1. Going Against the Grain

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

3. 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

4. Step One: pH assay

5. 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

6. Step 2: Inhibitor Assay

7. 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

8. 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

9. 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

10. Diagnosis
Ciliac’s Disease

11. 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

12. 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

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

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

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

16. 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