Indican
Microbial overgrowth
- Can include
- benzoate,
- Hippurate,
- Phenylacetate,
- Phenylpropionate,
- cresol,
- Hydroxybenzoate,
- Hydroxyphenylacetate,
- Hydroxyphenylpropionate
- 3,4-dihydroxyphenylpropionate,
- Indican,
- Tricarballylate,
- D-lactate,
- D-arabinitol
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Indican = Indoxyl sulfate
- Products from Tryptophan
- Bacteria in the upper bowel produce the enzymes that catalyze the conversion of tryptophan to indole
- Absorbed indole is converted in the liver to indoxyl
- Then sulfated to allow for urinary excretion
- Indican is present in urine at low levels in healthy individuals
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Elevated level of urinary indican
- Indication of upper bowel bacterial overgrowth
- Celiac disease - may be at greater risk
- Jejuno-ileal bypass surgery
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
SnĂĹľenĂ
- Oral, unabsorbed antibiotics reduce indican excretion
- When the gut is populated with strains of Lactobacillus at levels above 105 organisms/g
- Lactobacillus salivarius, Lactobacillus plantarum, and Lactobacillus casei
- Were more effective in achieving reduced indican than two strains of Lactobacillus acidophilus
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Cirrhosis of the liver
- tryptophan loading can produce neuropsychiatric manifestations
- Due to intestinal bacterial production of tryptophan metabolites
- Symptoms are reduced by antibiotic therapy
- Demonstrating the bacterial origin of the metabolites.
- Indican elevation has revealed that impaired protein digestion and increased bacterial conversion of tryptophan is a complication of cirrhosis of the liver
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Differentiating pancreatic insufficiency from biliary stasis as the cause of steatorrhea (fatty stools)
- Rise of indican from low values to above normal
- Steatorrhea due to pancreatic insufficiency when treated with pancreatic enzyme extract
- Urinary indican does not rise
- Steatorrhea not due to pancreatic insufficiency
- Normal subjects who receive pancreatic enzymes
- Demonstrates how bacterial populations respond to increased concentrations of luminal amino acids
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Saccharin
- Large shifts in bacterial populations induced by the artificial sweetener saccharin
- Changes in indican excretion
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Zvýšenà citlivosti testu
- Excretion has been shown to be constant for young and elderly control subjects
- Test sensitivity may be enhanced by oral loading of 5 g tryptophan
- False-positives can be reduced by including elevations of other bacterial metabolites
Clinical Applications of Urinary Organic Acids. Part 2. Dysbiosis Markers, Richard S. Lord, PhD, and J. Alexander Bralley, PhD, Alternative Medicine Review Volume 13, Number 4 2008
Maldigesce a malabsorbce proteinĹŻ
- Interpretation of indican results
- Complicated by impaired protein digestion
- Increases the tryptophan available for bacterial action
- Even patients with normal intestinal bacterial populations can show increased postprandial indican excretion when they fail to digest dietary protein.
- The relationship between increased indican and incomplete digestion might be utilized as a measure of protein digestive adequacy.
Scleroderma
- Indican evaluation has been used to assess intestinal absorption of tryptophan in scleroderma
ProteinovĂ© ztráty stĹ™evnĂ sliznicĂ
- Increased urinary indican has been shown to correlate with enteric protein loss.
Degenerace GIT seniorĹŻ
- Some degree of malabsorption was found in 30 % of an elderly population by combinations of indican with the Shilling and other tests
