use by powerlifters and weight lifters is a prevalent practice with little research support for improved performance. The purpose of this study was to investigate the effects of ammonia as a stimulant on athletic performance during a deadlift 1-repetition maximum (1RM) absolute strength test. Subjects (men: n = 10, mean ± SD age = 21 ± 1 year, mass = 72.5 ± 6.8 kg; and women: n = 10, age = 22 ± 5 years, mass = 66.2 ± 8.1 kg) were required to have at least 2 years of resistance training experience while lacking a history of asthma, lightheadedness, fainting, anaphylaxis, sickle cell traits, and other respiratory disorders. After a baseline 1RM test, subjects were paired by 1RM performance and gender, then randomly assigned in a counterbalanced treatment order to control (water) or ammonia trials after a minimum 72-hour recovery period for another 1RM test involving attempts at 100.0, 102.5, 105.0, and 107.5% of the established 1RM value. Testing was then repeated after the minimum rest period for the remaining trial. Results revealed the expected gender main effect for absolute deadlift 1RM (93.0 ± 29.5 [women]; 152.0 ± 29.5 kg [men]; p < 0.001), but no trial main effect (p = 0.874) or gender by trial interaction effect (baseline = 93.0 ± 15.3, 151.8 ± 42.3 kg; water = 92.0 ± 12.5, 150.9 ± 37.8 kg; ammonia = 92.5 ± 16.4, 153.4 ± 37.9 kg) for women and men, respectively (p = 0.559). Within the limitations of this study, there is no support for the practice of ammonia inhalation to improve deadlift 1RM in training or competition.
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7.
Carbon-dependent alleviation of ammonia toxicity for algae cultivation and associated mechanisms exploration.
Lu, Q, Chen, P, Addy, M, Zhang, R, Deng, X, Ma, Y, Cheng, Y, Hussain, F, Chen, C, Liu, Y, et al
Bioresource technology. 2018;:99-107
Abstract
Ammonia toxicity in wastewater is one of the factors that limit the application of algae technology in wastewater treatment. This work explored the correlation between carbon sources and ammonia assimilation and applied a glucose-assisted nitrogen starvation method to alleviate ammonia toxicity. In this study, ammonia toxicity to Chlorella sp. was observed when NH3-N concentration reached 28.03mM in artificial wastewater. Addition of alpha-ketoglutarate in wastewater promoted ammonia assimilation, but low utilization efficiency and high cost of alpha-ketoglutarate limits its application in wastewater treatment. Comparison of three common carbon sources, glucose, citric acid, and sodium bicarbonate, indicates that in terms of ammonia assimilation, glucose is the best carbon source. Experimental results suggest that organic carbon with good ability of generating energy and hydride donor may be critical to ammonia assimilation. Nitrogen starvation treatment assisted by glucose increased ammonia removal efficiencies and algal viabilities.
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8.
Two-stage partial nitritation-anammox process for high-rate mainstream deammonification.
Liu, W, Yang, D, Shen, Y, Wang, J
Applied microbiology and biotechnology. 2018;(18):8079-8091
Abstract
Increasing information supported that achieving high-rate mainstream deammonification through two-stage partial nitritation (PN)-anammox process should be a better option than through single-stage process. However, direct experimental evidence was limited so far. Herein, a two-stage PN-anammox process was successfully operated for nitrogen removal from low-strength wastewater in winter. Influent shift from synthetic wastewater to actual anaerobically pretreated sewage had little impact on the process performance. Promising nitrogen removal rates (NRRs) of 0.28-0.07 kg N m-3 d-1 with an average effluent concentration of 5.2 mg TN L-1 were achieved for the anaerobically pretreated sewage treatment at 15-7 °C. Moreover, nearly all the degradable COD in the pretreated sewage was steadily removed in the first-stage PN reactor, despite the varied influent COD concentrations of 22-78 mg L-1 and the operating temperature decrease, suggesting the positive role of the first-stage PN in protecting anammox bacteria. The low temperature seemingly was the only deterministic factor inhibiting the anammox activity, and hence made the anammox reaction to be the rate-limiting step for nitrogen removal in the two-stage PN-anammox process. Unexpectedly, nearly all the anammox bacteria remained active at low temperatures with the process actual anammox activity reached about 76-85% of their maximum potential, implying that higher NRRs would be easily realized through bioaugmentation or enrichment of anammox bacteria. Overall, the present investigation provides direct and valuable information for implementing the two-stage PN-anammox process to treat mainstream municipal wastewater. A control strategy was also proposed to optimize the operation of the two-stage mainstream deammonification process.
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9.
Glutamate production from ammonia via glutamate dehydrogenase 2 activity supports cancer cell proliferation under glutamine depletion.
Takeuchi, Y, Nakayama, Y, Fukusaki, E, Irino, Y
Biochemical and biophysical research communications. 2018;(1):761-767
Abstract
Cancer cells rapidly consume glutamine as a carbon and nitrogen source to support proliferation, but the cell number continues to increase exponentially after glutamine is nearly depleted from the medium. In contrast, cell proliferation rates are strongly depressed when cells are cultured in glutamine-free medium. How cancer cells survive in response to nutrient limitation and cellular stress remains poorly understood. In addition, rapid glutamine catabolism yields ammonia, which is a potentially toxic metabolite that is secreted into the extracellular space. Here, we show that ammonia can be utilized for glutamate production, leading to cell proliferation under glutamine-depleted conditions. This proliferation requires glutamate dehydrogenase 2, which synthesizes glutamate from ammonia and α-ketoglutarate and is expressed in MCF7 and T47D cells. Our findings provide insight into how cancer cells survive under glutamine deprivation conditions and thus contribute to elucidating the mechanisms of tumor growth.
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10.
Submucosal hematoma: a new distinctive sign during emergency upper digestive endoscopy for ammonia ingestion.
Gelu-Simeon, M, Chuong, AP, Saliba, F, Thiery, G, Laurent, M, Vilain, C, Borel, M, Amaral, L, Alexis, M, Saint-Georges, G, et al
BMC gastroenterology. 2018;(1):92
Abstract
BACKGROUND Submucosal hematoma has never been associated with caustic injuries. Long-term follow-up of patients who ingested ammonia is not well known and ammonia ingestion is rare. METHODS In a Single-center observational study, prospective data were collected from 2009 to 2013, in patients over the age of 14 years old referred for ammonia ingestion. The emergency and follow-up endoscopic data and the outcome were reported. RESULTS Ammonia ingestion occurred in 43 patients. Submucosal hematoma of the gastric wall was a distinctive endoscopic sign observed in 15 (34.8%) cases. Oropharyngeal lesions were present in 30 (69.8%) patients, which was associated with ingestion with suicidal intent in 18 cases. Mild and severe endoscopic lesions (grade IIB to IIIB) were found in 16 (37.2%) cases with 10 (23.3%) cases presenting submucosal hematoma at initial endoscopy. A complete spontaneous gastric healing was frequently observed in 36 (83.7%) cases. In 11 cases with submucosal hematoma, a favourable outcome was observed with a medical treatment, however 6 of these patients had severe endoscopic lesions initially. CONCLUSIONS Submucosal hematoma of the gastric wall is an endoscopic sign occurring frequently in ammonia ingestion. Submucosal hematoma should be distinguished from necrosis in order to avoid false misclassification in favour of more severe lesions, which would lead to an abusive surgery.