Going Against the Grain

Overview of this experiment Diagnose D. Atkins using: Symptoms Phosphatase isoforms found in serum Identify source of excess phosphatase

Our Strategy Renal Bacterial Intestinal Hepatic Prostate Fungal Unknown Serum Run serum through pH assays at both pH 5 and 10 Active at pH 10 only Run serum through assays of both levamasole and Sodium Fluoride Inhibited by sodium floride only Bacterial Inhibited by levamisole only Renal Not inhibited by levamisole or sodium floride Intestinal Active at both pH 10 and 5 Hepatic Active at pH 5 only Run serum through tartrate assay Inhibited by tartrate Prostate Not inhibited by tartrate Fungal Our Strategy

Step One: pH assay

Our Strategy Renal Bacterial Intestinal Hepatic Prostate Fungal Unknown Serum Run serum through pH assays at both pH 5 and 10 Active at pH 10 only Run serum through assays of both levamisole and NaF Inhibited by NaF only Bacterial Inhibited by levamisole only Renal Not inhibited by levamisole or NaF Intestinal Active at both pH 10 and 5 Hepatic Active at pH 5 only Run serum through tartrate assay Inhibited by tartrate Prostate Not inhibited by tartrate Fungal Our Strategy

Step 2: Inhibitor Assay

Our Strategy Renal Bacterial Intestinal Hepatic Prostate Fungal Unknown Serum Run serum through pH assays at both pH 5 and 10 Active at pH 10 only Run serum through assays of both levamasole and Sodium Fluoride Inhibited by sodium floride only Bacterial Inhibited by levamisole only Renal Not inhibited by levamisole or sodium floride Intestinal Active at both pH 10 and 5 Hepatic Active at pH 5 only Run serum through tartrate assay Inhibited by tartrate Prostate Not inhibited by tartrate Fungal Our Strategy

D. Atkins Patient Information Name: D. Atkins Age: 28 Sex: Female Symptoms: abdominal pain, fatigue, diarrhea, and nausea D. Atkins has experienced a recent development of lactose intolerance, although she has never had this issue before

Diagnostic Tests -Assays--renal alkaline phosphatase level elevation Additional Tests: -Blood test --presence of anti-endomysium antibodies (EMA) -Intestinal biopsy --flattening of villi -Genetic tests

Diagnosis Ciliac’s Disease

What is Celiac’s Disease? Condition that damages small intestine lining and prevents it from absorbing parts of food Reaction to eating gluten What does gluten affect? Intestine lining “villi” Immune system damages villi Affects proper nutrient absorption

Development of Disease Exact cause unknown Develops at any point in life Family members with Celiac’s are at greater risk More common in women

Signs of Celiac’s Disese High levels of alkaline phosphatase Abnormal clotting Low cholesterol

Symptoms of Celiac’s Disease Primarily gastrointestinal symptoms Lactose intolerance Nausea and vomitting Constipation, diarrhea, bloating Some develop over time Depression or anxiety, fatigue

Treatment Gluten-Free Diet Vitamins and minerals Support groups and dieticians

Prognosis Gluten-Free Diet and Dietician Follow-up biopsy in 1-2 years Villi should heal within 1-2 years Follow-up biopsy in 1-2 years Reevaluate diet Should maintain normal health with vitamins and minerals