By J.E. Block M.D., PhD, FACP
An example of a difficult diagnostic dilemma is Lectin Intolerance. Lectin not to be confused with Leptin or Lecithin)occur ubiquitously in nature. They are sugar-binding proteins in both animal and plants. The prototypic lectin is GLUTEN. Lectins
aggregates to the cell walls of other plants (bacteria) and our own
cells. Medical science is just beginning to understand Lectin physiology
and pathology. We naturally consume Lectins in our food. They play a
helpful role in the expulsion from our body of harmful bacteria. Lectins
and particularly gluten in people who are genetically predisposed who
consume them suffer damage to the delicate intestinal lining (the
microvilli). This negatively influence gut permeability (leaky gut) and
digestion. Lectins are capable of being actively endocytosed
(transported) across the intestinal membranes into the general
circulation where they may attach to other tissues (connective, nervous,
bladder) causing immune dysfunction and systemic inflammation. Lectins
play a role in biological recognition involving cells and proteins in
animals as well as plants.
They were first discovered by Peter Hermann Stillmark in 1888 initially isolated ricin, an extremely toxic hemaglutinin, from seeds of the castor plant.
The word “Lectin” comes from the Latin phrase, “I choose,” a fitting
phrase since Lectins are very specific as to what they chose to bind.
Most Lectins are non-enzymatic in action and non-immune in origin. They
functions in humans in other ways than the regulation of cell adhesion. These molecules control some of our circulating proteins and antibodies levels.
That can cause problems in those of us that genetically predisposed !
Additionally in the intestine it could help in recognizing
carbohydrates that are found exclusively on pathogens and target their destruction, or play havoc if the target is on friendly bacteria or our intestinal lining.
Our state of health and genetic make-up determine to
what Lectins we are sensitive and how we will react to them. Lectin in
the gut initiate inflammation that may be expressed in other parts of
the body. Also there are other genes that directly and indirectly
affect how we deal with Lectins. Many people have no digestive problems
but could have Lectins affect them. The damage is cumulative and
pathology occurs years later like cancer. As humans we all possess cell
surface sugars, such as n-acetylglucosamine, fucose, and mannose.
Lectins that bind to those sugars can affect those that are genetically
determined.
The toxicity of Lectins has been identified by
consumption of food with high content of these proteins, which can lead
to organ failure in addition to the GI tract where it destroys its
lining and causes bacterial over growth. Lectins elevate NF kappa
which, when up-regulated, are involved in almost every acute and
chronic inflammatory disorder including neurodegenerative disease,
inflammatory bowel disease, infectious and autoimmune diseases.Lectins
can dramatically reduce natural killer (NK) cell activity directly and
through disruption of intestinal flora. Natural killer cells are one of
the body’s most important defenses against viruses and other invaders.
Most dietary Lectins will also stimulate gut polyamines which are
important growth factors that may have negative effects if levels
become imbalanced. High polyamine level may also decrease NK cell
populations, can contribute to halitosis (bad breath), and is
considered an important biological marker for colonic precancer. It
may also be part of the cause of Ulcerative Colitis and Regional
Enteritis. Legume seeds such as Peanuts, Soybeans and Wheat are
significant for human illness. Wheat has gliadin, a component of gluten
which is an iso-lectin of wheat germ. Ancient wheat species had much
lower protein contents than the modern varieties. Genetic altering of
grain plants (GMO) increases the protein component and the
Lectin load with the resultant potential for inflammation and metabolic
disruption much more today than in yesteryear. Heating destroys much of
the Leptins in our food, but not so in Soybean and Wheat. In a study
published not too long ago in the Journal of Gastoenterology compared
the blood that was stored from 10,000 people for gluten antibodies and
that of a similar number of persons today and found 400% more in modern humans!
This is part responsible for our new epidemics of
heart, thyroid disease, arthritis, cancer and hard to diagnose and
treat conditions like acne, rosaccea, fibromyalgia, chronic fatigue,
IBS, allergy and obesity.
Lectins also make us fat in two ways! Leptins make
us skinny! Lectins decrease leptin activity by binding to the
receptor on our fat cells and amplifying the signal from insulin. This
encourages them to take in the circulating fats, rather than let them
go to our muscles to be burned. Research has shown that high insulin
levels, or in this case, an exaggerated response to normal insulin
levels a major causes of obesity. The other mechanism of Lectin obesity
is by binding to the cholecystokin receptor in the hypothalamus and
turning off the satiety factor while eating.
“Nightshade Arthritis” is the stiff and sometimes
painful joints of folks that are genetically predisposed to the
toxicity of these vegetable Lectin. Although some experts feel it is
just the alkaloid in these, most feel it is the combination. Nightshade
is a term used to describe the Solanaceae family of plants to
include white potatoes, tomatoes, gogi berries, eggplant, and all
peppers (bell, green, hot, etc) except: black. There are also deadly
nightshades to include mandrake, belladomnna, and perhaps tobacco. Most
Lectins are destroyed in the sprouting process, which allows for a
safer form of grain consumption, not to mention that the sprout is
generally higher in overall nutritional value than the seed. Organic,
sprouted grain bread products (with no added gluten) appear to be the
safest and healthiest way to reap the nutritional benefit of grain
without the Lectin burden.
Diagnosing a Leptin problem is difficult. First it
must be suspected and most doctors do not even know the word let alone
identify it! Lectins contribute to food sensitivities (or food
intolerances) and provokes the immune system to make antibodies against
them. Allergy skin test, a myriad of blood tests such as IgG, IgE,
Sage, and Promethius are used. Elimination diets are also helpful for
determining the demon food.
Another test we have found very helpful is the HYDROGEN BREATH TEST.
This is an inexpensive, paid by insurance study that gives a
presumptive diagnoses for Lectin intolerance. It detects bacterial
overgrowth in the small intestine. This is most common in intestinal
diseases in which the mucosa of the intestine is compromised like in
Lectin problems, but also small intestinal diverticulosis, abnormal
flora, parasites and previous surgery where the usual anatomy of the
intestine has been change. An example of this is By Pass surgery for
weight loss. Also if the intestine cannot make the enzymes to break down
food stuff there is Hydrogen produced. In cases of abnormal gases due
to the fermentation from normal bacteria such as in Lactose intolerance
it is positive. Normally there should be NO hydrogen
in the breath if the bacteria, the enzymes and the anatomy is doing its
job and there is no Lectin intolerance. But if something is awry then
hydrogen which is normally produced in minute amounts goes up.
Gastroenterologist picked the cut point of 10 parts per million or more to be abnormal. However other experts feel that anything above 0
is an indication of something wrong in the intestine. The test is done
by holding ones breath for 30 seconds then exhaling through a
cardboard tube into a special handheld device. In 20 seconds, the
results are apparent. There are several challenge test that can be done
such as by loading the subject up with lactose or sucrose and in
particular a Lectin in question like gluten and repeating the test to
see how much increase of hydrogen is produced thus nailing down the
exact culprit.
Treatment is to completely remove the
offending agent from the diet. It also adjunctively can not hurt in
improving bowel health by food enzymes and pre/probiotics. Presriptive
drugs like Diclocyamine also improve the problem but is only a bandaid.
In severe cases in which the offending food can not be found
antibiotics may improve the situation. Flagyl, Doxycycline, Cipro, are
good and the best and most expensive is Xifixam. When all else fails,
the off- lable use of the asthma drug Xolair will solve the allergy
problem. Acupuncture, NAET, Vibrational Therapy and Psychotherapy,
should be considered when nothing seems to help.
There are however more specific supplements that are
individually listed below such as NAG (N-Acetyl Glucosamine), DPP IV,
Bladderwack (Fucus vesiculosus), D-Mannose, Pepsin, and Aloe
vera, Xylitol and Okra. They can be used alone or in combination. The
doses are not fixed and it may be trial and error until fine tunning of
the bowel and body are achieved.
Aloe Vera provides the main
ingredient the intestinal cells need to reproduce, which they do every
four days. This is the amino acid L-glutamine of which we do not get
enough in our diet. Aloe Vera contains this compound thereby enhancing
the ability of cell regeneration. If "leaking gut syndrome" develops,
long chain polysaccarides (Acemannan is a D-isomer
mucopolysaccharide) in aloe vera leaves. This has been known to have
immunostimulant, antiviral, antineoplastic and heals the intestinal
lining. Aloe has amazing anti-inflamatory attributes
which are very effective in calming the intestinal spasms that cause
abdominal pain, as well as soothing other Irritable Bowel Syndrome
Symptoms. Aloe Vera works gently within the intestinal tract to help
break down food residues that have become impacted and help clean out
the bowel. When the bowel is cleaned out, it greatly reduces bloating,
discomfort, and helps ease stress. Aloe Vera contains 75 micro-
nutrients (vitamins, minerals, amino acids and enzymes) essential for
keeping our body in good working order. Aloe can be consumed as a food
or in a supplement. As a food, break off the bottom succulent leaf from
the plant that should be in everybody’s kitchen. Peal off the diarrhea
causing bitter “skin” and eat two to four square inches of this wonder
vegetable. It can be eaten plain or as part of a salad. Another way to
get glutamine is buying the glutamine powder and take one or two
teaspoons a day on an empty stomach.
Bladderwack (Fucus vesiculosus), Primary chemical constituents of this plant include , iodine, alginic acid, fucoidan, beta-carotene, zeaxanthin, bromine, potassium, volatile oils, and other minerals.
One of the emerging fields of research with regards to microorganisms
(and lectins) centers about an idea of adherence and anti-adherence.
Basically, an unwanted organism can do little harm if it cannot attach
to or anchor itself to intestinal lining. Lectin damages the cells and
the pathogenic organisms add insult to injury.
D-Mannose is a five-carbon sugar
that has specific Lectin and Gram negative (stains red rather than
blue) anti-bacterial properties. It prevents bacterial adhesion and binds to Lectins.
This changes the configuration of the Lectin and decreases its
“inflammatory” and adhesive qualities. Interestingly, the so called
‘friendly’ bacteria are left “unharmed” by mannose because they lack
the pili (bridging protein) that pathogenic bacteria develop for
adhesion. This allows the body to shed pathogenic bacteria through the
stool. One half a teaspoon of the powdered form is advised.
DPP IV (DiPeptidyl Peptidase IV) enzyme is
a serine exopeptidase that cleaves X-proline dipeptides from the end
of polypeptides from Lectins such as gluten and casein. Research
determined that the rate-limiting bond in the digestion of these Lectins
requires an enzyme known as DPP IV (dipeptidyl dipeptidase IV).
Biocore® DPP IV is a proprietary formulation of proteases providing a
standardized DPP IV activity. The DPP IV activity in Biocore® DPP IV is
standardized at 5000 units/g. Biocore® DPP IV also provides 300,000
HUT/g and 85 aminopeptidase units per gram of the product. The
recommended dose for Biocore® DPP IV is 100 mg. The proteases in
Biocore® DPP IV are stable in the acidic environment of the stomach.
Lycopene has the ability to prevent
macrophage (a Pac-Man type white blood cell) activation induced by
gluten and IFN-gamma (an inflammatory immune signaling chemical). Gut
microflora ,bacteria in the gut, reponses trigger tumor necrosis
factor-induced intercellular adhesion molecule-1 (ICAM-1) upregulation,
and are inhibited by the flavinoid apigenin. When
ICAM-1 is increased or upregulated – we are more prone to infection
with viruses and it also promotes Leaky Gut Syndrome. Apigenin helps
reduce this. Prepared tomatoes (spaghetti sauce etc.) are a good source
of lycopene. But beware, tomatoes, a night shade, for some predisposed
people may be a source of a Lectin problem.
NAG binds to Lectins in the gut so
they will not damage the intestinal wall. Also many pathogenic
bacteria are made up of Lectins and the NAG will glue these organisms
together rendering them harmless. Doses of 3000 to 5000 mg a day have
no toxicity and decrease gut Lectin load and the bad bacteria within.
Okra is source of Lectin-binding
protective mucilage. It protects the digestive tract from Lectins and
maybe the pathogenic bacteria. It also removes existing Lectins that
are already attached to cells. Okra is also beneficial for ulcers,
colitis, and other causes of malabsorption.
Pepsin is an proteolytic enzyme,
that breaks down certain amino acid molecules to include Leptins. It
comes in capsules with HCl containing 648 mg or in half doses. It also
is available with Okra which as noted below improves Leptin
intolerance. Pepsin clears away excess mucous formed as a result of
food intolerance allowing for better absorption of micronutrients. One
full dose with or without HCl or Okra with ameal breaks down the
Leptin.
Quercetin has also been shown to
have a specific activity against antigen-induced histamine secretion in
intestinal mast cells. Histamine promotes an allergic response, and
quercetin reduces this problem. Frequently, the flavinoid, luteolin, is
given along with quercetin. The Luteolin is a PDE4 inhibitor and a general phosphodiesterase inhibitor, and an Interleukin 6
inhibitor. Both Quercetin and Leteolin have demonstrated the ability
to prevent lipopolysaccharide-induced NF-kappaB kinase activity in
intestinal epithelial (wall) cells and dendritic (brain and nerve) cells
as well as TNF-alpha and IL-8 on colon epithelial cells.
The Quarcetin Luteolin combination cover up the
Lipopolysaccharides (also known as lipoglycans), the large molecules
consisting of a fat joined loosely with a chain of sugar molecules
(polysaccharides). They are found in the outer membrane of
Gram-negative bacteria, act as endotoxins (toxins within our body) and
elicit strong immune responses in animals and humans. NF-kappaB plays a
key role in regulating the immune response to infection. On the
converse, incorrect regulation of NF-kappaB has been linked to cancer,
inflammatory and autoimmune diseases, septic shock, viral infection,
and improper immune development. NF-kappaB has also been implicated in
processes of synaptic plasticity and memory.
Xylitol is an intestine-friendly,"
nonfermentable sugar alcohol. It is a prebiotic that feeds the
nonpathogenic gut bacteria, discourages the harmful organisms and acts as a bowel friendly laxative! Two to three teaspoons a day used as a sweetener is recommended.
Final thoughts for this hard to diagnose and easy to
treat disease is to consider that there can be more than one offending
agent. To remove it (them) is key. Beyond that since there is always a
chance that a small amount of the offending Lectin such as gluten is
consumed in some prepared food, I suggest doing the DDP IV first then
adding the Pepsin/Okra. If there are still problems try the others
depending upon availability and your pocketbook. Some folks may need to
do three or four of the supplements together. Lots of luck in your
journey to health.
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